POZ Community Forums
Meds, Mind, Body & Benefits => Insurance, Benefits Programs & HIV => Topic started by: buca45 on June 26, 2012, 01:09:16 pm
-
For the past 20+ years of being Poz I have been low income enough to qualify for assistance from ADAP in both Florida and for the past 7 years in NY state. At no time during this period have I had to pay for any prescriptions or any doctor visits.
I have been receiving SSDI for the past 10 years. Just this past week I received a call from a NY state ADAP representative telling me I had to enroll in Medicare as it is now their requirement for me to continue receiving assistance with both meds and doc visits/labs.
After a long talk with this rep she referred me to my clinic to talk with someone who could assist me in getting this enrollment started. I went in yesterday to speak to their 'specialist' and came out so frustrated and confused as he was of NO help whatsoever.
So my question to anyone who might be aware of how this enrollment process works and what I will be qualified for is: WHAT DO I DO??
Seriously this has got me so worried that my coverage will stop or just as bad my measly monthly SSDI check will be eaten up by my having to pay for premiums and co-pays. In the past reading through threads here that addressed this issue, I felt horrible for all of those who had to pay through the nose for their health care. Since I was receiving free care and meds for so long I thought I would never have to go through this myself. Now that ADAP is changing how their funding works and they are requiring everyone to enroll in Medicare I have to do the same.
Adding to my frustration and confusion, I have been taking large amounts of both Oxy and Xanax in addition to my HIV drugs which have made my thinking so foggy and easily confused / impatient. I cannot get through even reading the ADAP / Medicare website as the information just does not compute in my head.
Can someone please help me understand in plain and simple English what I have to do to stay covered and receiving my health care and meds? I am at the end of my rope trying to wrap my mind around this...seriously to the point of wanting to just stop all meds and treatment and just let myself die....or even worse yet contemplating suicide!
Seriously the dude I spoke with at my clinic was totally clueless and would leave the room to find out the answers to each of the most basic of questions I was asking of him. He finally got the ADAP / Medicare website on his computer and was just pointing at the questions I was asking of him without offering any type of help.
SOMEONE PLEASE help me understand what I have to do!!
-
If you are on Medicare A/B already they should have made you sign up for Medicare D for prescriptions five years ago when the program began, because ADAP is by law "payer of last resort". Nevertheless, in most instances your premium and copays will be picked up by NYS Dept of Health or some such entity. I live in Pennsylvania and that is how it is done here, you need to check with a case manager where you live and get them to figure all of this out in terms of how it's done in New York. I admit it was very confusing when the program began years ago, but the guy that was trying to answer the questions about this at your clinic is obviously inept, because it's a very typical thing any case manager should know. You need to go over his head and ask for his supervisor.
Sorry I can't be of more help other than to say this should be more easily solved. If you lived where I did I could tell you where to go and get it solved but I don't. Are you in NYC or upstate somewhere?
-
Hi buca ... I have been on medicare for a long while now and it can be confusing , luckily for me I finally figured out I really don't have to know every thing about how it works to get the benefits I needed .
There came a time when I had to move from adap to medicare part D for my drugs . It was pretty easy to do . I called medicare and told them what I needed to do and gave them my social security number and some info and I was enrolled . They also gave me the names of insurance company's and part D providers in my area and if I'm not mistaken they actually help guide me to a company with the best plan for the medications I was currently taking .
Please try not to get overwhelmed because I really think once you talk to the people at medicare you will see this isn't as tough as you might think . You can contact medicare by dialing 1-800 - Medicare or look at the website at https://www.mymedicare.gov/