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Found 6 results

  1. I am wondering if anyone has input on this issue. My wife has not been diagnosed (not for lack of trying) but has symptoms similar to Parkinson's and also some possible dementia. She will turn 65 in a couple of months and we have a one-time open enrollment and can choose any insurance plan to go with her medicare without questions. The way I see it, we could choose a comprehensive supplement such as plan F or a Medicare Advantage plan. She can have a MA plan from her former employer that looks pretty good. It is a plan I know because I am already on it. The MA network is not restrictive at all and out of pocket is $3500, about as low as I have seen. My only concern is over tests or procedures that might be required that they might not approve, whereas the plan F would approve anything allowed by Medicare. I think these would have to be pretty special procedures, beyond normal imaging and other things that have become routine. So what say you? Are there any procedures that may be common in PD or dementia that would possibly raise a flag with an insurance company? Any experiences good or bad with either type of plan?
  2. PLEASE HELP!!!! My step dad just died and my mom is no longer covered under his insurance. She has been diagosed with Parkinsons for over 10 years. I just got my mom medicare coverage Part B. I am looking for Part D coverage which is medications. I have tried a bunch of insurances and none of them covered Rytary. The only one I found was a company named Magellan and the cost would be $38.80 per month PLUS $391.34 bringing it to a total of $430.14 a month for medication coverage because of the Rytary. Does anyone have medicare Part D with a company that covers Rytary? Thank You
  3. ScottSuff

    DBS and insurance

    What should/can I do in this situation? I was approved for the DBS procedure by my primary insurance (a large national company), however they denied inpatient status for the 2nd phase surgery. My secondary insurance,Tricare covers DBS when it's for chronic pain, and they have it as an inpatient status, however when they are a secondary they use the guidelines set by the primary. I'd like to see if the working group that creates insurance guidelines would like to undergo surgery for 3+ hours having holes drilled in their head and leads inserted in their brain and then ride 3+ hours back to home? I sorta doubt it! Do I have any options?
  4. ScottSuff

    Overnight stay denied!

    I've been approved by my primary insurance for DBS. However, they have denied inpatient status for the second surgery. The first and third surgery is outpatient and there is agreement between Vandy and my primary insurance.They are saying this invention is considered to be an ambulatory procedure and can be performed in an outpatient status! I'm putting up an appeal and I need some help from this wonderful group. I'm just trying to get some data to help my case. How many of you have had the DBS procedure ( drilling holes and lead insertion) in outpatient status? I don't know of a hospital that will entertain doing it in outpatient status. Appreciate your help.
  5. Just wanted to share some frustrations with all of you and hope that you have better luck than I do. (WARNING: Long-winded rant!) I changed careers several years ago after going back to school to get a degree in nursing, and started working for my current employer (a major hospital in my area) in the fall of 2008. When I started, I enrolled in the short-term disability insurance program and have been paying approximately $50 per month for it since. After being diagnosed with PD last summer, I started checking into my benefits package at work and discovered some disturbing information. First, the short-term disability insurance is renewed every year and the insurance company asks questions at renewal about any changes in your health in the past year. A co-worker of mine went through the renewal process a few months ago after being diagnosed with MS just a few months prior to that, and they refused to renew his insurance after he had been paying for it for years! My renewal is coming up soon and I fully expect to loose my short-term disability as well. Second, I started checking into our long-term disability insurance program and found that I don't qualify for it until after 5 years of service - which will be in October 2013. However, there is a pre-existing condition clause that states that if I have any pre-existing conditions in the 12-months leading up to the start of the insurance, those conditions will not be covered (i.e. they won't cover me if I become disabled due to PD). Third, my wife and I work for the same healthcare system but have separate medical insurance policies. I couldn't cover her and my step-daughter on my insurance without showing proof that I am legally obligated to provide my step-daughter's health insurance - which I am not. So, we decided to just stay on separate policies at the time, not realizing that I would end up getting PD. The problem now is that if I should become disabled, I will lose my insurance and can't be covered by hers due to pre-exisiting conditions. As you all are probably aware, Medicare doesn't start coverage until 24 months after the date of approval for Social Security Disability. SO....it appears that my career change and my PD diagnosis came together at just the right point in time to really screw me! LOL! If I become disabled, I will have no income and no insurance until I get approved for SSDI and Medicare. I guess I had better find a really good MDO specialist because, one way or another, it looks like I'll be working to age 67. Again, I hope you all have better luck than me!