Tuesday, March 15, 2005

YEAR IN SUMMARY: Part 4 of 5 Insurance

Private health insurance specifically prescription benefits can make or break MS treatment options during the course of the disease. 


Disabled Americans under the age of 65 who can no longer work are usually eligible for Social Security and associated benefits. Medicare health insurance both A & B (hospitalization and medical care) became available to Patti at this point. Medicare is a wonderful safety net. However it did not help with prescriptions and most aggressive options available to treat MS.


Fortunately Patti was able to continue her private health insurance which included the prescription benefit plan through long term disability from her employer. Not as a COBRA policy but as a continuation of coverage at a monthly copay just like an employee and for many years at no cost.


International Paper is one of the 'good guys' when it comes to standing by their employee disability benefits. If you ever have to choose between buying two paper products, and everything else being equal, please keep that in mind.


Now, over the years as Patti's MS progression shifted in focus to home caregiving needs or what medical insurance likes to label “custodial care”, insurance isn’t of much help at all.


Next to nothing is available to help with home caregiving, however on the other hand EVERYTHING is picked up once admitted to a care facility. There really is no middle ground and in a sense the passage to the care facility era is rewarded by the medical insurance industry.


In a care facility with Medicare and private long term disability insurance plus Medicaid, Patti is receiving more medical attention, benefits, and therapy than ever before.


I would be lying if I said I don't sometimes experience frustration when I see so many resources in use that I tried to get for homecare and was repeatedly turned down. It just seems to me that millions a year could probably be saved and people could probably stay at home longer IF ‘the system’ ever woke up and smelled the coffee. However, I suspect there are too many people with their fingers and jobs in the pie for that to change.


However, that is blasphemy! I should and will just fall on my knees, face toward Harford, CT, be grateful we simply have medical insurance, and beat my chest while chanting mea culpa.


Caregivingly Yours, Patrick Leer


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