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PatientAdvocateFoundation
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| Communities: Breast Cancer | Thank You's: 4 |
| Member Since: Apr. 2011 | Questions: 0 |
| Answers: 15 |
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Organization Info
Our Mission: To provide effective mediation and arbitration services to patients to remove obstacles to healthcare including medical debt crisis, insurance access issues and employment issues for patients with chronic, debilitating and life-threatening illnesses nationally.
Organization address:
421 Butler Farm Road
Hampton, VA
23666
Contact phone:
800-532-5274
Webpage:
www.patientadvocate.org
PatientAdvocateFoundation Activities
I have been looking to see if I could find any resources to provide assistance without any luck. There is a running list of organizations that outline finanical aid for cancer. Maybe one of these can help offset the cost or be willing to cover the cost as a "medical supply". http://www.needymeds.org/copay_diseases.taf?_function=summary&disease_id=43&disease_eng=Cancer - All&dx=20. I do hope you find a resolution and will keep you question in mind if I do come across something in the future.
PatientAdvocateFoundation (Organization (Verified)) replied to answer by PatientAdvocateFoundation (Organization (Verified))
2
Answers |
3 months ago
It sounds as if your doctor is not a contracted provider under your insurance contract. If that is the case the doctor is not subject to the insurance company, the insurance company's rules, regulations, policies and procedures have no jurisdiction on the non-contracted provider. Therefore, the non-contracted doctor has no legal obligation to send a claim, receive payment from the insurance company, or appeal a denied or partially paid claim. Everything reverts to the contract between the patient and their insurance company. That contract requires the patient to submit their own claim, however they can decide to submit a claim but it is only as a courtesy to the member. If the doctor is contracted with your insurer they must submit your claim for you and this scenerio should be reported to your insurer.
Keep in mind if you are using a non-contracted provider you will be subject to higher out-of-pocket cost since they do not have a pre-negotiated rate with your insurer. PAF has a great publication on Usual, Customary and Reasonable Charges (UCR) a result from using an out-of-network provider/facility. http://www.patientadvocate.org/index.php?p=439
It sounds as if your doctor is not a contracted provider under your insurance contract. If that is the case the doctor is not subject to the insurance company, the insurance company's rules, regulations, policies and procedures have no jurisdiction on the non-contracted provider. Therefore, the non-contracted doctor has no legal obligation to send a claim, receive payment from the insurance company, or appeal a denied or partially paid claim. Everything reverts to the contract between the patient and their insurance company. That contract requires the patient to submit their own claim, however they can decide to submit a claim but it is only as a courtesy to the member. If the doctor is contracted with your insurer they must submit your claim for you and this scenerio should be reported to your insurer.
Keep in mind if you are using a non-contracted provider you will be subject to higher out-of-pocket cost since they do not have a pre-negotiated rate with your insurer. PAF has a great publication on Usual, Customary and Reasonable Charges (UCR) a result from using an out-of-network provider/facility. http://www.patientadvocate.org/index.php?p=439
Keep in mind if you are using a non-contracted provider you will be subject to higher out-of-pocket cost since they do not have a pre-negotiated rate with your insurer. PAF has a great publication on Usual, Customary and Reasonable Charges (UCR) a result from using an out-of-network provider/facility. http://www.patientadvocate.org/index.php?p=439
It sounds as if your doctor is not a contracted provider under your insurance contract. If that is the case the doctor is not subject to the insurance company, the insurance company's rules, regulations, policies and procedures have no jurisdiction on the non-contracted provider. Therefore, the non-contracted doctor has no legal obligation to send a claim, receive payment from the insurance company, or appeal a denied or partially paid claim. Everything reverts to the contract between the patient and their insurance company. That contract requires the patient to submit their own claim, however they can decide to submit a claim but it is only as a courtesy to the member. If the doctor is contracted with your insurer they must submit your claim for you and this scenerio should be reported to your insurer.
Keep in mind if you are using a non-contracted provider you will be subject to higher out-of-pocket cost since they do not have a pre-negotiated rate with your insurer. PAF has a great publication on Usual, Customary and Reasonable Charges (UCR) a result from using an out-of-network provider/facility. http://www.patientadvocate.org/index.php?p=439
New answer by PatientAdvocateFoundation (Organization (Verified)) in topic(s) Financial, Bill Payment, Financial Assistance, Financial Support, Reimbursement
1
Answer |
4 months ago
After being diagnosed with any illness, especially a serious one such as cancer, other areas of your life are unfortunately affected as well. When your health does affect your employment, the last thing you expect is to be confronted with harassment or the threat of losing your job, income and health benefits. Despite significant gains in cancer survival rates and the passage of the ADA, people with cancer still experience barriers to equal job opportunities. One reason individuals with cancer face discrimination at work is their supervisors' and co-workers' misperceptions about their ability to work during and after cancer treatment. Even when the prognosis is excellent, some employers expect that a person diagnosed with cancer will have long absences from work or not be able to focus on duties.
Keep a detailed journal of all incidents including the date, time and what was said and by who as well as when you sought assistance from managers to resolve the matter. Ask for a meeting with our manager, human resources or union depending on you company set up. Come to the meeting organized with detailed facts and your concerns. If you have suggestions offer them as well. Under the ADA, it prohibits harassment based on disability just as other federal laws prohibit harassment based on race, sex, color, national origin, religion, or age. Harassment is actionable under the ADA when a person is subjected to offensive conduct that is sufficiently severe or pervasive to create a hostile or abusive work environment. Employees who believe that they have been harassed because of cancer may file a charge with the EEOC if you still find your personalized meetings are not resolved to your satisfaction. Keep in mind that the charge must be filed by mail or in person with the local EEOC office within 180 days from the date of the alleged violation.
Patient Advocate Foundation's publication "First My Illness, Now Job Discrimination" is a good resource as well. After being diagnosed with any illness, especially a serious one such as cancer, other areas of your life are unfortunately affected as well. When your health does affect your employment, the last thing you expect is to be confronted with harassment or the threat of losing your job, income and health benefits. Despite significant gains in cancer survival rates and the passage of the ADA, people with cancer still experience barriers to equal job opportunities. One reason individuals with cancer face discrimination at work is their supervisors' and co-workers' misperceptions about their ability to work during and after cancer treatment. Even when the prognosis is excellent, some employers expect that a person diagnosed with cancer will have long absences from work or not be able to focus on duties.
Keep a detailed journal of all incidents including the date, time and what was said and by who as well as when you sought assistance from managers to resolve the matter. Ask for a meeting with our manager, human resources or union depending on you company set up. Come to the meeting organized with detailed facts and your concerns. If you have suggestions offer them as well. Under the ADA, it prohibits harassment based on disability just as other federal laws prohibit harassment based on race, sex, color, national origin, religion, or age. Harassment is actionable under the ADA when a person is subjected to offensive conduct that is sufficiently severe or pervasive to create a hostile or abusive work environment. Employees who believe that they have been harassed because of cancer may file a charge with the EEOC if you still find your personalized meetings are not resolved to your satisfaction. Keep in mind that the charge must be filed by mail or in person with the local EEOC office within 180 days from the date of the alleged violation.
Patient Advocate Foundation's publication "First My Illness, Now Job Discrimination" is a good resource as well.
Keep a detailed journal of all incidents including the date, time and what was said and by who as well as when you sought assistance from managers to resolve the matter. Ask for a meeting with our manager, human resources or union depending on you company set up. Come to the meeting organized with detailed facts and your concerns. If you have suggestions offer them as well. Under the ADA, it prohibits harassment based on disability just as other federal laws prohibit harassment based on race, sex, color, national origin, religion, or age. Harassment is actionable under the ADA when a person is subjected to offensive conduct that is sufficiently severe or pervasive to create a hostile or abusive work environment. Employees who believe that they have been harassed because of cancer may file a charge with the EEOC if you still find your personalized meetings are not resolved to your satisfaction. Keep in mind that the charge must be filed by mail or in person with the local EEOC office within 180 days from the date of the alleged violation.
Patient Advocate Foundation's publication "First My Illness, Now Job Discrimination" is a good resource as well. After being diagnosed with any illness, especially a serious one such as cancer, other areas of your life are unfortunately affected as well. When your health does affect your employment, the last thing you expect is to be confronted with harassment or the threat of losing your job, income and health benefits. Despite significant gains in cancer survival rates and the passage of the ADA, people with cancer still experience barriers to equal job opportunities. One reason individuals with cancer face discrimination at work is their supervisors' and co-workers' misperceptions about their ability to work during and after cancer treatment. Even when the prognosis is excellent, some employers expect that a person diagnosed with cancer will have long absences from work or not be able to focus on duties.
Keep a detailed journal of all incidents including the date, time and what was said and by who as well as when you sought assistance from managers to resolve the matter. Ask for a meeting with our manager, human resources or union depending on you company set up. Come to the meeting organized with detailed facts and your concerns. If you have suggestions offer them as well. Under the ADA, it prohibits harassment based on disability just as other federal laws prohibit harassment based on race, sex, color, national origin, religion, or age. Harassment is actionable under the ADA when a person is subjected to offensive conduct that is sufficiently severe or pervasive to create a hostile or abusive work environment. Employees who believe that they have been harassed because of cancer may file a charge with the EEOC if you still find your personalized meetings are not resolved to your satisfaction. Keep in mind that the charge must be filed by mail or in person with the local EEOC office within 180 days from the date of the alleged violation.
Patient Advocate Foundation's publication "First My Illness, Now Job Discrimination" is a good resource as well.
New answer by PatientAdvocateFoundation (Organization (Verified)) in topic(s) Workplace Communication, Workplace, Career, Discrimination
1
Answer |
4 months ago
Contact the treating provider/facility billing clerk for clarification of the bill. You may request an itemized statement that breaks down the cost for you to review. If your insured you may also contact the insurer for further clarification on the benefits or lack of. Patient Advocate Foundation has a publication on understanding your explantion of benefits at http://www.patientadvocate.org/index.php?p=441. Coding and Billing errors do occur so if the bills seems questionable and you feel if incorrect dig deeper you may find a simple phone call to the billing department where the claim may recify the situation. If you find these steps are unsuccessful, PAF can also provide assistance in reviewing the bill in question.
Contact the treating provider/facility billing clerk for clarification of the bill. You may request an itemized statement that breaks down the cost for you to review. If your insured you may also contact the insurer for further clarification on the benefits or lack of. Patient Advocate Foundation has a publication on understanding your explantion of benefits at http://www.patientadvocate.org/index.php?p=441. Coding and Billing errors do occur so if the bills seems questionable and you feel if incorrect dig deeper you may find a simple phone call to the billing department where the claim may recify the situation. If you find these steps are unsuccessful, PAF can also provide assistance in reviewing the bill in question.
New answer by PatientAdvocateFoundation (Organization (Verified)) in topic(s) Medical Bill, Payment, Health Care Payments, Medical Payments
1
Answer |
4 months ago
If you have worked at your new employer long enough to accumulate leave time I would utilize vacation, sick or personal days for a scheduled doctor appointment. If you find that you need more then one day or your request are frequent you should discuss with your human resources department your needs to see if accomidations are offered. Maybe you could seek a later afternoon appointment and flex. If you have been employed for at least 12 months and worked enough hours you could be eligible for Family Medical Leave assuming your employer employees the required number of employees (www.dol.gov).
If you have worked at your new employer long enough to accumulate leave time I would utilize vacation, sick or personal days for a scheduled doctor appointment. If you find that you need more then one day or your request are frequent you should discuss with your human resources department your needs to see if accomidations are offered. Maybe you could seek a later afternoon appointment and flex. If you have been employed for at least 12 months and worked enough hours you could be eligible for Family Medical Leave assuming your employer employees the required number of employees (www.dol.gov).
New answer by PatientAdvocateFoundation (Organization (Verified)) in topic(s) Workplace Communication, Workplace, Doctors Appointment, Post Cancer, Career, Work, Workplace Tips, Post Cancer Doctor Appointments
1
Answer |
5 months ago
The following are resources that provide free wigs as well as other items you may find of benefit:
Breast Cancer Network of Strength , formally known as Y-ME helps breast cancer patients and survivors regain their sense of well-being and self-confidence by providing bras, wigs, and/or prostheses at no cost to those with limited financial resources. www.y-me.org or 1-800-221-2141
CancerCare under their Women's Cancer Program, offers financial assistance and counseling, support groups, and patient education. They also provide free wigs and breast prostheses to women who have lost their hair or a breast as a result of their cancer treatment. 1-800-813-HOPE (4673)
Crickett's Answer for Cancer 1-301-935-4411 provides free wigs, mastectomy products, mastectomy and lymphedema massage, facials, and other pampering services, as a way to keep a woman feeling feminine and beautiful despite losing her hair and/or breasts. The Luminous Breast Cancer Foundation offers custom-made wigs for underserved women at no charge. Contact http://LuminousFoundation.org
Breast Cancer Network of Strength , formally known as Y-ME helps breast cancer patients and survivors regain their sense of well-being and self-confidence by providing bras, wigs, and/or prostheses at no cost to those with limited financial resources. www.y-me.org or 1-800-221-2141
CancerCare under their Women's Cancer Program, offers financial assistance and counseling, support groups, and patient education. They also provide free wigs and breast prostheses to women who have lost their hair or a breast as a result of their cancer treatment. 1-800-813-HOPE (4673)
Crickett's Answer for Cancer 1-301-935-4411 provides free wigs, mastectomy products, mastectomy and lymphedema massage, facials, and other pampering services, as a way to keep a woman feeling feminine and beautiful despite losing her hair and/or breasts. The Luminous Breast Cancer Foundation offers custom-made wigs for underserved women at no charge. Contact http://LuminousFoundation.org
New answer by PatientAdvocateFoundation (Organization (Verified)) in topic(s) Chemotherapy Side Effects, Support, Wigs, Chemotherapy Treatments
3
Answers |
5 months ago
The following are resources that provide free breast prostheses:
Breast Cancer Network of Strength , formally known as Y-ME helps breast cancer patients and survivors regain their sense of well-being and self-confidence by providing bras, wigs, and/or prostheses at no cost to those with limited financial resources. www.y-me.org or 1-800-221-2141
CancerCare under their Women's Cancer Program, offers financial assistance and counseling, support groups, and patient education. They also provide free wigs and breast prostheses to women who have lost their hair or a breast as a result of their cancer treatment. 1-800-813-HOPE (4673)
Crickett's Answer for Cancer 1-301-935-4411 provides free wigs, mastectomy products, mastectomy and lymphedema massage, facials, and other pampering services, as a way to keep a woman feeling feminine and beautiful despite losing her hair and/or breasts. The following are resources that provide free breast prostheses:
Breast Cancer Network of Strength , formally known as Y-ME helps breast cancer patients and survivors regain their sense of well-being and self-confidence by providing bras, wigs, and/or prostheses at no cost to those with limited financial resources. www.y-me.org or 1-800-221-2141
CancerCare under their Women's Cancer Program, offers financial assistance and counseling, support groups, and patient education. They also provide free wigs and breast prostheses to women who have lost their hair or a breast as a result of their cancer treatment. 1-800-813-HOPE (4673)
Crickett's Answer for Cancer 1-301-935-4411 provides free wigs, mastectomy products, mastectomy and lymphedema massage, facials, and other pampering services, as a way to keep a woman feeling feminine and beautiful despite losing her hair and/or breasts.
Breast Cancer Network of Strength , formally known as Y-ME helps breast cancer patients and survivors regain their sense of well-being and self-confidence by providing bras, wigs, and/or prostheses at no cost to those with limited financial resources. www.y-me.org or 1-800-221-2141
CancerCare under their Women's Cancer Program, offers financial assistance and counseling, support groups, and patient education. They also provide free wigs and breast prostheses to women who have lost their hair or a breast as a result of their cancer treatment. 1-800-813-HOPE (4673)
Crickett's Answer for Cancer 1-301-935-4411 provides free wigs, mastectomy products, mastectomy and lymphedema massage, facials, and other pampering services, as a way to keep a woman feeling feminine and beautiful despite losing her hair and/or breasts. The following are resources that provide free breast prostheses:
Breast Cancer Network of Strength , formally known as Y-ME helps breast cancer patients and survivors regain their sense of well-being and self-confidence by providing bras, wigs, and/or prostheses at no cost to those with limited financial resources. www.y-me.org or 1-800-221-2141
CancerCare under their Women's Cancer Program, offers financial assistance and counseling, support groups, and patient education. They also provide free wigs and breast prostheses to women who have lost their hair or a breast as a result of their cancer treatment. 1-800-813-HOPE (4673)
Crickett's Answer for Cancer 1-301-935-4411 provides free wigs, mastectomy products, mastectomy and lymphedema massage, facials, and other pampering services, as a way to keep a woman feeling feminine and beautiful despite losing her hair and/or breasts.
New answer by PatientAdvocateFoundation (Organization (Verified)) in topic(s) Breast, Patient Support, Support Organizations, Breast Cancer, Breast Prostheses, Organizations
3
Answers |
5 months ago
The impact on Medicare Part D as a result of healthcare reform provides the following relief, while small a stepping stone to the closure of the gap as anticipated in the year 2020. For this year (2011) manufacturer’s are to offer a 50% discount on brand name prescription drugs and 7% discount on generic prescription drugs. Over the next ten years, Medicare beneficiaries will receive additional savings on brand name and generic drugs until the coverage gap is closed in 2020.
I don’t have concrete evidence based on your message if the medication you have a large out of pocket expense is a result of a grandfathered drug under Part B or more common drug covered under Part D which you must elect to enroll. Either way if you have insurance coverage for the medication I would strongly encourage exploring co-pay relief programs such as our own Co-Pay Relief (www.copays.org) they offer a 12 months look back period if approved, which is especially helpful for money you are out of pocket currently. Other copay programs are Assistance Fund, Cancer Care, Chronic Disease Fund, Inc, Healthwell Foundation, Leukemia and Lymphoma Society, National Organization for Rare Disorders, Patient Access Network Foundation, Patient Advocate Foundation Co-Pay Relief, and Patient Services Incorporated. Qualifiers all vary based on disease, drug, income levels.
Depending on the household income and asset level you should look into programs such as the Medicare Savings Program, there are programs that help millions of people with Medicare save money each year. States have programs for people with limited income and resources that pay some or all of Medicare’s premiums and may pay Medicare deductibles and coinsurance. You can learn more by visiting www.medicare.gov See publication #10126. I have listed below each of the programs. These figures do change each year and can vary per state but the following are for 2011:
QMB- Qualified Medicare Beneficiary - Covers part A and B premiums, and other cost-sharing (like deductibles, coinsurance and co-payments)
• Individual Monthly Income limit $903.50
• Married Couple Monthly Income limit $1215.00
SLMB- Specified Low-Income Medicare Beneficiary -Covers part B premiums only
• Individual Monthly Income limit $1,083.00
• Married Couple Monthly Income limit $1,457.00
QI- Qualifying Individual- Covers part B premiums only
• Individual Monthly Income limit $1219.00
• Married Couple Monthly Income limit $1,640.00
QDWI- Qualified Disabled & Working Individuals-Covers part A premiums only
• Individual Monthly Income limit $1825.00
• Married Couple Monthly Income limit $2448.33
A government program is also available to discount the amount a beneficiary pays for their medications. Eligibility is based on income and assets.
Also referred to as the “Extra Help Program.” The 2011 Guidelines are listed below and help Medicare recipients with premiums, deductibles and co-pays/coinsurance.
• If your yearly earnings and resources are:
• $21,855 married w/resources <$25,010
• $16,245 single w/resources <12,510
• If you qualify, you can enroll into a Medicare part D plan at any time.
o Online at www.socialsecurity.gov
o See publication #11318-AA
Additionally, explore your state to see if they offer a prescription drug program (pays for premiums or discounts.) http://www.rxassist.org/patients/res-state-programs.cfm
You should always review your current Part D or Advantage plan coverage annual during open enrollment to see if you are enrolled in the best cost effective plan as well. PAF case managers are available to provide support as well. I hope this information was helpful.
The impact on Medicare Part D as a result of healthcare reform provides the following relief, while small a stepping stone to the closure of the gap as anticipated in the year 2020. For this year (2011) manufacturer’s are to offer a 50% discount on brand name prescription drugs and 7% discount on generic prescription drugs. Over the next ten years, Medicare beneficiaries will receive additional savings on brand name and generic drugs until the coverage gap is closed in 2020.
I don’t have concrete evidence based on your message if the medication you have a large out of pocket expense is a result of a grandfathered drug under Part B or more common drug covered under Part D which you must elect to enroll. Either way if you have insurance coverage for the medication I would strongly encourage exploring co-pay relief programs such as our own Co-Pay Relief (www.copays.org) they offer a 12 months look back period if approved, which is especially helpful for money you are out of pocket currently. Other copay programs are Assistance Fund, Cancer Care, Chronic Disease Fund, Inc, Healthwell Foundation, Leukemia and Lymphoma Society, National Organization for Rare Disorders, Patient Access Network Foundation, Patient Advocate Foundation Co-Pay Relief, and Patient Services Incorporated. Qualifiers all vary based on disease, drug, income levels.
Depending on the household income and asset level you should look into programs such as the Medicare Savings Program, there are programs that help millions of people with Medicare save money each year. States have programs for people with limited income and resources that pay some or all of Medicare’s premiums and may pay Medicare deductibles and coinsurance. You can learn more by visiting www.medicare.gov See publication #10126. I have listed below each of the programs. These figures do change each year and can vary per state but the following are for 2011:
QMB- Qualified Medicare Beneficiary - Covers part A and B premiums, and other cost-sharing (like deductibles, coinsurance and co-payments)
• Individual Monthly Income limit $903.50
• Married Couple Monthly Income limit $1215.00
SLMB- Specified Low-Income Medicare Beneficiary -Covers part B premiums only
• Individual Monthly Income limit $1,083.00
• Married Couple Monthly Income limit $1,457.00
QI- Qualifying Individual- Covers part B premiums only
• Individual Monthly Income limit $1219.00
• Married Couple Monthly Income limit $1,640.00
QDWI- Qualified Disabled & Working Individuals-Covers part A premiums only
• Individual Monthly Income limit $1825.00
• Married Couple Monthly Income limit $2448.33
A government program is also available to discount the amount a beneficiary pays for their medications. Eligibility is based on income and assets.
Also referred to as the “Extra Help Program.” The 2011 Guidelines are listed below and help Medicare recipients with premiums, deductibles and co-pays/coinsurance.
• If your yearly earnings and resources are:
• $21,855 married w/resources <$25,010
• $16,245 single w/resources <12,510
• If you qualify, you can enroll into a Medicare part D plan at any time.
o Online at www.socialsecurity.gov
o See publication #11318-AA
Additionally, explore your state to see if they offer a prescription drug program (pays for premiums or discounts.) http://www.rxassist.org/patients/res-state-programs.cfm
You should always review your current Part D or Advantage plan coverage annual during open enrollment to see if you are enrolled in the best cost effective plan as well. PAF case managers are available to provide support as well. I hope this information was helpful.
I don’t have concrete evidence based on your message if the medication you have a large out of pocket expense is a result of a grandfathered drug under Part B or more common drug covered under Part D which you must elect to enroll. Either way if you have insurance coverage for the medication I would strongly encourage exploring co-pay relief programs such as our own Co-Pay Relief (www.copays.org) they offer a 12 months look back period if approved, which is especially helpful for money you are out of pocket currently. Other copay programs are Assistance Fund, Cancer Care, Chronic Disease Fund, Inc, Healthwell Foundation, Leukemia and Lymphoma Society, National Organization for Rare Disorders, Patient Access Network Foundation, Patient Advocate Foundation Co-Pay Relief, and Patient Services Incorporated. Qualifiers all vary based on disease, drug, income levels.
Depending on the household income and asset level you should look into programs such as the Medicare Savings Program, there are programs that help millions of people with Medicare save money each year. States have programs for people with limited income and resources that pay some or all of Medicare’s premiums and may pay Medicare deductibles and coinsurance. You can learn more by visiting www.medicare.gov See publication #10126. I have listed below each of the programs. These figures do change each year and can vary per state but the following are for 2011:
QMB- Qualified Medicare Beneficiary - Covers part A and B premiums, and other cost-sharing (like deductibles, coinsurance and co-payments)
• Individual Monthly Income limit $903.50
• Married Couple Monthly Income limit $1215.00
SLMB- Specified Low-Income Medicare Beneficiary -Covers part B premiums only
• Individual Monthly Income limit $1,083.00
• Married Couple Monthly Income limit $1,457.00
QI- Qualifying Individual- Covers part B premiums only
• Individual Monthly Income limit $1219.00
• Married Couple Monthly Income limit $1,640.00
QDWI- Qualified Disabled & Working Individuals-Covers part A premiums only
• Individual Monthly Income limit $1825.00
• Married Couple Monthly Income limit $2448.33
A government program is also available to discount the amount a beneficiary pays for their medications. Eligibility is based on income and assets.
Also referred to as the “Extra Help Program.” The 2011 Guidelines are listed below and help Medicare recipients with premiums, deductibles and co-pays/coinsurance.
• If your yearly earnings and resources are:
• $21,855 married w/resources <$25,010
• $16,245 single w/resources <12,510
• If you qualify, you can enroll into a Medicare part D plan at any time.
o Online at www.socialsecurity.gov
o See publication #11318-AA
Additionally, explore your state to see if they offer a prescription drug program (pays for premiums or discounts.) http://www.rxassist.org/patients/res-state-programs.cfm
You should always review your current Part D or Advantage plan coverage annual during open enrollment to see if you are enrolled in the best cost effective plan as well. PAF case managers are available to provide support as well. I hope this information was helpful.
The impact on Medicare Part D as a result of healthcare reform provides the following relief, while small a stepping stone to the closure of the gap as anticipated in the year 2020. For this year (2011) manufacturer’s are to offer a 50% discount on brand name prescription drugs and 7% discount on generic prescription drugs. Over the next ten years, Medicare beneficiaries will receive additional savings on brand name and generic drugs until the coverage gap is closed in 2020.
I don’t have concrete evidence based on your message if the medication you have a large out of pocket expense is a result of a grandfathered drug under Part B or more common drug covered under Part D which you must elect to enroll. Either way if you have insurance coverage for the medication I would strongly encourage exploring co-pay relief programs such as our own Co-Pay Relief (www.copays.org) they offer a 12 months look back period if approved, which is especially helpful for money you are out of pocket currently. Other copay programs are Assistance Fund, Cancer Care, Chronic Disease Fund, Inc, Healthwell Foundation, Leukemia and Lymphoma Society, National Organization for Rare Disorders, Patient Access Network Foundation, Patient Advocate Foundation Co-Pay Relief, and Patient Services Incorporated. Qualifiers all vary based on disease, drug, income levels.
Depending on the household income and asset level you should look into programs such as the Medicare Savings Program, there are programs that help millions of people with Medicare save money each year. States have programs for people with limited income and resources that pay some or all of Medicare’s premiums and may pay Medicare deductibles and coinsurance. You can learn more by visiting www.medicare.gov See publication #10126. I have listed below each of the programs. These figures do change each year and can vary per state but the following are for 2011:
QMB- Qualified Medicare Beneficiary - Covers part A and B premiums, and other cost-sharing (like deductibles, coinsurance and co-payments)
• Individual Monthly Income limit $903.50
• Married Couple Monthly Income limit $1215.00
SLMB- Specified Low-Income Medicare Beneficiary -Covers part B premiums only
• Individual Monthly Income limit $1,083.00
• Married Couple Monthly Income limit $1,457.00
QI- Qualifying Individual- Covers part B premiums only
• Individual Monthly Income limit $1219.00
• Married Couple Monthly Income limit $1,640.00
QDWI- Qualified Disabled & Working Individuals-Covers part A premiums only
• Individual Monthly Income limit $1825.00
• Married Couple Monthly Income limit $2448.33
A government program is also available to discount the amount a beneficiary pays for their medications. Eligibility is based on income and assets.
Also referred to as the “Extra Help Program.” The 2011 Guidelines are listed below and help Medicare recipients with premiums, deductibles and co-pays/coinsurance.
• If your yearly earnings and resources are:
• $21,855 married w/resources <$25,010
• $16,245 single w/resources <12,510
• If you qualify, you can enroll into a Medicare part D plan at any time.
o Online at www.socialsecurity.gov
o See publication #11318-AA
Additionally, explore your state to see if they offer a prescription drug program (pays for premiums or discounts.) http://www.rxassist.org/patients/res-state-programs.cfm
You should always review your current Part D or Advantage plan coverage annual during open enrollment to see if you are enrolled in the best cost effective plan as well. PAF case managers are available to provide support as well. I hope this information was helpful.
New answer by PatientAdvocateFoundation (Organization (Verified)) in topic(s) Drugs, Medicare, Financial Assistance, Medications
2
Answers |
10 months ago
In our experience medical debt crisis is a large concerns for patients who contact Patient Advocate Foundation. Many cancer patients have inadequate insurance or none at all and due to affordability, pre-existing clauses or a multitude of other reasons find themselves in this situation upon diagnosis. Some of the areas a patient can explore depending on income, asset and qualifiers are to apply for governmental programs such as Medicaid and/or Medicare, obtaining charity care and/or financial assistance through medical facilities, and obtaining necessary medications through prescription assistance programs or other state/national medication assistance programs (www.needymeds.com). Patients can explore clinical trials as a feasible option for access to care as well. It is always important to explore insurance options such as enrolling in plans offered at their own place of employment or their spouses. Children now can remain enrolled or re-enroll in their parents plan up until age 26 under healthcare reform, explore high risk pools or pre-existing health insurance plans (www.pcip.gov) now mandated by healthcare reform in each state, guarantee issues plans, individual/group insurance, and COBRA options. Georgetown University has an excellent website, http://www.healthinsuranceinfo.net that is a state by state consumer guide on how to get and keep health insurance and addresses topics I outlined here.
If the patient is insured is underinsured meaning he/she has health insurance coverage but lacks the financial resources needed to cover out-of-pocket expenses for medical care. Or underinsured when access to medical services is inhibited as the direct result of insurance benefit exclusions the patient can follow the same options as listed above. If they are insured through an employer who offers more than one plan, they should consider switching their benefit plan to a better option come open enrollment or if there has a been a qualifying event. Also there are many co-pay relief programs available such as our own Co-Pay Relief (www.copays.org)that can offer financial relief to qualified patients.
PAF is here to provide support to any patient with cancer who has difficulty accessing care regardless of their insurance status. We can be reached at 800-532-5274.
In our experience medical debt crisis is a large concerns for patients who contact Patient Advocate Foundation. Many cancer patients have inadequate insurance or none at all and due to affordability, pre-existing clauses or a multitude of other reasons find themselves in this situation upon diagnosis. Some of the areas a patient can explore depending on income, asset and qualifiers are to apply for governmental programs such as Medicaid and/or Medicare, obtaining charity care and/or financial assistance through medical facilities, and obtaining necessary medications through prescription assistance programs or other state/national medication assistance programs (www.needymeds.com). Patients can explore clinical trials as a feasible option for access to care as well. It is always important to explore insurance options such as enrolling in plans offered at their own place of employment or their spouses. Children now can remain enrolled or re-enroll in their parents plan up until age 26 under healthcare reform, explore high risk pools or pre-existing health insurance plans (www.pcip.gov) now mandated by healthcare reform in each state, guarantee issues plans, individual/group insurance, and COBRA options. Georgetown University has an excellent website, http://www.healthinsuranceinfo.net that is a state by state consumer guide on how to get and keep health insurance and addresses topics I outlined here.
If the patient is insured is underinsured meaning he/she has health insurance coverage but lacks the financial resources needed to cover out-of-pocket expenses for medical care. Or underinsured when access to medical services is inhibited as the direct result of insurance benefit exclusions the patient can follow the same options as listed above. If they are insured through an employer who offers more than one plan, they should consider switching their benefit plan to a better option come open enrollment or if there has a been a qualifying event. Also there are many co-pay relief programs available such as our own Co-Pay Relief (www.copays.org)that can offer financial relief to qualified patients.
PAF is here to provide support to any patient with cancer who has difficulty accessing care regardless of their insurance status. We can be reached at 800-532-5274.
If the patient is insured is underinsured meaning he/she has health insurance coverage but lacks the financial resources needed to cover out-of-pocket expenses for medical care. Or underinsured when access to medical services is inhibited as the direct result of insurance benefit exclusions the patient can follow the same options as listed above. If they are insured through an employer who offers more than one plan, they should consider switching their benefit plan to a better option come open enrollment or if there has a been a qualifying event. Also there are many co-pay relief programs available such as our own Co-Pay Relief (www.copays.org)that can offer financial relief to qualified patients.
PAF is here to provide support to any patient with cancer who has difficulty accessing care regardless of their insurance status. We can be reached at 800-532-5274.
In our experience medical debt crisis is a large concerns for patients who contact Patient Advocate Foundation. Many cancer patients have inadequate insurance or none at all and due to affordability, pre-existing clauses or a multitude of other reasons find themselves in this situation upon diagnosis. Some of the areas a patient can explore depending on income, asset and qualifiers are to apply for governmental programs such as Medicaid and/or Medicare, obtaining charity care and/or financial assistance through medical facilities, and obtaining necessary medications through prescription assistance programs or other state/national medication assistance programs (www.needymeds.com). Patients can explore clinical trials as a feasible option for access to care as well. It is always important to explore insurance options such as enrolling in plans offered at their own place of employment or their spouses. Children now can remain enrolled or re-enroll in their parents plan up until age 26 under healthcare reform, explore high risk pools or pre-existing health insurance plans (www.pcip.gov) now mandated by healthcare reform in each state, guarantee issues plans, individual/group insurance, and COBRA options. Georgetown University has an excellent website, http://www.healthinsuranceinfo.net that is a state by state consumer guide on how to get and keep health insurance and addresses topics I outlined here.
If the patient is insured is underinsured meaning he/she has health insurance coverage but lacks the financial resources needed to cover out-of-pocket expenses for medical care. Or underinsured when access to medical services is inhibited as the direct result of insurance benefit exclusions the patient can follow the same options as listed above. If they are insured through an employer who offers more than one plan, they should consider switching their benefit plan to a better option come open enrollment or if there has a been a qualifying event. Also there are many co-pay relief programs available such as our own Co-Pay Relief (www.copays.org)that can offer financial relief to qualified patients.
PAF is here to provide support to any patient with cancer who has difficulty accessing care regardless of their insurance status. We can be reached at 800-532-5274.
New answer by PatientAdvocateFoundation (Organization (Verified)) in topic(s) Medicaid, Medicare, Health Insurance, Insurance, No Insurance
2
Answers |
10 months ago
Without specific information on your current health condition, treatment protocol and review of your disability plan, I am not able to tell you if you would qualify for benefits. Each disability plan have their own contract language that dictates benefits offered, when they start and how long and when they continue. Additionally, often the medical support of your treating physician(s) is necessary to support a disability claim. If your treatment and/or side effects are affecting your ability to work, review your plan and discuss going on disability with your provider. File a claim and await a decision. If you do find yourself denied, review the reason why and file an appeal. Patient Advocate Foundation wrote a publication called Your Guide to the Appeal Process available at http://www.patientadvocate.org/index.php?p=489.
Some areas I would request your review are:
1. Does the policy have a waiting period (period of time) before it will allow you to submit a claim?
2. Are there medical requirements you have to meet, i.e, cannot perform your job or ANY job; must be unable to work for at least 6,12 months etc.
3.Do you have/have you applied for disability through work? or if your disease is suspected to bypass a 12 month timeframe for recovery applied for Social Security Disability (www.ssa.gov)?
On a side note, if you are out of work now. Are you currently on medical leave? If your employer has over 50 employees and you have worked there for at least a year you may be eligible for Family Medical Leave Act, which protects your job up to 12 weeks. It’s important to discuss this with your employer to protect your job, and or apply for benefits that you may be entitled to. Some employers will also allow accommodations to work modified schedule or use their FMAA intermediately if working less hours is what you need as well.
I'd be happy to offer additional support if you are willing to share more information. Or you may contact us at 800-532-5274
Without specific information on your current health condition, treatment protocol and review of your disability plan, I am not able to tell you if you would qualify for benefits. Each disability plan have their own contract language that dictates benefits offered, when they start and how long and when they continue. Additionally, often the medical support of your treating physician(s) is necessary to support a disability claim. If your treatment and/or side effects are affecting your ability to work, review your plan and discuss going on disability with your provider. File a claim and await a decision. If you do find yourself denied, review the reason why and file an appeal. Patient Advocate Foundation wrote a publication called Your Guide to the Appeal Process available at http://www.patientadvocate.org/index.php?p=489.
Some areas I would request your review are:
1. Does the policy have a waiting period (period of time) before it will allow you to submit a claim?
2. Are there medical requirements you have to meet, i.e, cannot perform your job or ANY job; must be unable to work for at least 6,12 months etc.
3.Do you have/have you applied for disability through work? or if your disease is suspected to bypass a 12 month timeframe for recovery applied for Social Security Disability (www.ssa.gov)?
On a side note, if you are out of work now. Are you currently on medical leave? If your employer has over 50 employees and you have worked there for at least a year you may be eligible for Family Medical Leave Act, which protects your job up to 12 weeks. It’s important to discuss this with your employer to protect your job, and or apply for benefits that you may be entitled to. Some employers will also allow accommodations to work modified schedule or use their FMAA intermediately if working less hours is what you need as well.
I'd be happy to offer additional support if you are willing to share more information. Or you may contact us at 800-532-5274
Some areas I would request your review are:
1. Does the policy have a waiting period (period of time) before it will allow you to submit a claim?
2. Are there medical requirements you have to meet, i.e, cannot perform your job or ANY job; must be unable to work for at least 6,12 months etc.
3.Do you have/have you applied for disability through work? or if your disease is suspected to bypass a 12 month timeframe for recovery applied for Social Security Disability (www.ssa.gov)?
On a side note, if you are out of work now. Are you currently on medical leave? If your employer has over 50 employees and you have worked there for at least a year you may be eligible for Family Medical Leave Act, which protects your job up to 12 weeks. It’s important to discuss this with your employer to protect your job, and or apply for benefits that you may be entitled to. Some employers will also allow accommodations to work modified schedule or use their FMAA intermediately if working less hours is what you need as well.
I'd be happy to offer additional support if you are willing to share more information. Or you may contact us at 800-532-5274
Without specific information on your current health condition, treatment protocol and review of your disability plan, I am not able to tell you if you would qualify for benefits. Each disability plan have their own contract language that dictates benefits offered, when they start and how long and when they continue. Additionally, often the medical support of your treating physician(s) is necessary to support a disability claim. If your treatment and/or side effects are affecting your ability to work, review your plan and discuss going on disability with your provider. File a claim and await a decision. If you do find yourself denied, review the reason why and file an appeal. Patient Advocate Foundation wrote a publication called Your Guide to the Appeal Process available at http://www.patientadvocate.org/index.php?p=489.
Some areas I would request your review are:
1. Does the policy have a waiting period (period of time) before it will allow you to submit a claim?
2. Are there medical requirements you have to meet, i.e, cannot perform your job or ANY job; must be unable to work for at least 6,12 months etc.
3.Do you have/have you applied for disability through work? or if your disease is suspected to bypass a 12 month timeframe for recovery applied for Social Security Disability (www.ssa.gov)?
On a side note, if you are out of work now. Are you currently on medical leave? If your employer has over 50 employees and you have worked there for at least a year you may be eligible for Family Medical Leave Act, which protects your job up to 12 weeks. It’s important to discuss this with your employer to protect your job, and or apply for benefits that you may be entitled to. Some employers will also allow accommodations to work modified schedule or use their FMAA intermediately if working less hours is what you need as well.
I'd be happy to offer additional support if you are willing to share more information. Or you may contact us at 800-532-5274
New answer by PatientAdvocateFoundation (Organization (Verified)) in topic(s) Work, Employment, Disability Insurance, Insurance Claim, Private Disability Insurance, Insurance, Disability, Chemotherapy
1
Answer |
10 months ago
A law was passed in 1996 to protect individuals who are seeking new employment opportunities or who simply would like to change group health insurance options. The Health Insurance Portability and Accountability Act also known as HIPAA (http://www.dol.gov/ebsa/newsroom/fshipaa.html) will provide anyone who has health insurance for at least 12 months and has had no break in coverage greater then 63 days an opportunity to pick up their new insurance without a pre-existing clause. Since some employers have a waiting period of 3 months before insurance will be in effect, but sure to elect COBRA benefits in the interim. Also under the Patient Protection and Affordabe Care Act, there are provisions in place to remove pre-existing health conditions starting in 2014 for adults and have already impacted those under age 18. (www.insureUStoday.org or www.healthcare.gov) Additionally, each state is mandated to offer a Pre-Existing Insurance Health Plan (www.pcip.gov) for when you are not eligible for other coverage and have had a lapse of 6 months or more.
Life insurance does not have any laws to offer the same protection. This is not an area of specialty for PAF, I recommend you speak to your employer human resource department about conversion opportunities or open enrollment options without medical disclosure requirement at the new employer or even a life insurance agent.
A law was passed in 1996 to protect individuals who are seeking new employment opportunities or who simply would like to change group health insurance options. The Health Insurance Portability and Accountability Act also known as HIPAA (http://www.dol.gov/ebsa/newsroom/fshipaa.html) will provide anyone who has health insurance for at least 12 months and has had no break in coverage greater then 63 days an opportunity to pick up their new insurance without a pre-existing clause. Since some employers have a waiting period of 3 months before insurance will be in effect, but sure to elect COBRA benefits in the interim. Also under the Patient Protection and Affordabe Care Act, there are provisions in place to remove pre-existing health conditions starting in 2014 for adults and have already impacted those under age 18. (www.insureUStoday.org or www.healthcare.gov) Additionally, each state is mandated to offer a Pre-Existing Insurance Health Plan (www.pcip.gov) for when you are not eligible for other coverage and have had a lapse of 6 months or more.
Life insurance does not have any laws to offer the same protection. This is not an area of specialty for PAF, I recommend you speak to your employer human resource department about conversion opportunities or open enrollment options without medical disclosure requirement at the new employer or even a life insurance agent.
Life insurance does not have any laws to offer the same protection. This is not an area of specialty for PAF, I recommend you speak to your employer human resource department about conversion opportunities or open enrollment options without medical disclosure requirement at the new employer or even a life insurance agent.
A law was passed in 1996 to protect individuals who are seeking new employment opportunities or who simply would like to change group health insurance options. The Health Insurance Portability and Accountability Act also known as HIPAA (http://www.dol.gov/ebsa/newsroom/fshipaa.html) will provide anyone who has health insurance for at least 12 months and has had no break in coverage greater then 63 days an opportunity to pick up their new insurance without a pre-existing clause. Since some employers have a waiting period of 3 months before insurance will be in effect, but sure to elect COBRA benefits in the interim. Also under the Patient Protection and Affordabe Care Act, there are provisions in place to remove pre-existing health conditions starting in 2014 for adults and have already impacted those under age 18. (www.insureUStoday.org or www.healthcare.gov) Additionally, each state is mandated to offer a Pre-Existing Insurance Health Plan (www.pcip.gov) for when you are not eligible for other coverage and have had a lapse of 6 months or more.
Life insurance does not have any laws to offer the same protection. This is not an area of specialty for PAF, I recommend you speak to your employer human resource department about conversion opportunities or open enrollment options without medical disclosure requirement at the new employer or even a life insurance agent.
New answer by PatientAdvocateFoundation (Organization (Verified)) in topic(s) Breast Cancer, Medical Insurance, Legal, Insurance, Changing Jobs
1
Answer |
10 months ago
Telling your boss is your personal choice, however there are protections available to you only if they know about your illness and the modifications you need. Depending on how large your company is, you may only have to tell your Human Resources Department and you can specifically ask that they not to share your diagnosis with other co-workers if that is your preference.
Prior to your conversation, talk to your doctor and determine what accommodations if any you will need and be fully prepared for your conversation with a notebook and any medical documentation you may need.
• Several U.S. laws protect people with disabling chronic illness from workplace discrimination.
• Per the Americans with Disabilities Act (ADA), individuals with cancer account for 2.5% of ADA complaints. ADA protects workers against discrimination in the process of hiring, firing, promotions, training opportunities and many other activities. The law also requires that employers make reasonable accommodations, so that people with a disability or disabling chronic illness are able to function in the workplace. Accommodations can include anything from modifying a work schedule to altering the physical workplace to make it accessible.
• And if more time then you have is needed to complete treatment, the Family Medical Leave Act (FMLA) allows employees to take up to 12 weeks of leave in a 12-month period. During this leave, an employee's job is protected and that person must be considered for any promotions he or she might be eligible for. You can take leave in one 12-week block, or it can be taken in smaller increments, as long as the reason for the leave is the same. A parent, child or spouse can also take FMLA leave. You are only eligible for FMLA leave if you have worked with your employer a year and have put in 1,250 hours throughout the previous 12 months. In some rare cases, employers may not be required to provide leave, such as if the company has fewer than 50 employees, but many may still provide it.
• Additionally, some employers have Employee Assistance Programs (EAPs) that help employees deal with personal problems that might affect work and overall well-being. These are private and confidential services.
Many accommodations such as ADA or FMLA leave require application through the your human resources representative.
Telling your boss is your personal choice, however there are protections available to you only if they know about your illness and the modifications you need. Depending on how large your company is, you may only have to tell your Human Resources Department and you can specifically ask that they not to share your diagnosis with other co-workers if that is your preference.
Prior to your conversation, talk to your doctor and determine what accommodations if any you will need and be fully prepared for your conversation with a notebook and any medical documentation you may need.
• Several U.S. laws protect people with disabling chronic illness from workplace discrimination.
• Per the Americans with Disabilities Act (ADA), individuals with cancer account for 2.5% of ADA complaints. ADA protects workers against discrimination in the process of hiring, firing, promotions, training opportunities and many other activities. The law also requires that employers make reasonable accommodations, so that people with a disability or disabling chronic illness are able to function in the workplace. Accommodations can include anything from modifying a work schedule to altering the physical workplace to make it accessible.
• And if more time then you have is needed to complete treatment, the Family Medical Leave Act (FMLA) allows employees to take up to 12 weeks of leave in a 12-month period. During this leave, an employee's job is protected and that person must be considered for any promotions he or she might be eligible for. You can take leave in one 12-week block, or it can be taken in smaller increments, as long as the reason for the leave is the same. A parent, child or spouse can also take FMLA leave. You are only eligible for FMLA leave if you have worked with your employer a year and have put in 1,250 hours throughout the previous 12 months. In some rare cases, employers may not be required to provide leave, such as if the company has fewer than 50 employees, but many may still provide it.
• Additionally, some employers have Employee Assistance Programs (EAPs) that help employees deal with personal problems that might affect work and overall well-being. These are private and confidential services.
Many accommodations such as ADA or FMLA leave require application through the your human resources representative.
Prior to your conversation, talk to your doctor and determine what accommodations if any you will need and be fully prepared for your conversation with a notebook and any medical documentation you may need.
• Several U.S. laws protect people with disabling chronic illness from workplace discrimination.
• Per the Americans with Disabilities Act (ADA), individuals with cancer account for 2.5% of ADA complaints. ADA protects workers against discrimination in the process of hiring, firing, promotions, training opportunities and many other activities. The law also requires that employers make reasonable accommodations, so that people with a disability or disabling chronic illness are able to function in the workplace. Accommodations can include anything from modifying a work schedule to altering the physical workplace to make it accessible.
• And if more time then you have is needed to complete treatment, the Family Medical Leave Act (FMLA) allows employees to take up to 12 weeks of leave in a 12-month period. During this leave, an employee's job is protected and that person must be considered for any promotions he or she might be eligible for. You can take leave in one 12-week block, or it can be taken in smaller increments, as long as the reason for the leave is the same. A parent, child or spouse can also take FMLA leave. You are only eligible for FMLA leave if you have worked with your employer a year and have put in 1,250 hours throughout the previous 12 months. In some rare cases, employers may not be required to provide leave, such as if the company has fewer than 50 employees, but many may still provide it.
• Additionally, some employers have Employee Assistance Programs (EAPs) that help employees deal with personal problems that might affect work and overall well-being. These are private and confidential services.
Many accommodations such as ADA or FMLA leave require application through the your human resources representative.
Telling your boss is your personal choice, however there are protections available to you only if they know about your illness and the modifications you need. Depending on how large your company is, you may only have to tell your Human Resources Department and you can specifically ask that they not to share your diagnosis with other co-workers if that is your preference.
Prior to your conversation, talk to your doctor and determine what accommodations if any you will need and be fully prepared for your conversation with a notebook and any medical documentation you may need.
• Several U.S. laws protect people with disabling chronic illness from workplace discrimination.
• Per the Americans with Disabilities Act (ADA), individuals with cancer account for 2.5% of ADA complaints. ADA protects workers against discrimination in the process of hiring, firing, promotions, training opportunities and many other activities. The law also requires that employers make reasonable accommodations, so that people with a disability or disabling chronic illness are able to function in the workplace. Accommodations can include anything from modifying a work schedule to altering the physical workplace to make it accessible.
• And if more time then you have is needed to complete treatment, the Family Medical Leave Act (FMLA) allows employees to take up to 12 weeks of leave in a 12-month period. During this leave, an employee's job is protected and that person must be considered for any promotions he or she might be eligible for. You can take leave in one 12-week block, or it can be taken in smaller increments, as long as the reason for the leave is the same. A parent, child or spouse can also take FMLA leave. You are only eligible for FMLA leave if you have worked with your employer a year and have put in 1,250 hours throughout the previous 12 months. In some rare cases, employers may not be required to provide leave, such as if the company has fewer than 50 employees, but many may still provide it.
• Additionally, some employers have Employee Assistance Programs (EAPs) that help employees deal with personal problems that might affect work and overall well-being. These are private and confidential services.
Many accommodations such as ADA or FMLA leave require application through the your human resources representative.
New answer by PatientAdvocateFoundation (Organization (Verified)) in topic(s) Communication, Career, Breast Cancer, Work, Cancer
3
Answers |
1 year ago
I believe my boss is discriminating against me at work, but I cannot afford a lawyer, what can I do?
After being diagnosed with any illness, especially cancer, other areas of your life are unfortunately affected as well. When your health does affect your employment, the last thing you expect is to be confronted with harassment or the threat of losing your job, income and health benefits. Our publication, First My Illness, Now Job Discrimination (http://www.patientadvocate.org/index.php?p=122) is designed to empower you to fully understand what your rights are, to assist you with direction in filing a claim of discrimination and to help you deal with job discrimination.
I concur with Tanya's recommendations as documentation of the events you feel are discriminatory is important. Discrimination can come in all forms and if you dealing with needing time off from work to undergo treatment, depending on the size of the employer and how long you have been employeed with them you can qualify for up to 12 weeks of Family Medical Leave (FMLA) allowing you protected time away from work.
If you find that your Human Resources is not helpful or your still having challenges you can file a complaint with the US Equal Employment Opportunity Commission (EEOC) at 800-669-4000 or contact Patient Advocate Foundation at 800-532-5274.
The first thing to do is to document what is happening. What is your boss saying, when it was said and its repercussions should be noted by you.
If your job has a human resources department, contact them with this documentation to inform them what is happening.
LawHelp helps low and moderate income people find free legal aid programs in their communities, and answers to questions about their legal rights. You can check out Lawhelp's website and find free legal aid by clicking on your state. http://www.lawhelp.org/
Since the law varies from state to state, (though the Americans with Disabilities Act (ADA) is a federal law), your state may offer additional forms of legal protection.
I concur with Tanya's recommendations as documentation of the events you feel are discriminatory is important. Discrimination can come in all forms and if you dealing with needing time off from work to undergo treatment, depending on the size of the employer and how long you have been employeed with them you can qualify for up to 12 weeks of Family Medical Leave (FMLA) allowing you protected time away from work.
If you find that your Human Resources is not helpful or your still having challenges you can file a complaint with the US Equal Employment Opportunity Commission (EEOC) at 800-669-4000 or contact Patient Advocate Foundation at 800-532-5274.
The first thing to do is to document what is happening. What is your boss saying, when it was said and its repercussions should be noted by you.
If your job has a human resources department, contact them with this documentation to inform them what is happening.
LawHelp helps low and moderate income people find free legal aid programs in their communities, and answers to questions about their legal rights. You can check out Lawhelp's website and find free legal aid by clicking on your state. http://www.lawhelp.org/
Since the law varies from state to state, (though the Americans with Disabilities Act (ADA) is a federal law), your state may offer additional forms of legal protection.
New answer by PatientAdvocateFoundation (Organization (Verified)) in topic(s) Career, Work, Discrimination, ADA
2
Answers |
1 year ago
SSDI is a federal disability insurance program designed for individuals who have worked enough to earn sufficient "work credits". Under this program monthly payments are based on the individual’s earning record, which is on file with the Social Security Administration.
SSI is a federal financial assistance program which provides monthly payments to individuals who have either never worked or have insufficient credits on their earnings record to qualify for SSDI. SSI recipients are required to have limited financial resources and assets that do not exceed $2,000.00. In 2010, the basic SSI benefit program paid $674.00 per individual or $1,011.00 per couple per month.
SSDI is a federal disability insurance program designed for individuals who have worked enough to earn sufficient "work credits". Under this program monthly payments are based on the individual’s earning record, which is on file with the Social Security Administration.
SSI is a federal financial assistance program which provides monthly payments to individuals who have either never worked or have insufficient credits on their earnings record to qualify for SSDI. SSI recipients are required to have limited financial resources and assets that do not exceed $2,000.00. In 2010, the basic SSI benefit program paid $674.00 per individual or $1,011.00 per couple per month.
SSI is a federal financial assistance program which provides monthly payments to individuals who have either never worked or have insufficient credits on their earnings record to qualify for SSDI. SSI recipients are required to have limited financial resources and assets that do not exceed $2,000.00. In 2010, the basic SSI benefit program paid $674.00 per individual or $1,011.00 per couple per month.
SSDI is a federal disability insurance program designed for individuals who have worked enough to earn sufficient "work credits". Under this program monthly payments are based on the individual’s earning record, which is on file with the Social Security Administration.
SSI is a federal financial assistance program which provides monthly payments to individuals who have either never worked or have insufficient credits on their earnings record to qualify for SSDI. SSI recipients are required to have limited financial resources and assets that do not exceed $2,000.00. In 2010, the basic SSI benefit program paid $674.00 per individual or $1,011.00 per couple per month.
New answer by PatientAdvocateFoundation (Organization (Verified)) in topic(s) Social Security Administration, Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI), Social Security
1
Answer |
1 year ago
There are multiple strategies that may be employed to help with unpaid medical bills. You may want to discuss options with your treatment facilities on ways to reduce or eliminate your out of pocket expenses:
For assistance with Part A or B cost, apply for financial assistance through the billing office at your provider’s office or medical facility.
You may first need to apply and be denied for Medicaid or one its programs, such as Qualified Medicare Beneficiary (QMB) or Specified Low-Income Medicare Beneficiaries (SLMB) Program to qualify for financial assistance from the hospital. To apply contact your State Department of Social Services in the State where you reside.
Co-pay relief programs may be able to cover some of your pharmaceutical co-payments. Check with each program to see what is covered. You can also contact Patient Advocate Foundation’s Co-Pay Relief Program at 1-866-512-3861 to see if you qualify for assistance with your co-payments or explore websites such as www.pparx.org for a list of programs by disease.
Negotiate discounts or payment plans with the hospital or medical provider. Some providers will offer a discount for prompt payment of your balance.
Drug replacement programs may be available to assist you by providing medications to your physician’s office specifically for your use. Discuss these programs with your physician.
Contact a disease specific organization to see if there are any financial grants available to assist you. These programs vary widely and may pay for transportation or other related expenses. Patient Advocate Foundation’s National Underinsured Resource Directory can lead you to the best resources for you needs. Visit http://www.patientadvocate.org/help4u.php
For assistance with Part D cost, apply for Extra Help through www.ssa.gov that offers qualified individuals with extra help to pay for the monthly premiums, annual deductibles, and co-payments related to the Medicare Prescription Drug Program.
Some states offer a State Prescription Assistance Plan. Explore the site http://www.needymeds.org/state_programs.taf to learn more about the your state.
Discuss generic alternatives with your physician if brand named drugs are too costly.
We encourage the review of our publication, A New Approach: A Simple Dialogue between the Patient and Provider about the Cost of Medical Care available at http://www.patientadvocate.org/pdf/pubs/a_new_approach.pdf.
There are multiple strategies that may be employed to help with unpaid medical bills. You may want to discuss options with your treatment facilities on ways to reduce or eliminate your out of pocket expenses:
For assistance with Part A or B cost, apply for financial assistance through the billing office at your provider’s office or medical facility.
You may first need to apply and be denied for Medicaid or one its programs, such as Qualified Medicare Beneficiary (QMB) or Specified Low-Income Medicare Beneficiaries (SLMB) Program to qualify for financial assistance from the hospital. To apply contact your State Department of Social Services in the State where you reside.
Co-pay relief programs may be able to cover some of your pharmaceutical co-payments. Check with each program to see what is covered. You can also contact Patient Advocate Foundation’s Co-Pay Relief Program at 1-866-512-3861 to see if you qualify for assistance with your co-payments or explore websites such as www.pparx.org for a list of programs by disease.
Negotiate discounts or payment plans with the hospital or medical provider. Some providers will offer a discount for prompt payment of your balance.
Drug replacement programs may be available to assist you by providing medications to your physician’s office specifically for your use. Discuss these programs with your physician.
Contact a disease specific organization to see if there are any financial grants available to assist you. These programs vary widely and may pay for transportation or other related expenses. Patient Advocate Foundation’s National Underinsured Resource Directory can lead you to the best resources for you needs. Visit http://www.patientadvocate.org/help4u.php
For assistance with Part D cost, apply for Extra Help through www.ssa.gov that offers qualified individuals with extra help to pay for the monthly premiums, annual deductibles, and co-payments related to the Medicare Prescription Drug Program.
Some states offer a State Prescription Assistance Plan. Explore the site http://www.needymeds.org/state_programs.taf to learn more about the your state.
Discuss generic alternatives with your physician if brand named drugs are too costly.
We encourage the review of our publication, A New Approach: A Simple Dialogue between the Patient and Provider about the Cost of Medical Care available at http://www.patientadvocate.org/pdf/pubs/a_new_approach.pdf.
For assistance with Part A or B cost, apply for financial assistance through the billing office at your provider’s office or medical facility.
You may first need to apply and be denied for Medicaid or one its programs, such as Qualified Medicare Beneficiary (QMB) or Specified Low-Income Medicare Beneficiaries (SLMB) Program to qualify for financial assistance from the hospital. To apply contact your State Department of Social Services in the State where you reside.
Co-pay relief programs may be able to cover some of your pharmaceutical co-payments. Check with each program to see what is covered. You can also contact Patient Advocate Foundation’s Co-Pay Relief Program at 1-866-512-3861 to see if you qualify for assistance with your co-payments or explore websites such as www.pparx.org for a list of programs by disease.
Negotiate discounts or payment plans with the hospital or medical provider. Some providers will offer a discount for prompt payment of your balance.
Drug replacement programs may be available to assist you by providing medications to your physician’s office specifically for your use. Discuss these programs with your physician.
Contact a disease specific organization to see if there are any financial grants available to assist you. These programs vary widely and may pay for transportation or other related expenses. Patient Advocate Foundation’s National Underinsured Resource Directory can lead you to the best resources for you needs. Visit http://www.patientadvocate.org/help4u.php
For assistance with Part D cost, apply for Extra Help through www.ssa.gov that offers qualified individuals with extra help to pay for the monthly premiums, annual deductibles, and co-payments related to the Medicare Prescription Drug Program.
Some states offer a State Prescription Assistance Plan. Explore the site http://www.needymeds.org/state_programs.taf to learn more about the your state.
Discuss generic alternatives with your physician if brand named drugs are too costly.
We encourage the review of our publication, A New Approach: A Simple Dialogue between the Patient and Provider about the Cost of Medical Care available at http://www.patientadvocate.org/pdf/pubs/a_new_approach.pdf.
There are multiple strategies that may be employed to help with unpaid medical bills. You may want to discuss options with your treatment facilities on ways to reduce or eliminate your out of pocket expenses:
For assistance with Part A or B cost, apply for financial assistance through the billing office at your provider’s office or medical facility.
You may first need to apply and be denied for Medicaid or one its programs, such as Qualified Medicare Beneficiary (QMB) or Specified Low-Income Medicare Beneficiaries (SLMB) Program to qualify for financial assistance from the hospital. To apply contact your State Department of Social Services in the State where you reside.
Co-pay relief programs may be able to cover some of your pharmaceutical co-payments. Check with each program to see what is covered. You can also contact Patient Advocate Foundation’s Co-Pay Relief Program at 1-866-512-3861 to see if you qualify for assistance with your co-payments or explore websites such as www.pparx.org for a list of programs by disease.
Negotiate discounts or payment plans with the hospital or medical provider. Some providers will offer a discount for prompt payment of your balance.
Drug replacement programs may be available to assist you by providing medications to your physician’s office specifically for your use. Discuss these programs with your physician.
Contact a disease specific organization to see if there are any financial grants available to assist you. These programs vary widely and may pay for transportation or other related expenses. Patient Advocate Foundation’s National Underinsured Resource Directory can lead you to the best resources for you needs. Visit http://www.patientadvocate.org/help4u.php
For assistance with Part D cost, apply for Extra Help through www.ssa.gov that offers qualified individuals with extra help to pay for the monthly premiums, annual deductibles, and co-payments related to the Medicare Prescription Drug Program.
Some states offer a State Prescription Assistance Plan. Explore the site http://www.needymeds.org/state_programs.taf to learn more about the your state.
Discuss generic alternatives with your physician if brand named drugs are too costly.
We encourage the review of our publication, A New Approach: A Simple Dialogue between the Patient and Provider about the Cost of Medical Care available at http://www.patientadvocate.org/pdf/pubs/a_new_approach.pdf.
New answer by PatientAdvocateFoundation (Organization (Verified)) in topic(s) Financial, Financial Assistance, Medicare, Personal Finance
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1 year ago
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PAF does tremendous work to help thousands of patients with cancer and other life-threatening diseases each year. Battling a serious illness like breast cancer is one thing, but for many patients the administrative, financial and logistical issues they have with insurance reimbursement, their employer and/or hospital or healthcare providers can be overwhelming. PAF is truly the patient’s advocate when a patient or their family may have no other place to turn for help.
PAF has been on the frontline of the healthcare access battle for millions of American patients since 1996 and has been instrumental in documenting the patient experience and translating that into data driven reports that have ultimately impacted dozens of significant healthcare reforms, including the recent elimination of pre-existing condition clauses for children, limitations on out of pocket expenses and the extension of parental insurance benefits to children up to age 26, which were all included in the recent Healthcare Reform Act. Last year alone, PAF received in excess of 4 million contacts from patients, family members and care professionals requesting educational information and direct assistance. Of those contacts, PAF’s professional case managers successfully resolved 82,963 cases for patients that required direct, sustained mediation and arbitration services. PAF also contracts with other national organizations and agencies, such as the American Cancer Society, the Lance Armstrong Foundation, Susan G. Komen for a Cure and the Centers for Disease Control and Prevention to directly handle their most difficult patient cases. Since inception PAF has touched more than 43 million American lives and in many instances, PAF has improved the quality of life and actually saved the lives of thousands of patients.
We believe that it is crucial for patients to know they are not alone in their fight to regain good health. Seventy-one percent of the patients contacting PAF in 2010 were diagnosed with cancer, so we know first-hand the importance of educating cancer patients about their options.
We encourage those facing challenges with obstacles to healthcare including medical debt crisis, insurance access issues and employment issues to contact us for help. www.patientadvocate.org or 1-800-532-5274.