I have been diagnosed with ESRD and will need a transplant.
I haven’t yet applied for Medicare.
Can I get a Covered CA – QHP- Qualified Health Plan – ObamaCare instead?
If you have Kidney Disease ESRD and haven’t applied for Medicare your eligible for premium tax credits if your income is between 100% and 400% (600% in CA) of the federal poverty limit (FPL).
You can get Covered CA, instead of enrolling in Medicare.
If you are considering a Covered CA plan or direct instead of Medicare you should carefully compare all the costs and benefits associated with both a QHP and Medicare before making your decision.
Please read the answer to #5 and 6. If you do not enroll in Medicare Part A before you have a transplant, you will not be eligible for Medicare’s immunosuppressive medication benefit under Part B, even if you decide to enroll in Medicare later.
You cannot buy additional coverage through Covered California
if you have premium-free Medicare Part A Hospital
Policies sold through Covered California are intended to be primary coverage. Medicare is your primary coverage, and it is illegal for anyone to sell you coverage that duplicates your Medicare benefits.
NOTE: This information also applies to people younger than 65 whose benefits begin the first month they receive disability benefits because they have Amyotrophic Lateral Sclerosis (ALS), better known as Lou Gehrig’s Disease, and to people younger than 65 who have Medicare because of a disability and are receiving Social Security Disability Insurance.
Medicare Publication # 11694 Medicare & Covered CA
Scan Foundation Summary on Chronic Care Act
home-delivered meals, transportation for nonmedical needs, pest control, indoor air quality equipment (e.g., air conditioner for someone with asthma), and minor home modifications (e.g., permanent ramps, widening of hallways or doorways to accommodate wheelchairs). Listening
telehealth is the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration. Technologies include videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.
Telehealth is different from telemedicine because it refers to a broader scope of remote healthcare services than telemedicine. While telemedicine refers specifically to remote clinical services, telehealth can refer to remote non-clinical services, such as provider training, administrative meetings, and continuing medical education, in addition to clinical services.
Average Billed Charges – 2017 Transplant
Kidney – $414k
click to enlarge and view course CA Health Line.org
Medicare and/or/vs Covered CA
Publication # 11694