If you know of resources to help people with kidney disease pay for treatment and/or medications other than Medicare and Medicaid/MediCal, post your these here.

My husband is a HD pt and not qualified for disability/SSI. He just got m/care A&B and threw a fit when he found out we have to pay $216 per quarter as a premium. We have insurance through my employer (Gambro) and he thinks this should be enough. I know he needs the m/care but we're already strapped for money since we only have my income and I already pay out big bucks for co-pays on meds and OV's. How do I pay this m/care premium along with everything else? The programs I've seen online are for "low-income" families which we don't qualify for.
I hear Gambro has a program to pay for the m/care premiums for their patients if they are unable to pay (says our soc. wkr) but unfortunately, he runs at PDI. Any suggestions?

If Medicare hasn't paid any claims yet, you can disenroll if you and your husband think your insurance is sufficient. I'd check with your HR person or the insurance company to find out exactly what the insurance will and won't pay before you decide if the premium for Medicare is too much. Also, I'd suggest you find out from his dialysis clinic if they will bill Medicare as a secondary payer. Medicare may be able to pay deductibles, copays, and any services that aren't covered by the Gambro insurance but are by Medicare. By the way, the Medicare premium for 2002 is $54/month so I suspect that the $214 you owe is for 4 months instead of 3. Sometimes when Medicare first starts, they have to make up months. It should be $162/quarter for the rest of the year. It may go up in Jan 2003.

If you choose to disenroll from Medicare, disenroll from both Medicare Part A and Part B to avoid having a premium surcharge later when your Gambro insurance is no longer required to be primary (30 months from when his Medicare would have been effective). The downside to waiting to take Medicare for 30 months is that Medicare won't pay anything for the first 30 months and if your husband gets a transplant, you'll need to remember to apply for Medicare A and B right away and back pay premiums so the month he received the transplant is included or he will NEVER be eligible for Medicare coverage for immunosuppressant medications.

Like Gambro, every dialysis and transplant program has the option to help needy patients in paying premiums. The question is whether the clinic where he goes does this and whether your husband would qualify for the help because of your income.

Clinics pay premiums for needy patients to the American Kidney Fund and the AKF pays premiums to Medicare or the insurance company. There have been some problems with delayed premium payments due to cash flow problems. There is a law that prohibits clinics from paying premiums directly to Medicare or insurance companies.

I don't know where you live, but your social worker should know if your state has a state kidney program. Sometimes these can help pay premiums or medical expenses not covered by other sources.

I suspect that your income would disqualify him for help from your state Medicaid office, but you could call to find out what their income guidelines are for a family of your family's size.

My parents were refused SSI and Medicaid because their income was to high. I went to the Medicaid office with their medical bills and because they paid so much in co-pays; they were eligible for Medicaid. We have to pay Medicaid so much per month but all co-pays and prescriptions are covered by them now and they can stay a float. However when you go this route there are limits on savings, life insurance, etc. that you can have.