St. Petersburg - "After husband's stroke, a woman finds their health coverage isn't coverage at all"

[TomCADem]

Oops, I should have put this in this forum. The Eric Cantor (GOP) health care plan in action. A man with insurance suffers a stroke, then has to give up most of his pension and go on Medicaid when his insurance benefits ran out.

http://www.tampabay.com/features/humaninterest/article1039160.ece

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She met John Kenny in Germany, a lifetime ago. He was a recent recruit in the U.S. Air Force. She was working at her grandmother's bookshop. He spotted her on a ladder, shelving books — a willowy young woman, taller than he — with the longest legs he had ever seen.

John did four tours in the service, then worked in Tampa's water department. Helga raised their five children. Married 49 years now, they live in Tampa, in a modest home they own outright. They have always had insurance, through the military and city plans. And, for the last few years, Medicare.

Then, the stroke. Now the Kennys are maxed out — their insurance benefits exhausted, their finances wrecked.

Much of the debate about health care reform has centered on the nation's 47 million uninsured. But those pushing the nearly $1 trillion plan are also concerned about families like the Kennys — people who have insurance but find that it runs out or becomes prohibitively expensive when they need it most.

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A few days after Helga learned John's benefits were gone, she arrived at the hospital to find a doctor's order. Her husband had to leave that night.

Social workers had a list of nursing homes with open beds. But many of them had already rejected John. "Unable to accept patient," the forms said. "Insufficient funding. Benefits exhausted."

You'll have to go on Medicaid, Helga was told.

She was appalled. To qualify, she and John would have to transfer most of their pension into a trust fund. Of their $4,300 monthly income, they would have to give up all but $1,352 — barely enough for the car payment, taxes, groceries and the care of their autistic son.

All this so John could go to a nursing home Helga didn't want him to be in.

"I feel like I'm throwing everything we worked for out the door," she would say later. "And I can't tell John. He wouldn't be able to take that."

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[Captain Hilts]

1. Many people don't know they're UNDERinsured. nt

[TheCowsCameHome]

2. At what point does Medicare "max out"?

[enough]

3. These two people are on Medicare. When you sign up for medicare,

it is very clearly spelled out exactly how many days of different kinds of care you will be covered for. (I know this because my husband I recently reached the age and signed up.) It is very clear that you will not be covered indefinitely. I think the problem is that none of us can imagine that we will need more care than that. It seems like a lot of days until you actually face the problem.

Having just gone through several years of my father's Alzheimer's, I am still not clear on the answer to the question: should society take care of those who need total care unlimitedly?

These are more difficult questions than we can imagine until we experience it.

[KamaAina]

4. "All this so John could go to a nursing home Helga didn't want him to be in. "

This is why progressives should support the Community First Choice Option, included in the Senate Finance Committee version of the health care reform package! It would allow John's (and millions of others') Medicaid funding to go to care provided in his -- and Helga's -- home, not a nursing home, which is kind of like a homeless shelter with better landscaping (no privacy, no access to the community, etc.) As it stands, John is entitled to nursing home "care", but the same (and much cheaper!) care in his own home is an option left up to the states. :grr: :banghead:

FREE OUR PEOPLE!

http://www.adapt.org

[virgogal]

5. I'm on Medicare and this lady apparently never read "Medicare and

You",which is sent out every year.

Keeping informed is the best defense.

[mdmc]

6. kick