NJ still in crisis


My state is still in crisis due to the coronavirus. We have over 130,000 new cases and over 8000 deaths. Pretty sobering and quite scary.

My father is in long term care and most of those facilities are being hit hard. My dad’s facility is doing quite well. No residents are sick and the 6 positive employees are quarantined. My dad is 88 and I worry about him and this virus, but out of all the facilities in the state we are one of the few with no cases at all except for 6 employees.

I just switched my medical insurance to Original Medicare, Part D prescriptions and Medicaid. I should now be pretty much covered completely and have benefits I didn’t have before. I can even get hearing aids now. Needed them 10 years ago, but couldn’t afford them. Medicaid covers them. I also now have dental and eye care. They cover dentures and eyeglasses. Two things I need or will need in the case of the dentures in the future. I am also covered for an aide and that will be so much help. I am really struggling right now. I can’t clean or push a vacuum cleaner or change my bed. I grocery shop and do laundry but it is very difficult. I need help showering and dressing among other things of a personal nature. I will get one meal a day provided to me at no cost. This Medicaid program is called MLTSS and is fairly new and I am not sure it is in all states, but it is specifically for the blind, disabled and aged who need nursing home care, but want to stay in their homes. My kids don’t want me living alone, but I am not ready for a nursing home. My dad is in one and he’s 88, but I am only 63. I just have medical issues that I need help with and this program is designed to take care of those issues.

Tessa – 

Advocate for mental health and invisible illnesses, also a devout Christian

Author – http://www.finallyawriter.com (this blog contains my old work mostly although occasionally I do add something new here), new work is mainly on this blog http://www.tessacandoit.com

Author of a book, a work in progress on the blog, https://tessacandoit.com/government-property-a-memoir-as-a-military-wife/

Highlighted chapters are done and ready to be read.

6 thoughts on “NJ still in crisis

  1. morgueticiaatoms

    Glad to hear you’re on a different healthcare program, Medicaid really helps me with the cost of my meds, so hopefully it will help you.

    I watch way too much news and I saw how bad the numbers are in New Jersey. Ilinois just cracked fifty thousand plus last week but everyone thinks they should open stuff back up. It terrifies me. Worse than the virus is going through all of this and learning absolutely nothing from the experience so it repeats.

    Take care of yourself best you can. ❤

    Liked by 1 person

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    1. Tessa Post author

      I know I can’t believe they are opening things up. There is going to be a resurgence of the virus. Can’t they see that?

      Through Medicaid I also get an aide to help with my personal care and my house cleaning, shopping, laundry, cooking etc. 20 hours a week.

      I also get dental including dentures if needed eventually, hearing including hearing aids which I qualified for 10 years ago, but couldn’t afford and eye care with glasses. I am also trying to get a continuous glucose monitor to go with my insulin pump. That is a little harder. Not sure it will be approved although they are set to go through a company that sells their products and takes my insurance so we will see where that goes. As for my meds, they won’t be covering them. I get extra help from medicare and my state so I will be using medicare’s part d program. Zero premium and except for a few meds mostly the inhalation medications for my nebulizer I only pay 1.30 to 3.60 or less. The other meds are on medicares part be so I have to pay 20% and they are expensive. I can’t take the one because it would cost me over $200 a month. So the 3 I am on now cost me $32 a month, but don’t work as well. They cover my medical alert button, incontinence supplies and more. I also get one meal every day supplied by them. There is probably more, but that is all that comes to my mind right now. It is not regular medicaid. It is a special medicaid program for the blind, disabled and aged called MLTSS. This should cut my medical costs way down. Plus I have a case manager just for me (well she has others) but I mean she helps me with the program and get the stuff I need. We have a review every 90 days and then the big one where I have to recertify at the year mark.

      Liked by 1 person

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      1. morgueticiaatoms

        I’d say any help you can get is much needed so sign up for whatever they offer.

        I don’t know what I would do without Medicaid’s extra help, Medicare is useless for my meds. Just 3 of my meds are over $650 a month-and those are the generics.

        Criminal how they get away charging that much for meds and services.

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        1. Tessa Post author

          Medicare gives me extra help and it is through my state. I guess not all states have the same help. Unless it is an inhaled medication or part b I don’t pay more than 3.90 per prescription and most are less than that and some are free. That isn’t counting medicaid as they won’t use my medicaid. Medicaid is my secondary insurance. My extra help even covers my part b premium. Actually my medications did go down when I got medicaid, but they weren’t that bad before medicaid and my extra help also pays for my part d prescription plan premiums.

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          1. morgueticiaatoms

            My Medicare script plan gets processed first but due to out of pocket expenses I can’t pay, Medicaid automatically picks up my med costs for the $1-4 copay. I also get my Medicare premium assistance or I’d never be able to keep my kid sheltered.
            That healthcare is such a luxury makes me sad for this country.

            Liked by 1 person

            Reply
            1. Tessa Post author

              Sounds like you get a lot of what I get in some form or another. I don’t pay for my medicare part d insurance and now I have no copay on part d drugs. My problem is part b drugs. But it seems they just updated that so as long as I use a pharmacy that accepts medicare as payment in full no copay, but they can send it to medicaid if they want to. Still fighting with them about that. I paid for my part b drugs (20%) and they weren’t supposed to charge me that so trying to get a refund, plus make sure they don’t charge me for the next refill. I have complained numerous times and not gotten too far, but this time I got a girl who has worked there for 10 years and she told me almost everyone is new thanks to the virus and she would call medicare’s provider line and find out how to process it so the 20% copay doesn’t show up and then they have to send it to medicaid if they want to get it back. That is of course if it is in their formulary. The only one they sent was not in the formulary so nothing there. I hope she wasn’t just playing along with me to get me out of there. I am still learning my way around the new healthcare I have. They say the dual coverage of Medicare and Medicaid covers almost everything. Guess we will see. I am getting overpayment checks since they lowered my copays for meds to zero and I had already paid them so this new pharmacy owes me since they lowered them to zero on May 1 which is when I started with them. I have gotten 60 plus dollars back so far from my old insurance. I had no idea it had gone down. Medicare is the one who told me when I called about them charging me the 20% and Medicare had sent the claim and said due to my help I don’t owe them that. And they should be sending it to medicaid, but they were refusing. Stupid people.

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