November 22, 2024
Column

Medicare needs heart

My father had a heart transplant not quite seven years ago, the last option for him. He has since received Medicare coverage with Medicaid as his supplementary which has been a lifesaver because he is on numerous medications, which are covered by Medicaid (with a small co-pay).

When you have a transplant you have to be on many medications to prevent rejection and you have to be closely followed by your physician to monitor your medication levels and overall health conditions which means blood work, etc. You are not allowed to take any medication or over-the-counter medication unless it is approved by your physician because you have no immune system and some things interact with your heart transplant medication. My father would not be alive if this was not monitored closely and would not be able to have this done if he did not have Medicare and Medicaid to pay for this because for just one regular month it runs to thousands of dollars. If he has a month with an illness, the bills will run into thousands of dollars.

My mother died several months ago after a short illness. Recently, my father received a letter in the mail from Medicaid stating that since my mother died, he no longer qualifies for Medicaid (he makes too much money). My father has been on disability for over 10 years, his only income. How can that be too much money? So now my father is once again severely depressed and states he now knows he will die because he can in no way afford the medication, doctor, and testing bills.

We are in the process of appealing this decision but have been told by the supervisor of the Ellsworth Division of Human Services that there is nothing that they can do because he is over the income bracket. We have been advised that if he incurs medical expenses totaling $3,860 he can be reviewed and will be allowed to have Medicaid coverage for six months. Does anyone know how to get your prescriptions filled without paying for them up front? Who living on a fixed income has $3,860? We are being sent information on applying for a discount prescription card and have been told by a social worker that with his income it should be no problem for him to qualify. This will be helpful, but with the amount of prescriptions that he has to have monthly it is going to still run into several hundred dollars a month.

How did we get to this point when the only change is that my mother has died? My father is now being subjected to the fact that he can no longer afford his medication or his doctors visits and testing that he requires to live. We thought that since Medicaid had approved the heart transplant that they would continue to follow through with the treatment that goes along with having the transplant. Obviously we were wrong and my father is just an income amount in the Medicaid computer system.

Becky Murphy is a resident of Franklin.


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