Need help for medical procedure costs

[Boni]

Hello all:

I'm writing for a friend I have who has IC. She is already on low income Section 8 for housing, food stamps for food and low income heating assistance. She calls me in tears because she is suffering with IC pressure and urgency and does not have any qualified medical treatment available to her except a clinic that has told her not to come back! It seems they can't do anything for her and feel she is to overbearing in her complaints about chronic pain, etc.

I also have IC and it breaks my heart to hear her suffering. She has no meds to take for pain and knew very little about the IC diet until I told her. I told her I would pay for her to see my urologist and will take her, (she has no car).

However, my urologist may want to do a hydrodistention or some other procedure and I will not be able to afford to pay for that for her. I have insurance to cover my needs, she doesn't.

Can anyone advise me as to how I can get her qualified medical help? What do we do? I cannot abandon this woman, she is clinically depressed and suffering. I am trying to encourage her to not give in to IC but it is hard. She is extremely poor and cleans offices for a living. She only makes $129.00 every week!

Any thoughts?

Thanks,

Boni

[dg2901]

You could start by talking to the finance dept at the local hospital; if youre near a teaching hospital this would be even better. Most hospitals have some sort of charity program that patients can apply for.
I think once you start asking questions someone will be able to guide you in the right direction.

good luck
diana

[Babs RN]

Boni,
If she qualifies for all the other assistance, she should qualify for Medicaid I would think. Then her scripts are covered some as well. I don't know a whole lot about this but if she qualifies for everything else, her care should be covered as well.

Hugs,
Barb

[Boni]

Thanks for the help. I know she is 54 yrs. old. I suppose that qualifies her for Medicaid. Do I go with her to her appt with my Urologist, discuss with my Urologist about the hospitals' financial aid plan? I would like to see her get some quality medical help rather than a clinic that seems to be uncooperative toward IC patients. She told me the clinic diagnosed her with Chronic Bladder Inflammation. They did not specifically say Interstitial Cystitus.

I am also thinking that her job cleaning, is exposing her to chemicals which may be causing the chronic symptoms. Is there any way she may be eligible for Disability due to the nature of her job?

Also, my IC consists mostly of burning when I urinate, hers is mostly pressure and urgency. Is there any thing that is specifically the cause of the pressure and urgency? I know that diet has been my biggest culprit. Once i changed my diet the results were astounding. I was no longer acidic in nature on foods and the urine no longer burned. When my pH level is alkaline I am pain free. She however, is in constant pain.

[Babs RN]

Her income qualifies her for medicaid and based on what I see it seems like she would. She can file for SS Disability as well and that qualifies her for Medicare. She does deserve care and I am saddened she is being blown off. Thank goodness for you. She is lucky to know you.

Hugs,
Barb

[Dixiefireball]

if she is able to get those others food stamp, housing, heating help she should have no problem what so ever getting on medicaid. all you would have to do is take her down to the D.S.S department to pick up a form (call first because sometimes the medicaid offices has there on private spots, but most of the time there with D.S.S) she should have no problem with her age factor and the other help she gets from the government the sad part it it can take any where from sixty to ninety days for an answer.
She will need proof of income. proof where she lives such as a light bill, proof she gets help from other sources. S.S.N card. Proof of any other income she had coming in. proof if anyone lives with her how much they make there s.s.n cards I.D what bills they pay etc.
has she signed up for her ssdi? if so she can also get medicare..
but she is under sixty so that still would take two years but medicare should kick in asap and they should also pay back three months.

Also Most hosp has a program to pay for in hosp stays or help paying for surgeries in the hosp. There plan will only pay for what happen at the hosp. It will not cover the cost of the Dr. doing the surgery and so forth.
she would also have to have the surgery done at a hosp. not an out patient surgery center. it can be same day surgery but has to be in a hosp. (i hope that makes since) I only know how S.C laws work in my area. I can't be a 100% sure that is how it works in all states but wouldn't hurt at all to call and see what you may be able to find out.
I would also talk to your Dr. while she is there with you both. Explaning to him you are the one who is paying for her visits she has no inc. You do understand she needs this surgery, but your not sure if you can afford it. Can he help you some how?
See if he works threw a local clinic. if he does he may be able to get her threw the system there and then the state would end up paying the cost of all her Dr. visit and surgeries if she can get in the clinic they will also help pay for her medicine. until she can get help from the medicaid place.
You need to also ask does his office accept medicaid without an second inc. A lot of Dr. office doesn't accept medicaid because they only get paid 0.20 on every dollar. which is truly sad.
if i can be of anymore help to you at all Please send me a Personal P.M and I will try to get up all as much info. for you as i can.
b.t.w. i want to tell you what a good friend you are. you are truly an angel to help your friend like this. You are truly one in a million hon. there is many angels out there i do know this but very few people would take the time to take a friend to a Dr. visit and pay the full cost.
sending you hugs and prayers. Merry Christmas dear.
Rhonda

[ICNDonna]

I agree with what others have said. If she qualifies for other financial help, she should qualify for Medicaid help.

Donna

[JaniceB]

She can apply for Medicaid, but I'm doubtful. Unless its different in every state, from what I have been told by the Medicaid people here, you have to be under 21, over 62, or on disability, to get Medicaid. I have no insurance, and our income is low enough that my 2 year old is on Medicaid, but they will NOT cover myself (or my husband).

I saw a urologist through a hospital program. The hospital I went to calls it "community care" . Almost all hospitals have something like this but you have to ask. She will have to provide up-teen records of proof of income, assets, etc, but then most of the costs should be covered. Like I saw the urologist, the convenient care dr, had my ultrasounds and IVP done at no cost. Its on a sliding fee scale, we happen to qualify for 100% but others may qualify for 80% (so would have to pay 20% of the cost), etc. I still had to pay the radioligists 100% of their bill, though. But I am making payments to them. If she gets on some type of program like this she needs to apply for medicaid anyway. The hospital I went to required a denial letter from Medicaid .

Also, I participated in a study for IC through the NIDDK and got some of my medical care for free this way through a university hospital. (check clinicaltrials.gov)

As for meds - I am getting Elmiron and Vistaril (as well as a NSAID) for free through the patient assistance programs. Check needymeds.com. IT will show you what drugs you can get for free through the different programs and how to apply. Some you can download the forms right from home, then take to your dr to have them fill out their part. Then the drugs are sent to the dr's office (a 3 month supply).

I hope this helps. Please post about the medicaid issue, I am interested to hear what they tell her , I can only tell you of my actual experiences.

Janice


I hope this helps and I hope she can get the help she needs.

[Boni]

Thank you so much all of you for you advice. I know there there has to be a way for her. I keep assuring her that we will find a way and all of you have helped immensely in the process of doing just that. I wish she had internet access to she could come here for help and encouragement.

I will print out your posts and send them to her plus, keep all of you posted.

Again, thanks..

[Dixiefireball]

Please let us know how things come out.

Janices sadly there is diff. rules for diff. states. Here you have to be 21 or under and low income to get medicaid, or be preg. like you said. or disable or have children and have a low income.
at one time. My husband I and all our children (three of them) where on medicaid.
the is a catch in the system in some states if you get goverment help then you are most likely are able to get on medicaid.

Janice it wouldn't hurt if you ask your childs case worker about being low income since you have a child. Now for children you have to be pretty avg in income for them not to get medicaid but for an adult you have to be so low in income you can barely live, because they only count what is coming in not what is going out. its so unfair.
they don't even count the avg. cost of living. for adults to get it even with children but i know it can be done based on income, but the income has to be so low its like no having any at all.

With this lady already on housing, food stamps, getting help with heating and cooling cost. she should have no problem getting it.
there is a website for medicaid (i'm sorry i don't have it on hand) but you should be able to type it in your search engine to find the rules for medicaid in your state. or better yet get your childs medicaid care and call that 800 number on the back and ask them question there more likely to give you the answers your looking for rather then a lazy case worker that doesn't want to do paper work, and I've ran in to a quite of few of those in the pass.) they will tell you No so you want fill out the paper work for them to have to check things out and tell you yes or no.
its a shame how the system work but its mainly because a lot of the workers (not all) don't want to do there jobs.
sending everyone hugs and prayers.
Merry Christmas.
Rhonda

[JaniceB]

Hi Rhonda
Medicaid won't cover me. I was on it while I was pregnant, but they kicked me off when my son was 2 months old, said I did not qualify anymore. The income levels are much higher when you are pregnant or for babies under 1 year old than they are for when you are not pregnant or your children are older. My husband has never qualified. I had to get a Medicaid denial letter from my son's caseworker this summer so that my IVP and other tests were paid for by the Hospital's low income program. It said "there is no state or county program for Janice". I applied for the radiologists "hardship" program, but didn't qualify for that, so I have to pay 100% of their bill. Its just a messed up system if you ask me, LOL.

I'm lucky my son has a good caseworker who is on top of things and nice to work with. But when you fall between the cracks, you fall between the cracks.

I've used needymeds.com for alot of this info. Besides the medication program info you can also look up the programs for your state. Like in our state, if we ever get to where our son will not be on medicaid, he can go on another program with all the same benefits, just that we would pay $10 per month for his coverage. In fact his caseworker said they would automatically enroll him in it so he will not be without coverage. I am fine with that. I wish they had something like that for adults, I would happily pay it. Having my son's coverage is a major relief to me, anyway.

I'm just glad I will (hopefully, still waiting for them) get my medications for free on the drug assistance programs. Otherwise there would be no way I could afford Elmiron.

Thanks Rhonda!
Janice