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Don't waste time trying to get benefits you're not eligible for

To the editor,
Mr. Meade, I read with interest your latest article entitled "A few things to ponder". Although I understand what your points are about Social Security and Medicare some of your statements are inaccurate. It was fairly obvious that you weren't familiar with the rules and procedures for applying for SSDI.
First of all, the government has not made it easier for people whose unemployment benefits have run out to get SSDI. Unemployment and SSDI are two separate agencies. Being unemployed is not a qualifying disability. In order to qualify for SSDI you must go through a very lengthy procedure and mountains of documentation to prove your disability makes you incapable of working. In most cases you will be denied the first time. And once you have been found eligible it takes another full six months before you even get your first check. If you go online and research SSDI you will find a list of qualifying disabilities/conditions. The way you worded your statement you implied that people whose unemployment benefits had run out would be found eligible for SSDI and that just isn't necessarily true. You must be disabled by Social Security standards to receive SSDI. I see that as one of those "someone getting something for free" ploys to make the employed have bad feelings toward the disabled — very common occurrence with conservatives.
You then went on to say that these people would then, after 18 months, become eligible for Medicare and get free health care. Not true at all. It is 24 months. And Medicare is not free. Medicare has many parts to it. Part A usually costs a person nothing. They do however have to meet a deductible every year and may have to pay co-insurance for some services. And this is paid at 80 percent insurance and 20% you. Part A is the inpatient hospital insurance, inpatient nursing home care, hospice care, and home health care services. This is that portion of your paycheck over the years that has gone into Social Security. Part B is the medical portion you can PURCHASE. This is not free. You pay a premium. This covers office visits, blood, labs, doctors and services not related to inpatient care in a hospital. In 2013 people with Part B pay a monthly premium of $104.90 for this coverage and this is automatically removed from the Social Security check. In fact when I was working in the private sector I was paying less per month for my health insurance through my employer then I pay Medicare. The difference was I paid higher co-pays. This coverage is like any insurance coverage. You must meet a yearly deductible. Insurance pays 80 percent and you pay 20 percent of covered services. Then you have Part D which is prescription insurance. Parts A & B only cover some medications that are taken as an inpatient. Part D is insurance you BUY to cover the cost of your prescriptions on a co-pay basis. Just like any other insurance you may have had when employed. Right now the monthly premium depends on the company you choose but the average cost is $37.78 per month. In most cases you will pay a co-pay of $2.65 for generic medications and $6.60 for brand name medications if on Medicare. There are some prescriptions that do not have generic equivalents and you may be told to have your doctor authorize a generic brand because the insurance coverage won't pay for it. If there isn't one your doctor will have to call to explain why you need this one.
And you may have missed it but not to long ago there was an article where people from LRGH administration explained in detail how "reasonable and customary rates" were achieved. And, contrary to your statement, both Medicare reps and insurance reps are included in determining these rates. Rates of payments are negotiated every year and they determine the charges doctors, labs, hospitals, etc. charge a person and/or the insurance company. When you get your bill from a hospital or clinic you will see it broken down into three columns: cost, reasonable and customary charges, and patient cost.
You brought up rationing of care. In case you aren't aware that has been going on forever. Insurance companies decide whether or not they will pay for a service. In 2008, I was diagnosed with a brain tumor so large it needed to be removed ASAP. After I had the first operation I received a letter from my private insurance company telling me I could have this operation and that they would pay for it. I was astonished! I called the insurance company and found out that if they had felt another course of treatment should be tried first they would not have paid for the surgery. The reality of my situation was that my life was in the hands of insurance agents not my doctor. So, you see, the insurance companies decided what services you need not your doctor. Oh you can have the operation but the insurance you have been paying for all those years may not fork out a cent in payment. They don't say you can't have the service only that they won't pay for it.
None of this has to do with "ObamaCare". Obviously with your dislike for our president and the health care program, which you have clearly showed for a very long time, you just assumed it did. Didn't bother to research the facts. Which are all online and easily accessible.
The only reason I've bothered to take the time to respond is because your statements may give some people false hope so they spend unnecessary time trying to get benefits they are probably not eligible for.
Nancy Parsons
Laconia
 
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