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Honored Contributor
Posts: 13,510
Registered: ‎05-23-2010

Re: THE HEALTHCARE COVERAGE GAP AND A DIABETIC WITHOUT INSULIN

For me personally, I retired due to severe illness. I was so ill that I couldn’t even do the tasks necessary to apply for disability. Luckily, I was able to take my pension early, with a 25% cut in benefits for taking it early. At least it was something. When I was 62 I was able to get Social Security with a 25% reduction in my benefit. I have had no insurance for eleven years because the ACA premiums, even with two types of subsidies, are so high for my county and my age that they are unaffordable. Premiums here for the second highest priced silver plan run just under $1000 a month. The monthly premium must be added to the other costs. The annual deductibles, copays, and  medication costs up to the high annual out of pocket limits made most of the plans in far in excess of $15000 a year. I’m so happy that I’ve finally become eligible for Medicare. I chose an Advantage plan. Part B premiums are deducted from my Social Security (about $140 a month). There still is an annual out of pocket and copays for doctor visits and RX, but at least I can get medical care now. There is also a troubling feature of all the Advantage plans I looked at. This is that the plans pay only 80% for  chemotherapy and 80% of radiation if a person were to get cancer. 

Honored Contributor
Posts: 13,510
Registered: ‎05-23-2010

Re: THE HEALTHCARE COVERAGE GAP AND A DIABETIC WITHOUT INSULIN

[ Edited ]

@SilleeMee wrote:

I qualify for no-cost marketplace insurance but it has such a high deductible that  I might as well not have it. I am in the category where I don't make enough money to afford descent insurance and too much income to qualify for Medicaid. The category I'm in is tough on me. I pay a lot for my heath care and I don't have enough money to get all that I need. The dental part is even worse. 

 

I'm 64 and disabled. Someone who is under 65 and disabled with fixed income as myself, is in a terrible place...there are no discounts or financial breaks of any kind to help things out.


Are you receiving SSDI? If you get SSDI you don’t need the marketplace because you are eligible for Medicare.  If you don’t get SSDI, you are in the same predicament I was in. I just started getting Medicare. I have already been on Social Security. I took this early. If you have opted to wait for your Social Security, you can still get Medicare when you turn 65. You pay about $140 a month if you decide to take the coverage for part B. If you only use Meducare Part A hospital coverage you are not charged at all (I think). 

Esteemed Contributor
Posts: 5,896
Registered: ‎03-20-2010

Re: THE HEALTHCARE COVERAGE GAP AND A DIABETIC WITHOUT INSULIN

The problem is the high price of the actual healthcare not the insurance to cover it.  Do something to reduce the prices and people will not need to have major policies to pay for medical care.  As long as the prices keep going up the insurance policies will continue to increase to pay for them.

Someday, when scientists discover the center of the Universe....some people will be disappointed it is not them.
Honored Contributor
Posts: 30,239
Registered: ‎03-12-2010

Re: THE HEALTHCARE COVERAGE GAP AND A DIABETIC WITHOUT INSULIN

This post is long (as always)  You might think it isn't about Health Care, but I think it is.  Don't read it if you are easily bored.

 

I don't understand anything involved with health insurance.  I have someone who tells me which health insurance company is best for me.

 

Every year I give him a list of my medicine (I only take a very few) and he does whatever it is (puts it in his computer) and he and I meet.

 

He asks for a check made out to the company and that's it.  For the past 3 or 4 years he's had me go with companies he doesn't even represent.

 

He's amazing.  I've been with him since my husband died in 2004.  Every year I sweat out if he's going to retire because he makes all of this so easy (for me).

 

I have medicare and a supplement.  I never pay a penny when I go to the Drs.

 

I just had an evaluation at the eye Drs, then went back two days later and spent another 2 hours there.  I only paid 45$ so far.

 

I have to go to another Dr to set up removal of cataracts.

 

I'm lucky and I know it.  Everything would be an entirely different situation had my late husband not been extremely successful.

 

I live on the interest of his investments and don't have to touch the principal (it's invested with a large envestment company).  Every month they put in an amount I decided and that's what I live on.  Plus I get a little over $2,000 a month from HIS social security.

 

That's what makes me realize how lucky I am.  You see I worked for 7 years for the Federal Government.  At that time they had their own retirement program.  But when I had my first daughter, I quit.  It was only a few thousand dollars and that's what we used to buy our first house.  I never had to go back to work.

 

But my point is, if we'd divorced, I'd be living on whatever my alimony was and that would be it.  I wouldn't have his social security!

 

It boggles my mind to think there are people who are expected to live on less than $2,000.  The reason his is over $2,000 is because he paid a lot more into it.  Otherwise it would be less which is what a lot of other's are.

 

My oldest daughter manages my investments (I guess she keeps an eye on things).  She reminds me when to send it estimated taxes, etc.  But the accountants I have make out everything except the check (I do that).

 

She draws a salary (like I did when I worked for my late husband) by working for her husband's company.  It's a two person business.

 

Many (maybe even most) people have no idea how to do the things she manages (I should say the mazes) the government puts these people through who manage their own businesses.

 

THAT'S how people get behind in their taxes, etc.  I pay huge amounts of money in taxes because of my investments but it would be a lot more if I didn't hire accountants (they are worth their weight in (sorry...gold).

 

The only reason I am mentioning this is because I have a problem with the way the government forced me to go on Medicare.  I have the money and had excellent health insurance.  I didn't mind that I was paying $1,000 per month for my insurance.

 

I just feel like people who can afford to pay for insurance should be expected to pay for it.

 

But then other's say that the money would just be mis-managed (like it is now).  I think it's sad/funny when people say things like I do "That the money could be used for good for others" because I worked for the Government.  I saw tremendous waste.

 

My friend's General she worked for had her entire office redecorated in Air Force blue.  The way the government is there is a feeling if they don't spend all of the money, they won't get that amount (and more) next year.  It's simply wasted, wasted.  

 

I don't know how it works in other places around the country, I can only speak for what I saw and my friends saw working for the government in the DC/Md/Va area. 

 

I'm 72 and I'm convinced things won't change.  I'm to the point where I think, "Shoot!  The money will always be mis-managed....you'll never convince me otherwise."

 

I often wonder what people who aren't working for the government like here in the DC area must think of us (former and now government workers).

 

Most people do the work they're paid for, but if you think about it, it's mostly shuffling papers here and there.

 

Where there was a shut down, the country ran just fine for the most part, didn't it?  OK, so some of the museums and parks, etc felt the pain, but I'm talking about the Federal government (as we think of it).

 

I always say I have two pesky sides of my brain.  I'm grateful that I was able to work for the government. 

 

Did you non-government people know that even as a lowly secretary I always got a raise?  Yepper, I turned down having to go to DC over and over (I worked at the Pentagon and loved working there).  But I always got a promotion (you slide down the grade (called steps).

 

I often what it would be like if those Senators and Congressmen had to live like people in other parts of the country.  It would be very interesting, wouldn't it?

 

My Congressman here in Virginia fought so hard to try to make Congress stay in session this Summer because they didn't get anything done.  Nothing, zip.

 

He said they are the only people who still get paid and don't have to prove what they've done to get paid.  He makes a lot of sense.

 

People in private sector, if they don't work, they either don't get paid or they loose their job, right?  Well, it doesn't work that way around here.

 

I've never heard of a government employee getting fired.  They mostly just get moved somewhere else.

 

I know there are always a FEW exceptions to the rule, but a very few exceptions.

 

I know this was about Health Care.  My reason for posting all of this is because it seems like, in this country, which I love more than anything is the rich get richer and the poor....well..they don't.

 

My mother used to say, "One half doesn't know how the other half lives."  She sure was right.

 

I know there are going to be people who'll come on here and tell me how wrong I am.  That's their perogative.  I'm expressing why actually, in my opinion, I think it all dribbles down to health care.

 

You guys want to blame someone?  Start with the lobbyists.  Why do you think Amazon wanted to move to the DC area?  Why do you think Google gets away with all they do?

 

It's all about money.  My youngest daughter says that to me all of the time.  My middle daughter is going through a terrible divorce.  She's lucky she has me to fall back on but most single mom's don't.  

 

If I feel for any group it's single mom's and elderly.  They seem to be this country's throw-aways......

Honored Contributor
Posts: 13,510
Registered: ‎05-23-2010

Re: THE HEALTHCARE COVERAGE GAP AND A DIABETIC WITHOUT INSULIN


@Susan Louise wrote:

Thank goodness DH and I have changed our lifestyle so we don't have to worry about diabetic meds.

 

In general, meds either keep going up in price, not always available, not regulated (latest news of meds out of China), and other issues.

 

Folks need to strive to do what they can to stay off of meds whenever possible. Too many folks look for a magic pill to solve their health problems. More times than not, the drugs create other health issues down the road.

 

All the commercials on tv for drugs are not for you, they are to help pharma companies make $$$. That's the real bottom line...out to cure the symptoms, not the disease. Pharma companies can't make money off of healthy folks.

 

DH is off of his 2 diabetic meds, Crestor and I'm off of all acid blockers/PPI's.

 

Not only do we avoid these issues, but we additionally save over $1,000 a month on meds we would still had been taking if we didn't change our lifestyle. Lastly, we are also healthier too...win, win, win.

 

It is sad some folks can't get off their diabetic meds...

 

Still others can but choose not to change their lifestyle. We personally know several folks in that regard. They would rather stay on insulin and eat whatever they want no matter what because it's easier...SMH.


Hello, Susan Louise. The young man in my post has a Type 1 diabetes. This stems from a defective pancreas. The pancreas either totally lacks the cells necessary to produce insulin or it almost lacks these cells. This is not the type of diabetes that people that can get off their diabetic medicines have. Type 2 is different. It’s wonderful your husband has been able to change his lifestyle and get healthier and able to discontinue his medications. 

Honored Contributor
Posts: 15,365
Registered: ‎05-01-2010

Re: THE HEALTHCARE COVERAGE GAP AND A DIABETIC WITHOUT INSULIN

@Annabellethecat66   Both my parents worked for the Government and still were when they retired.

Honored Contributor
Posts: 13,510
Registered: ‎05-23-2010

Re: THE HEALTHCARE COVERAGE GAP AND A DIABETIC WITHOUT INSULIN


@GAQShopr53 wrote:

Heathcare seems to be a very sensitive topic in this country. It almost seems as if those with money are battling those that don't have or can't afford the insurance. I keep hearing people say that their taxes are being used to cover people. I have lived in countries that have universal healthcare systems and these countries are not bankrupt.

 

I think everyone should have affordable healthcare and no one should be denied care because they can't afford to pay. My son's healthcare plan premiums doubled last month and this was an expense that caused a ripple affect in his budget. I paid for healthcare for years and only used the benefit when I really needed it. The healthcare and pharmaceutical industries, in my opinion, are money and profit driven and people's lives really are not a concern.


The irony in my post is that besides those that can’t afford to pay, there are thousands that can afford to pay but they are not allowed to pay because their income falls into a specific income range. 

Honored Contributor
Posts: 15,354
Registered: ‎03-09-2010

Re: THE HEALTHCARE COVERAGE GAP AND A DIABETIC WITHOUT INSULIN

@Mindy D 

 

If you are on SSDI and under 65 there isa 24 month waiting period before you can qualifiy for Medicare


@Mindy D wrote:

@SilleeMee wrote:

I qualify for no-cost marketplace insurance but it has such a high deductible that  I might as well not have it. I am in the category where I don't make enough money to afford descent insurance and too much income to qualify for Medicaid. The category I'm in is tough on me. I pay a lot for my heath care and I don't have enough money to get all that I need. The dental part is even worse. 

 

I'm 64 and disabled. Someone who is under 65 and disabled with fixed income as myself, is in a terrible place...there are no discounts or financial breaks of any kind to help things out.


Are you receiving SSDI? If you get SSDI you don’t need the marketplace because you are eligible for Medicare.  If you don’t get SSDI, you are in the same predicament I was in. I just started getting Medicare. I have already been open Social Security. I took this early. If you have opted to wait for your Social Security, you can still get Medicare when you turn 65. You pay about $140 a month if you decide to take the coverage for part B. If you only use Meducare Part A hospital coverage you are not charged at all (I think). 


 

Stop being afraid of what could go wrong and start being positive what could go right.
Esteemed Contributor
Posts: 6,527
Registered: ‎03-10-2010

Re: THE HEALTHCARE COVERAGE GAP AND A DIABETIC WITHOUT INSULIN

[ Edited ]

@Mindy D  You may not know since you only reprinted an article, but no running water in the trailer because....? 

 

@Annabellethecat66  I don't know how the Government "forced" you to go on Medicare.  Are you sure that's what you meant?  Is that what your man told you...you HAD to go on Medicare? 

*********************
Keepin' it real.
Honored Contributor
Posts: 9,139
Registered: ‎04-16-2010

Re: THE HEALTHCARE COVERAGE GAP AND A DIABETIC WITHOUT INSULIN

*There are no guarantees with anything. Those who are to have a pension and health care when they retire, believe me, it can all disappear if the One In Charge deems it so. Ask my in-laws what happened to their "guaranteed" health coverage and pension for life when my FIL retired from his job (and everyone who did as well). They never received it.

 

*Healthcare, prescriptions and end of life care is HUGE business. Major for-profit. And the majority of us with a 401K are part of those shareholders who WANT them to stay in business. Sad but without any type of pension or the measly amount of SS you receive (and that may be gone for many of us when we need it), I don't know anyone who is willing to sacrifice theirs for the sake of everyone getting coverage *sigh*.

 

My son has Medicare but doesn't use it. We cover him for now on private insurance. At 26, we will have no option but to switch him over. NOT ONE OF HIS DOCTORS accepts Medicare. Their choice. Where we live will always be determined by the benefits provided for him by the state (OMG, how it differs from state to state is a nightmare) once we retire. We do have options; we can always return to England. That said, there are major issues with National Health and it's only going to get worse. And don't get me started on the issues we are now having getting his medications (opiates).

 

The only people I know who just shrug their shoulders and have no worries are young, single, healthy adults OR those who are VERY wealthy.....both of which see no reason to pay into a healthcare program (which makes it worse for those of us who do if you understand how the whole number game is played regarding insurance coverage).

 

Oh, and did I mention we DID lose our home when our eldest had his life changed by a drunk driver?  Mortgage or care for our son....which one should we choose? From dream home to rental to where we are now. Yep, been down that path too. At least we had the ability to make choices that worked for our family each time; most do not.

 

I have no answers but empathy for every single person dealing with this $#*%.