DH has had arthritis issues for the past 20+ years, having one total knee replacement in '95. His other knee is now so bad, and so deteriorated that he keeps saying he needs the other knee done. His PCP, Neurologist, and Orthopedic Surgeon all agree with me that his dementia level makes him a very poor candidate for surgery. The intense rehab would go over his head. It happened to my Dad after his total knee replacement (Dad has AD too, and lives in an Alz Care Facility near me). DH was awful after shoulder surgery due to surgical stress and general anesthesia. He was noncompliant, and very, very confused. I am noting DH complains "more" of pain in his knee, and also his lumbar region. Only recently did I consider that his increased pain and stiffness could be in part, due to Risperdal.
DH's Neurologist suggests that controlling the pain with meds is by far the best route if I want to keep DH home. He would be getting a free ride to becoming bedridden if I were to let him get the surgery. A moral dilema: Pain in his legs? Or pain in the butt for me? Can't quit the Risperdal. Without Risperdal giving us peace back in our lives I could not keep him at home and put our two kids through that hell again.
DH is a salaried retiree of General Motors (defense division, not automotive. Salaried, not hourly, so no union protection). July 15 those wonderful, caring GM executives made an announcement to the media of their restructuring decisions, one of which was to cancel all health benefits for their retirees who are Medicare eligible. EFFECTIVE JAN 1, 2009. Yep! learned it on TV. Called GM and they confirmed that since my medicare eligible DH is the "retiree" and he is being cut, so goes the benefits for me, and our two teens. Ain't that nice of them? Our long term, and Extended Care Coverage is G.O.N.E. too!!!!!
None of the chain store $4 RX programs include Risperdal, Aricept, Namenda, or any other AD meds. We will be given $300 extra each month to put toward a medicare supplement plan for DH. The cheapest I've found the meds is mail order with a WA state RX discount card. $1,100 every three months for the three meds DH takes. Yes, its a $500 savings from paying cash, and I'll take it if I have to. But what program is gonna take on DH now? With AD pre-existing, and these meds being so expensive?
I have had to make some huge plans/decisions now about our future. I called the tenant who rents a little bitty house we purchased 5 years ago as an investment. I had hoped to keep it, have rent make the payments and expenses related to it, and when it came MY time to retire I would have built plenty of equity in it. It would become my income since my only job now is caring for DH. I don't have a "retirement." The tenant has wanted to buy the house ever since she began renting 2 years ago. Let me tell ya, I am blessed that she is able, and ever so happy to buy the house from me now. I have decided that the equity I get will go into an special account designated for health care. I'll pay doctor bills and Rx's for the two teens and myself with cash. But I will purchase "Catastrophic" health insurance policy for the kids and I. It would be significantly cheaper than general health insurance, and we'd be OK if we had a major illness or injury requiring hospitalization. All I can do in addition to this is hope that I can find a supplemental policy for DH. And daughter has emotional health issues, sees a psych once every couple of months, and a counsellor every 2-3 weeks, and takes psych meds. I talked to the county health dept about her and might be able to get her a "medical coupon" to help with her expenses. She'll be 18 soon, so may qualify on her own. Her care is really important to me. I had counted on the fact that our benefits through GM were going to cover her until she was 23.
Like the news says, retirements are no longer sacred, and regardless of any promises or contracts signed, corporations are allowed to break them. A friend who worked for United for decades had his retirement taken away only 5 months from retirement. Class action suits were filed and the retirees lost. Ford did similar action a couple years ago. Another friend works for a major paper products mill and says her employer is discussing the same thing. The financial news pundits are warning this is the wave of the future.
Sorry to be an infrequent visitor here lately (been a member from day one) only to pop back in with such depressing stuff.
Anyone have suggestions in addition to what I'm already planning?
New Realm, so sorry this is happening with the benefits. it is happening like you say all over the nation. my DH has a total knee replacement in 95 like yours. the other one is pretty good still but i worry all the time something will happen to it and may be intervention like surgery. (he fell in bathroom a while back) i remember the agony of rehab then he didnt have AD but maybe looking back the morphine/surgery etc made him more susceptible as yrs came. it would be a nightmare to have rehab with an AD and knee replacment is all i can say. i think if it were me, i'd go with the pain management like dr says instead of surgery. what good if he can recoup the new knee but lose more cognitive abilities- maybe including walking itself if the AD worsens with surgery? i hope you can get your house sold and have that cash for use for you and the kids. my best to you in what you decide. divvi
I'll answer the easy question. Avoid surgery at all costs. The anesthesia will put your LO over the edge. He will not be able to comply with rehab and if he injures the new knee he will Be worse off than before. Believe me-I speak from experience-all bad.
So sorry to hear. I suggest we vote for Obama & hope for reformed universal health care. I ordered prescriptions from Canada, which were much cheaper, when Blue X, Blue Shield (Anthem) when they said I did not qualify. It was easy & inexpensive. Hope this helps. I am truly sad to hear what is happening to Americans who have worked their entire lives to be treated this way. THERE OUGHT TO BE A LAW!
Ditto divvi & bluedaze.
Jane, pls. fill her in on the rental house. Thanks. May be in the 5 year look back period.
Before we found we had meds coverage I ordered everything from Canada. It was considerably less expensive and very easy to do on line. Worth checking out.
New Realm, I purchased a Blue Care Network Advantage plan for my wife to supplement Medicare. The cost varies by state and county, but hers is $44.60 per month and includes Part D prescription with no deductible. Her Aricept and Namenda cost $75.00 each for a ninety day supply. You can find more information on the Medicare website (www.medicare.gov) On the front page click on the 2008 Medical Plans and follow the prompts. DickS
I am so sorry this is happening to you, tragic. Where your husband qualifies for medicare, he should also be able to get medicare part D I have been disabled since 99 and couldn't find a company we could afford that covered my meds Part D has been a life saver for me.
I am in a hurry right now but will be back later... oh and no comment on obama LOL
Good to see you here too! Hope you'll also continue to visit Alz.org. I enjoy talking to everyone. Those who care for grandparent, parent, etc. But when it comes to the unique topics of husband and wife I check in here.
I must say I am somewhat relieved to read from some of you that despite the pre-existing AD we should be able to get a supplemental plan for DH. One that includes RX's. That is what scares me the most. RX's. Kids and I will survive.
I just don't relish the thought of going broke from medical expenses. I am interested in all "financial advice." Re the rental house, I believe it would be considered asset regardless if its in the form of equity or cash, wouldn't it? My thinking is I might as well convert equity to cash (liquidatable) rather than leave it in the house. Anything could happen there. Lose a renter, lose the house to fire or anything else. Personally, I'm thinking being a landlady (tenant, agency fees, insurance, responsibilities) is not something I need to continue doing. It's a decisions I've had in the back of my mind even before this health insurance issue. The recent revelations just made the decision a little easier.
Sorry I had to take off earlier, Lynn wanted his second dinner thus far this evening ...can't keep him waiting LOL As to the other forum, I was left with a bad taste in my mouth over the whole medication debate. I had been lurking here for months, and decided I would give it a try... very glad I did and thank you JAB!! I do like some of the people there, so I might pop in from time to time. Yes I agree it is much different when it is your spouse.
I really have no advice on the rental property, but I know Jane who posts here has a lot of valuable information, maybe she can help you. I can see where the added stress of the property would be a bit too much with a plate as full as yours!
I was thinking about all the therapy needed after a knee surgery (i had one, but not a whole replacement) I can't imagine Lynn ever being able to do that! Like you said, it would be too much for them to understand. And if your husband is anything like mine, he would fight me all the way...eeeek! I am glad you have a surgeon who could see through the profit lost and did what was in the best interest of your family. Rare indeed.
Again, so sorry you are having to face this on top of all you are already dealing with. Thinking of you, Nikki
I appreciate all the replies. I am just so sad to hear of this happening to people. Stripping people of their hard earned retirements and benefits is so widespread. People give loyalty and deserve it in return. But no.......... corporate America is not teaching our youngsters much about commitments, loyalty, and dedication.
Since your husband has been on a good health insurance plan, no plan can refuse to accept him, whether it's Medigap or Medicare Part D. You just have to apply within a certain amount of time after he loses the GM insurance.
Have you used the "personal calculator" at the Medicare site to find the Medicare Part D plan that's best for your husband? You enter all his meds, current dosage, zip code, etc, and they pull up every plan available in your area with the average monthly cost for each plan after everything (premiums, co-pays, "gap" expenses, etc) has been taken into account. It also shows what your first year's cost will be (since you're going on a new plan mid-year, you probably won't hit the "gap".)
You can also research the Medigap plans there pretty effectively. The best one I found for my husband was through USAA. Turns out they accept non-military for health insurance. That's a good company with an excellent reputation. They offer Medicare Part D through Humana, which also turned out to be best, given my husband's meds.
Also, have you checked into:
www.needymeds.com
for information on getting financial assistance for meds (your entire family, not necessarily just your husband.)
New Realm - this disease is bad enough without having to deal with the insurance companies. I have never understood how it could be legal to renig on retirement agreements. My widows benefits were reduced from 60% to 59% of my deceased spouse's income - it made a little bit of difference to me, and probably saved civil service billions! Still, I don't understand why there aren't successful lawyers out there to defend and win these cases. My DH complains about his knee and I just listen. There is no way we could address knee replacement at this point of the journey. I just feel lucky his gallbladder can be removed so easily - it seems, anyway. I thought I read something about Canada getting tired of selling prescription drugs to Americans because their drugs are subsidized, but I might be wrong on that. As we say - Jane probably knows! There is that 'happy van' that goes around America giving drugs away to those who can't afford it - everytime I see that ad I have to laugh. I'd like to know someone who benefited from a drug company give away...
Regarding cancelling retirees insurance coverage: I think that those who have already retired should be grandfathered to prevent the catastrophic financial situation that they are placing thousands of hard working people! I wish there was some way of fighting it for those who are effected.
I agree, Mary. We worked for SWBell/SBC for years & now it's AT&T. We've "heard rumors" that the same thing New Realm spoke of with GM retirees may also be happening to us.
Thanks to ALL of you for all the info on the Medicare part D stuff for meds. I am only 48 & will need insurance at some point -- not sure what I will do. DH currently has medicare with his "retiree" insurance via United Health Care as his supplemental. I am a dependent, so all of mine goes thru UHC. I am healthy, thankfully, but you never know. And, we pay about $320 per mth for the UHC part too! Plus a $2200 deductible each year...they pay nothing until we meet that deductible, but with some of DH's Alz meds, that $2200 gets met pretty quickly.
As for the "rehab" of the knee, I can tell you, New Realm, that my DH had a shoulder problem & we tried to get him therapy...he absolutely could not understand what was being asked of him. They also wanted me to work with him at home doing the exercises...very hard and put alot of stress on us, because as y'all may know, they really don't like us "telling them" what to do, or when to do it. My DH ended up getting cortizone shots & that helped him alot! No more pain! At least for now. And the dr. said to just return if we needed to. That was back in February I think.
As for the "stress" of keeping up with things that need maintenance, well, one home is enough for me to try to keep up with, let alone two. We have gotten rid of a 2nd car and LOTS of things that I just think we don't need for "me" to keep up with. Full-time care-giving IS a job & the stress levels leave little room for additional stress caused by other stuff to try to keep up with. Heck, I can't imagine being a landlord for another property right now. I hope you are able to sell the house, esp considering the current market. It's good that you have a prospective buyer.
Speaking of deductibles, my husband changed his Anthem Blue X, Blue Shield to a $5,000 deductible to save $100 per month. He doesn't have $5,000. That's pretty scary.
i have a 2500 ded on bluecross for my own insurance. its costing an arm and leg to keep it up as i dont qualify for any reg insur due to mitral valve issue when i used fenfen -my last eccho in oct said it all looked the same and the dr said nothing 'scary' so i may be able at some point to try for some different coverage but it will be dicey. i cant imagine paying 600/mo with 2500 deb til i can get medicare -divvi 5000k deduct is going to be very tuff when he needs doctors later.
I had a $750 deductible policy for the 18 months between retirement and Medicare. I think you only save money on these policies if you don't actually need medical care. I used up the deductible both years, by the way, even though I put off surgery and some tests until after Medicare kicked in. You need to figure out how much you are actually paying, after you've paid out the deductible to know if that policy is saving you money.
One of the things that surprised me what the insurance company basically telling some of my providers, oh no you don't with the higher bills. Even though I was doing the paying, they were giving me insurance level costs instead of the uninsured costs.