Question for Anyone That Knows About Medical Disability??

End Stage Renal Disease (ESRD), a need for dialysis, is an automatice disability qualifier for Medicare approval. Her physician (i.e. nurse) should (can) contact a social worker or case manager with a dialysis clinic to assist with Medicare enrollment. There is very little chance that she will be able to afford COBRA plus the co-pays of her existing insurance without hitting the lifetime max in a very short time frame. Please look on line for the OFFICAL Medicare website for a local office and set up and appointment with them as soon as possible. Then get with her physician for a statment of disability as well as her physician orders (current meds, lab work, history and physical, all diagnosis, and her need for dialysis treatment.

This is a very frustrating expereince. Please understand that up front. You need to record all notes and names from all phones calls with their phone numbers and extentions. They will not be forgiving on due dates so have everything in on time if not early. Make copies of everything that you give the office and send it certified. I know it is an added expense but then they can not say that they have not recieved or it wasn't on time.

I was a nursing home administrator for several years. If you have any questions, please PM me. I do not mind helping.

Looks like you received a lot of good info already. I just wanted to add a note about pre existing. Most insurances will waive the pre existing if she has had group health insurance coverage for 1 year or 18 mos (depending on the plan.) So if she has had continuous coverage previously, the new insurance may waive the pre existing period. Once her coverage ends she will be sent a Certificate of Credible Coverage, that her new insurance will need.

I have been working in the health insurance industry for 15 years. I don't know much about disability though.

I'm not sure what the process or rules are. She should call the social security office and they will be able to answer her questions and help fill out a form.

M. i hope this will help. i have been on medical disability since 2/93. i receive medical social security checks every month. its just like social security but it is medical. your sister needs to go see her dr, and have him complete the form to get ss. once that is approved, maybe that will help her financially. you can ask her dr or ss how you can get insurance if you cant afford cobra. maybe medicare or medicade. i also think your employer has to have a min of employees before its a company that gives cobra. i sorry for your sister. im not sure if i helped or not. let me know if you need anything else.

If she is in the Houston area she should looking into getting the Gold Card from the Harris County Hospital district. Like someone else told you, make sure you get all of your paper work in on time, all of the time and don't ever miss an appointment.

Does she have short term disability through her job that she has been at for years. If so she should apply. If she can go on short term they might offer long term disability that she would be able to qualify for once her short term runs out. COBRA is very expensive I know for a fact and if she does not carry cont. coverage they will consider her to have a pre-exisiting condition. She may want to check with medicare and medicaid and see if she would qualify with her condition. Disability is very hard to get approved and they always deny the first time but she has to appeal and keep trying. She can choose COBRA for just her when her ins. terminates and this may help with the expenses and try and find something else for her hubby or other family members. Hope this helps.

Good Luck!