Why can't an average, working person get Masshealth when they discover a brain tumor has returned?

I looked into the guidelines and did a pre-qualification test based on my own personal financial information.

In order for a family of five to qualify for Masshealth, they must not have income of more than $2,800 a month, or 133% the federal poverty level. Masshealth recognizes the disability, but you must meet income guidelines to qualify.

Medicare, the federally funded health insurance for people over 65 or those with certain disabilities is also very confusing. If you are disabled, you must meet certain criteria before you qualify for coverage.

First, if you have end stage renal disease, you qualify right away. If you have a different disability, you must be out of work and collecting SSDI for at least 24 months before you qualify.

This scenario leaves those with some ability and desire to work stuck in the middle. What if you work part time, collect from your private disability insurance and only periodically collect SSDI?

I would think there are special circumstances where the government would approve Medicare health coverage, despite not having collected SSDI for two years, but I wouldn't count on it.

COBRA does offer reduced payments if you are under financial hardship or disabled, but for a certain period of time. Although reduced payments are more than welcome, a person with a diagnosed malignant brain tumor should not have to pay for health care costs.

There is still a gap between COBRA coverage and Medicare, even when you get approved. COBRA lasts for 18 months (as far as I am aware) and Medicare coverage doesn't start until you have collected SSDI for 24 months.

When you are approved for Medicare, this is still not the end all be all we would think it is. Ask an older relative who is on Medicare and they will tell you that Medicare doesn't pay for medications unless, again, you meet federal poverty level guidelines and apply for certain programs.

With health care reform in the national spotlight, consider the following scenario:

A family of 5, with a father who is collecting disability because of a brain tumor and an inability to work, is not eligible for any health insurance assistance because of the pittance received from disability.

This family of 5 must come up with a COBRA payment every month so that the father can receive treatment. COBRA payments for a family of five are generally over a thousand dollars a month. Without insurance, treatment options rapidly decline to comfort care only.

Health insurance is a necessity for all of us and it seems impossible that a person receiving disability is not automatically granted free health care. Health insurance is a right, a basic human right, and health insurance premiums should not stop anyone from the best medical care possible.

Although Social Security Disability is set up as a way to help disabled Americans continue their standard of living, most people that apply for social security benefits will be denied the first time.

Social Security Denies at Least 70% of Applicants the First Time

Applicants looking for SSDI benefits are often denied as a way to weed out people who aren't serious about getting disability benefits. People often get fed up with the appeals process and will give up before they see a dime.

Seizure Disorders are Not Considered a Disability

Oh, really?

After applying for benefits because I was having trouble driving, reading, walking, thinking and otherwise functioning due to a seizure disorder, I was denied benefits myself. Despite the words "if you have a disability such as a seizure disorder, etc." on the SSDI website, I was told that a seizure disorder is not considered a disability.

I might understand if it was written that "we are not sure your seizure disorder is causing you to be disabled" but a blanket statement that a seizure disorder is not a disability was not only wrong, it was callous and stupid.

I am thankful that I was able to return to work once doctors figured out how to help my condition.

Fight for Your Right to Collect Disability

Social Security Disability is for Americans. We are supposed to feel secure that if we are disabled, we will be taken care of. Instead, we wait for benefits, we worry and we have to fight for what we deserve.

Isn't there a better way?

Author Yamileth Medina

The fight over healthcare reform has reached the Senate, and may take longer than previously expected. Reform intended to promote the wider availability of affordable health insurance seems to have lost the momentum recently gained via its nail-biting passage in the House of Representatives. Republican senators have expressed unanimous disapproval of the bill and vow to filibuster in order to block it. Healthcare reform will require 60 votes to pass, which means that the entire Democratic caucus--the party's entire Senate delagation with a handful of independents--needs to support it. Senate Majority Leader Harry Reid is attempting to hold together two divergent wings of the Democratic caucus, with several factors coming into play.

As it currently stands, the health care reform bill isn't ideal for either liberal or conservative Democrats. While Democratic leaders have encouraged passage under the logic of imperfect reform being preferable to leaving the current system as it stands with soaring health insurance rates, many senators are understandably leery of voting for legislation that will take a monumental effort to amend later. Reid is doing his best to convince Democrats, as well as Democratic sympathizers, that this is a rare opportunity that shouldn't be passed up. Whether he will manage to bring them around to his viewpoint remains to be seen. President Obama has also pushed for a completed bill on his desk before January, although that possibility is becoming more and more remote. Obama has several major priorities on his plate (both domestic and foreign) besides healthcare reform, and is currently suffering from lower popularity ratings. Therefore, his influence is probably more decreased than many once thought.

One of the most controversial aspects of healthcare reform is the public option, which would create a federal government-run alternative to private health insurance plans. Proponents claim that it would drive down the cost of health care through using its buying power and regulatory muscle to buy health care services at lower rates, while at the same time forcing for-profit health insurers to lower their health insurance premiums to stay competitive. They predict more affordable health insurance as the result. On the other hand, opponents decry the increased level of governmental involvement and potentially deficit-busting cost of a public option. The former group consists of liberal progressives, such as independent Vermont Senator Bernie Sanders and Democratic National Committee chairman Howard Dean. Sanders, in particular, is threatening to vote against a bill that lacks a public option. Those in the latter group, including Ben Nelson of Nebraska and Connecticut's independent Joe Lieberman, have expressed their willingness to jump ship and vote against a healthcare reform bill that includes a public option.

The Democratic caucus appears to have reached an impasse in some respects. A compromise currently proposed in the Senate allows individual states to opt out of the public option. Liberals seem to begrudgingly accept the clause, but it isn't good enough for staunch fiscal conservatives like Lieberman and Nelson. Due to the Democrats' razor-thin majority in the Senate, Reid can't afford to lose a single vote. The chances of garnering Republican support for this healthcare reform bill are slim to none. The only hope of doing so is through writing a trigger function into the bill. Such a measure would only enact a public option if certain goals of expanding affordable health insurance to more Americans are not met. There may be a handful of Republican moderates like Maine Senator Olympia Snowe willing to vote for such a measure, allowing for a cushion in the event that Lieberman bolts; but that gamble has the possibility of angering progressives.

In the recent past, liberal Democrats tended to hold their nose and vote for legislation they had serious issues with because it was preferable to the alternative of getting even less of what they wanted; now, they are becoming more outspoken, threatening to withhold their votes if provisions regarding the public option or abortion are unacceptable to them--using the same tactics conservatives on both sides of the aisle have used to pressure party leaders in the past. It will be a significant struggle to keep all of the Senators in line. The bill is still being written, but Reid appears to be supporting a moderate approach that, by its definition as a comprehensive healthcare reform bill, leans more towards centrist and liberal Democrats but still has too many flaws for them to endorse wholeheartedly.

The chances of healthcare reform soon passing the Senate are mixed. Michigan Senator Carl Levin believes that the bill stands a "decent chance" of gaining the 60 votes needed to break a filibuster. Indiana's Evan Bayh seems to be similarly ambivialent, though he admits that a solution that satisfies everyone is virtually impossible. Meanwhile, Republicans are calling the bill fatally flawed and recommending that it be scrapped and healthcare reform put on the back burner. That idea is unacceptable to Democrats, who believe that increasing access to affordable health insurance is essential to their larger economic recovery effort. Moreover, they probably want to have some legislation to show their constituents before the 2010 midterm elections. If the Senate manages to pass the bill, its version will need to be combined with the House's version. In the event that the combined bill is approved by both chambers of Congress, it then goes to President Obama's desk. While it is doubtful that he would veto a bill regarding one of his highest domestic priorities, one that strays too far from its indended purpose has the small chance of not receiving a signature.

Yamileth Medina is an up and coming expert on Health Insurance and Healthcare Reform. She aims to help people realize that they can find affordable health insurance right now while waiting for a public option, if it ever gets passed. Yamileth lives in Miami, FL.

Article Source: http://EzineArticles.com/?expert=Yamileth_Medina

Medicare coverage is for adults in the United States 65 and older or younger adults that have been collecting social security disability benefits for a period of 24 months.

Photo by: Monique Discawicz

Medicare is free to those that qualify, but what many people don't know until they are covered under Medicare is that it is a very basic insurance that does not cover medications. As we age, we become more and more dependent on medications. Does it make sense that Medicare doesn't cover medications?

How does a person over 65 get their medications paid for by insurance?

It depends on the Medicare rider that is purchased by the insured. Medicare might be free, but it is such a basic insurance that few people have Medicare insurance only. Rider policies can range anywhere from $100 a month to $600 and beyond for a single person.

How does a senior on a fixed income afford a rider plan to cover the cost of medications?

A senior citizen on a fixed income will have to pay for a cheap (100$) a month rider to get any prescription medication coverage at all. Some plans offer $800 worth of medication a year, so if a Medicare recipient pays for their medications anyway, $800 a year of medication will cover eight months of a cheap Medicare rider.

There are programs available for those on a fixed income such as prescription advantage, that will offer medications at a reduced or free rate, but just try as a senior citizen to figure out how to qualify for such programs.

From personal experience, I give you the example of my grandmother, who earned about $900 a month from Social Security.

She paid $105 a month for Blue Care 65. This covered $800 a year in medications. She was on six medications and this $800 ran out every February.

It took my sister and I months to apply for prescription advantage programs and you have to reapply every six months. She continued to pay anywhere from $100-$250 every month for prescription medications.

So her monthly budget was 900-105=795. Subtract the minimum 100 for medications. $695. This is before food, rent, phone or cable. Thankfully she was on a subsidized rent program and only paid $300 a month. This left her with $395 a month for food, phone, cable and entertainment.

My grandmother worked her entire adult life. She pinched pennies everywhere she could. She never relied on any government assistance until the subsidized rental which didn't start until she was 85 years old. From 65-85 she paid for all her bills out of her social security, including her medical costs.

I believe that my grandmother was not out of the ordinary. She did not take an excessive amount of medications during her "senior" years. She worked hard in her lifetime and saved all she could. It was ridiculous that money was so tight because she had to pay for her medications and a Medicare rider plan. 20-30% of her income went every month for health related costs, and she was a healthy senior.

What are we doing?

When buying medical insurance you will find that you have lots of different types of policy that you can choose from. Some systems let you select the doctor you want to care for you and your family and the hospital you want to use but others limit you to certain ones so that you do not have a choice of health care provider.

Preferred Provider Organization is a policy which lets you choose which doctor you want to you and you do not have to use a specialized allocated one. This costs much more than opting for a system of insurance where you join a medical health scheme organized by a big company.

There are a number of increasingly complex systems out there to choose from and a medical insurance provider will be able to tell you the costs for each different level of care and exactly what options you have when it comes to selecting a doctor, or hospital.

Make sure that you ask the right questions and find out exactly what care you are getting for your premium each month and which doctors and hospitals you are permitted to use. A mistake can be quite costly and you really do need to be prepared and know what your options are in case the worst happens on the spur of the moment.

the last person most people do not ask is the one that understands the most about what type of cover you need. Do you know who that is? It is your doctor, they may not be allowed to mention companies by name but they can tell you exactly what type of cover is right for you.

The best thing to do once you have decided what level of care you need for yourself and your family is to go onto an internet price comparison site, type in what you are looking for and your personal details and you will get a list of suitable insurance policies within a very short time. You will then be able to select which one you want at a price that you can afford.

Once you have decided what you want ask questions. Do not assume that all the information is there for you to see. You need all the details about restrictions and limitations on your health insurance firmly in your mind just in case they are needed quickly. The only way to get real peace of mind is to ensure that you know what you are buying and more importantly, what is not covered.

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Article Source: http://EzineArticles.com/?expert=Andy_Ryan