Medicare Now What ????

mikeandbarb(z8 D/FW)January 1, 2008

I've been on disability for a year now and I'm past having the nerves in my back burned so that I'm not in pain but I was sent a notice from medicare that they have changed how they pay. I may have to pay up front for any medical care I receive. When I had this done last year it cost 15,000.00 dollars.

I had one steroid injection last month, medicare did not pay the bill and said they're not going to pay the bill? It was over 1000.00 dollars. We cannot afford for me to have this done on our budget. I can't get insurance from my husbands work because the time frame to enroll has come and gone besides the fact that this is a pre-condition and insurances don't pay for pre-conditions.

I'm limited to pain medicine because of the control our government has put on how much or how often they give you pain medicine.

I don't know what I'm going to do if they don't help me with my pain. BTW my problems are in my back and hips degeneration of the spine and hip joints.

I can't even walk in mall anymore to take my grand kids shopping if I wanted to.

Back in Dec. I went to my grand daughters basketball game and the next night I went to her school choru program to see her sing. The next morning I wasn't able to stand on my left leg due to sitting on the bleachers and sitting on the chair, I can't even stay at the hospital with my dad when he's been omitted because of nothing to sit on that does not leave me crippled :( All the chairs leave my back and hips in such pain that I can't walk the next day.

Is there no help for people that have this problem????

If this is the case that I can't get help, I think I'd rather not be alive.

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oakleif(z6 AR)

Mike and Barb, Sorry you're having such bad problems. My DD has pretty much the same back problems as you but hers is caused by apinched nerve.She managed to get on medicaid and they pay for her drug ins. But not medical bills and Drs refuse to see her because she can't pay.

You might try to get into a teaching hospital. It seems like Texas has some good ones.
Try to get started as soon as you can. It looks like things can get pretty bad for us on SSI.

Loved the pictures of your dogs. I have two also.

    Bookmark   January 14, 2008 at 10:09PM
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I'm sorry to hear of your troubles an pain. My DD is on SSI an I don't look forward to having to deal with the SSI an Medicare issues that are coming up soon. Anyway I don't know if this link will help, but who knows they may can direct you in another direction for help.

    Bookmark   February 13, 2008 at 6:09PM
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oakleif(z6 AR)

Thanks Trudy,
I'll look it up tonight.

    Bookmark   February 16, 2008 at 5:28PM
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julieyankfan(z9FL Pasco Cty.)

MikeandBarb, I don't understand why they won't pay for the shot. I'm on disability and get Medicare, too, and they always paid for shots. I can't have them anymore since I developed heart arythmias from them. Call Medicare or call whoever handles the billing at your dr.'s office.

That idea about teaching hospitals is a good one. I know there's one in TX that is pioneering the replacement discs.

I have 3 discs removed and replaced with cadaver bone and screws and rods and I'm still having a lot of pain after 5 yrs. and I'm only in my 40's, so by the time grandchildren come, I'll be a mess! I had the rfa done once and it didn't help, but I'm going next week for the hour long rfa where they go in deeper and burn off more nerves. This new instrumentation isn't covered by Medicare, so I have to pay $750 up front and they only do one side of your spine at a time, so I guess I'll be out $1500!!! I keep thinking that I'm throwing this money away if it doesn't work, but what if it does??? I'm not exactly in a position to be throwing money away, but I'll do anything to be able to stand or walk for more than a few minutes at a time. The only thing I won't do is take pain meds. Those things will kill you.

Please let us know what you find out.


    Bookmark   February 27, 2008 at 2:41PM
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mikeandbarb, I understand your frustration. I also have degenerative arthritis in lower spine and pinched sciatic nerve. I can't offer much useful info except to tell you the main reason I shop at Walmart is because they have carts I can ride. I haven't been to the mall in years, can't take the walking.

Trudi, if anyone is on SSI they do not have to deal with medicare but can stay on medicaid which is much better and covers a lot more.

Hope you all get some relief! I didn't even know this forum was here but sure is nice to see others dealing with problems and still gardening. Love it!!! Jackie

    Bookmark   March 1, 2008 at 4:07PM
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mikeandbarb(z8 D/FW)

Thank you for the info.
I take the plunge and started the first series of the Risotomy. Had it done last Monday the 10th. Right now it's leaving my right hip out of whack cause when I walk I feel a nerve being pinched.
I have tricare for life insurance through my DH and it seems they are paying most of the bill. Now I sure don't understand how the insurance companies work cause Medicare and Tricare are one of the some. Meaning that the money paid out to Dr's, Hospitals and such comes from the same insurance. Meaning it's all Government funds. I get most of my Meds free through Tricare so that I don't have to worry about right now. But they are going up in price. If I can get our meds on the base I do but sometimes they chance mid-steam and I have to go back to the Dr. to get a different med or start getting it through walgreens.
I have been told by 4 Dr's that my back is non-operative. My lower lumbar the 4th and 5 th lumbar is fused together from the time of birth but I question their knowledge on this because when I was 16 we'd gone on a vacation to a family friends farm. Well, the one of the kids asked if I wanted to ride a calf. So needless to say I went with him , hopped on the calf and he took a hold of the calf's tail and twisted it. It jumped over the feeder and down I came right on my tail bone. I didn't have any problems till later on after I had my daughter. Then it wasn't bad just a little catch.
Any who - my gardening has slowed way down, right now it's nil but hoping after it's all done I'll be able to do some. My house wrok has been at it's all time slow and I'm thinking of looking into getting help. This is all so hard to say you can't do what you use to.
Oh yeah, The Dr wants to do an update MRI cause it's been two years since I've had one done.

Hope you all are doing ok and your able to get out in the garden. Our winter had been very mild right up till last week and we got hit with two snow storms in a week. That's Texas for ya LOL and that's why my Great Grandpa moved back to AR.

    Bookmark   March 12, 2008 at 10:45AM
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I'm new here--so forgive me for just jumping in with a question before introducing myself, but something said in this thread really concerns me. I am also disabled and have recieved no notice or information regarding change in Medicare payment, etc. So, apparently, I am simply uninformed at this point.

Can someone explain what the changes are and how I can learn about it?

Peace from the,

    Bookmark   March 27, 2008 at 4:17PM
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If you have not already done so, please contact the DADS office in either Dallas or Tarrant County depending on your residence. Your local number can be found at:
DADS is the state agency on aging, disability, and mental retardation. Most of the services you might be able to plug into, they could guide you.

There is also another source of benefit information for people like us who are disabled at:
The benefits checkup walks you through an interactive questionnaire and gives you services you are eligible for and where and who to contact. There is help available once you can get into the system.

The county hospitals for charity care are: Dallas = Parkland; and Tarrant County = JPS (John Peter Smith). There are several teaching hospitals, 1) UT Southwestern 2) Baylor University Medical Center, etc.

Here is a link that might be useful: Texas Dept. of Aging and Disability Services Contact Information

    Bookmark   July 15, 2008 at 11:21PM
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