Is There Any Hope for this Guy?

[Cenla Agent]

In every state in which I've ever sold, he won't be able to have anything but Original Medicare.

This guy must be the one person in the USA who is on disability who isn't getting paid under the table.

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Not in TN, but other states, Blue Cross tends to take anybody, especially if he has a letter that he has involuntarily lost his other coverage.

That might be the case with some Blue plans (which ones?) but others underwrite quite stringently. United (AARP) typically has the most liberal underwriting. I don't know if they would take someone with ESRD though. The other variable here is him being U65.

 

[Brian F 11]

I could be wrong, but no one will touch ESRD. With that diagnosis they get additional benefits from Medicare and can not even qualify for an MA Plan.

The only thing I can tell you to do is refer him directly to Medicare. 1-800-Medicare

Sent from my iPhone using InsForums

 

[AllGold]

I have no idea about TN, but in some states a SNP (Special Needs Plan) might be available to cover ESRD. That's probably a no for TN since you haven't heard about it and no one has mentioned it.

Original Medicare DOES cover ESRD but I have no experience with it (because my state does have an ESRD SNP) so I can't say how it would compare to Tenncare.

 

[roadrunner]

I also dwell in TN and yes the Medicaid office is useless.

How often does he receive treatment? Talk to the treatment center, they are usually very helpful in navigating the system.

Spent down with Medical costs of dialysis should take him back on Medicaid.

My mind is thinking.. I thought that when you became ESRD in Tennessee you were placed on TN Care due to Medical reasons, (the cost of treatment runs in the thousands a month) I doubt this guy is pulling in any kind of real $$, as you know they can jump on and off Medicaid every month.

You can always refer him to SHIP. They might be able to help.

I would suggest he call his case worker to see where is income is monthly and yearly. Perhaps working one less hour a week might do the trick.

 

[TN_agent]

Yes, he has been on TNcare for years. Now he has gotten a letter pulling it. He is on dialysis. Not sure if weekly or three times a week or how much kidney function he has (we haven't gotten that far into discussions). I have told him to call his caseworker and ask what needs to happen to get him back on Tncare. He moved from one restaurant to another as far as his job. I want to help the guy, but unless I can sell him something, this is just taking up my time calling around.

Hate to be callous about it like that but losing U65 commissions daily has definitely reduced the amount of time I can devote to charity cases. He is pretty young and not likely to be able to give me referrals. At least I can point him in the right direction.