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

[TomCADem]

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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[BlooInBloo]

1. Sigh. The same story. Over and over and over and over.

[donco6]

2. No matter how well you plan -

- this is the ultimate end for most of us.

[geckosfeet]

3. Hear this. More 50% of personal bankruptcies are due to medical expenses.

Over 75% of that 50% had health insurance at the onset of the incident.

This and the fact that over 44,000 Americans a year die from lack of health care, and 44,000,000 Americans are uninsured should be enough for any sane society to say enough is enough.

[napi21]

4. Does Medicare have a max that they will pay? I didn't know that.

I know they only pay for a certain # of days in the hospital, but I think it's quite a few...150 or something like that.

[GCP]

18. Medicare only pays for acute care

When a condition becomes chronic, it will not pay for long term care. If he got pneumonia, for instance, Medicare would pay because it's considered a short term illness.
Unfortunately many old people come to this - either they can pay for private duty help in the home, or a nursing home (which is hugely expensive), or they have to 'pay down', IOW get rid of assets and give up a lot of income to the nursing home before Medicaid will kick in.
At least they don't (yet) demand that the other spouse gives up the home.

[Orangepeel]

5. I don't understand. Does medicare have a lifetime cap?

This article makes it sound like it does.

[Historic NY]

6. REPUBLICAN Death panels take away your money so in the end you die.

[Zoeisright]

11. +1

And that's what they want.

[TheCowsCameHome]

7. Is this a case of them not having supplemental Medicare insurance?

It sounds like it could be the reason, but I'm not sure.

[DURHAM D]

8. Sounds like it.

I don't think most people understand that this can happen without a supplemental. I don't think anyone under 65 knows how expensive they are. BTW, the supplemental cost varies tremendously by what state you live in.

[GCP]

19. No, it's not related

See above post. Medicare only pays for acute illness, and so does the supplemental insurance. What's needed is long term care insurance - but that's a minefield in itself, figuring out what they will and won't cover.

[FlaGranny]

9. This man is a veteran.

He should be able to get VA care. His current medical expenses could bring down his priority rating to a level where he would be eligible and could afford the VA nursing home. The maximum charge for that is $97 a day, but the first 21 days are free. I wonder if anyone has suggested that to them. There is a VA hospital/nursing home in Tampa.

[Cha]

12. It seems strange to me

that he's a Vet and has to go on Medicare!

[FlaGranny]

17. Not all vets are eligible for VA care.

If there is no service connected disability, there is a "means test" that determines eligibility. It is recommended that most veterans take Social Security when they don't meet eligibility or someday might lose eligibility. The man in this story is well over the income limits for eligibility and possibly for assets, but the VA can and does make exceptions for hardship, and the man's medical condition and expenses very well might be enough to put him into an eligible category or get him "special dispensation" for hardship.

My husband was under VA care for about 5 years and he really was pleased with the care he got. He was able to get a "special dispensation" because he was diagnosed with cancer and we had no medical insurance. He's now on a Medicare HMO and goes to a private physician, but he is now completely eligible for VA care and is thinking about going back there although it is a 20-mile trip instead of a 2-mile trip to the private doctor.

[ThomCat]

10. Many don't realize that there are Maximum Caps on most Insurance Policies.

If you really need your insurance, it will run out and you will have no insurance exactly when you need it most.

In what civilized nation would your healthcare run out when you need it most?

"I'm sorry, you've used your lifetime allotment of healthcare. Please die now."

[Rosa Luxemburg]

13. relatives and friends have to start protesting!

camp outside Cantor's door

[Avalux]

14. Fuck. I want Obama to use these cases to his advantage.

Why not? If it gets us what we need to save lives, tug at people's heartstrings, DO IT!

I am at a loss why the WH isn't doing this.

[MadMaddie]

15. Unbelievable and trajic. They work their whole lives and

contribute to society and then they get sick and this is what happens.


This makes me so disgusted with the soft Dems in Congress, these are the people they should be fighting for.

[ind_thinker2]

16. sorry to hear this tragedy