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  • Medicaid

    Hi Guys,

    I wanted to know I am a full time worker.........have my own insurance but I was told that after so many years like 3 on dialysis medicaid has to become your primary insurance and then your private becomes your secondary.........

    I am so confuse..........why do we have to go thru this because I am experiancing that in this process I would pay more out of pocket.......can someone help explain or atleast give advice because anyone who knows of a kidney patient knows it's quite expensive......

    please help

  • #2
    I'm not sure what your referring too, but medicaid is likely not it.
    Medicaid is mostly for people who have no health insurance and are low income. Medicaid requirements are handled state by state but generally the qualifications are you cannot have more than $2000 dollars, a car worth more than $4500 dollars, and an extremely low to no monthly income.

    It also does not have copayments like medicare that usually only covers 80% of your medical costs. so its good to have except you cannot own anything or work any meaningful hours as that would put you over the limit per month and disqualify you.


    • #3
      Maybe I meant medicare


      • #4
        Originally posted by SweetGRL
        Maybe I meant medicare
        There is a 90 day waiting period between the time you start dialysis and when Medicare starts paying for any of it. Usually your insurance pays 80% and you pay the remaining 20%.

        After 3 months, your insurance pays 80% and Medicare pays 20%.

        After a longer time period, (I've forgotten, I think it's between 1.5 and 3 years) Medicare pays 80% and your insurance pays 20%.

        The social worker at any dialysis clinic should know the exact figures from memory.


        • #5
          Your social life is basically over unfortunately if you get put on Medicare.....

          I hate to say this, but based on my personal experiences with the farce that the government of this country has for a medical insurance program, if you are forced to resort to Medicare and have no private insurance program through employment to float the remaining twenty percent of the costs Medicare does not cover, your social life is over since you are forced to use Medicaid which is a State administered program. The restrictions for Medicaid are so tight that you are limited to $2,000 in liquid assets, a single vehicle for travel and that's only out of medical necessity, and at least here in Nevada, to qualify for Medicaid under the Qualified Medicare Beneficiary (QMB) status you can make no more than $817.00 a month from all sources of income, including your disability benefits!! Since I receive $764.00 a month in disability benefits, that essentially denies me the right to work, and school is out of the question since even with assistance, you would need to prepare yourself for a thirty dollar an hour or more job just to survive on Medicare alone which is four plus years of school and even financial assistance might not go the distance there; transplantation is an even messier issue financially. All I can say is I wish anyone in this scenario the best of luck, but ultimately, I say you might as well try to live the best you can in an existence that for me feels without direction, purpose, or ambition.....


          • #6
            Well, I am 19 and on disability, Medicare and Medicaid, and my life isn't over. Anyway, I'm not going to argue about that at the moment. Medicare is what you get automatically when you start dialysis. It covers you until 3 years after a transplant. I am also on Medicaid to cover the rest bc I am still a dependant on my mom and I'm in college. The money I get for college doesn't count toward any of the medical stuff, since it is meant for college. I don't have to pay anything out of pocket, an dI live a very fulfilled life on dialysis.
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