grayceworks
Well-Known Member
Actually, I think my brain up and left. I just noticed when I click my teeth together, there's an echo in my head.
Wish us luck....
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Lin
Well-Known Member
Ugh I know exactly what you're talking about. I'm on Medicaid, and I'm stuck in this vicious circle. There's no way I can pay for my medical costs without insurance, and if I made too much money I'd lose my Medicaid. So how the eff am I supposed to get back to being self sufficient and get a job/career with health coverage? I'd need to be independently wealthy to make it through the gap between being on Medicaid and getting a job with good enough medical benefits (and that's not even going into the pre existing condition crap). But of course if I was independently wealthy I wouldn't be on or need Medicaid in the first place!
grayceworks
Well-Known Member
Yeah. It was kinda frustrating sitting there in her office yesterday, and trying to tell her how much our medical expenses are, and having her look at us all suspicious-like. And then she said, "Well, I'll just put down 2500 instead." *sigh*
Can't get medicaid. Can't afford an obamacare premium, even with subsidies. Can't keep paying out of pocket. Can't get on disability since I can still sit at a computer. Even if I did, that would cut my income in half, and it would still be 2 years before I will be allowed to get on medicare through them. Dunno.
Got hubby de-stressed about his VA appointment though.
So that's good. Helped to get the doctor doing the exam swapped out.
Can't get medicaid. Can't afford an obamacare premium, even with subsidies. Can't keep paying out of pocket. Can't get on disability since I can still sit at a computer. Even if I did, that would cut my income in half, and it would still be 2 years before I will be allowed to get on medicare through them. Dunno.
Got hubby de-stressed about his VA appointment though.
So that's good. Helped to get the doctor doing the exam swapped out.
grayceworks
Well-Known Member
I think it would be cool if all of us with fibromyalgia, autoimmune stuff, inherited stuff, etc, that can't get individual insurance affordably, would form a "group" and see if we can get a good group rate instead. lol
I finally got to look at some of the health plans available here and for one that covers my doctor and my meds that I need at a decent copay and out of pocket max, after the subsidies and tax credits, would have a premium of $411 monthly. geez. Sure, it's less than I'm paying out of pocket for my prescriptions, but still.
That's what the "Affordable Care" costs after subsidies... those who don't get subsidies are looking at a premium of almost $1k. Craziness.
I still couldn't get signed up on the website. My app is approved, but it won't take me to the health plans. I'm gonna have to call on the phone on Monday for that I guess. I think if I add hubby on the plan, he could cancel his existing private insurance which is costing him $600 a month for less coverage, and then this plan would be much more affordable.
So many people keep asking me, why don't I go on disability instead of trying to work with all my illnesses. Before I told them I'd go crazy sitting around at home all day, and I like to pull my own weight, although, I realize I have been paying IN to that fund for years... but there's just this "stigma" associated with being on disability when you're so young, in the way people look at you. Like the way they look at me when I use the disabled parking spots or the electric shopping carts. I'm sure you know the look. *sigh*
And also, it would cut my current income in half to do that... but at this point, I might actually save money by not working, instead of continuing to try and struggle through and putting myself in the hospital several times a year. If I figure in the extra O2 I have to buy, the transportation to and from work, since I can't drive myself, the extra meds I have to take to make it through a work-day. Actually, I'd just about break even if I went on disability instead. And I'd be healthier and stay out of the hospital easier too, which would be a definite money-saver. lol
I have no idea what I'd do at home all day though. Hmmmm *ponders*
I finally got to look at some of the health plans available here and for one that covers my doctor and my meds that I need at a decent copay and out of pocket max, after the subsidies and tax credits, would have a premium of $411 monthly. geez. Sure, it's less than I'm paying out of pocket for my prescriptions, but still.
That's what the "Affordable Care" costs after subsidies... those who don't get subsidies are looking at a premium of almost $1k. Craziness.
I still couldn't get signed up on the website. My app is approved, but it won't take me to the health plans. I'm gonna have to call on the phone on Monday for that I guess. I think if I add hubby on the plan, he could cancel his existing private insurance which is costing him $600 a month for less coverage, and then this plan would be much more affordable.
So many people keep asking me, why don't I go on disability instead of trying to work with all my illnesses. Before I told them I'd go crazy sitting around at home all day, and I like to pull my own weight, although, I realize I have been paying IN to that fund for years... but there's just this "stigma" associated with being on disability when you're so young, in the way people look at you. Like the way they look at me when I use the disabled parking spots or the electric shopping carts. I'm sure you know the look. *sigh*
And also, it would cut my current income in half to do that... but at this point, I might actually save money by not working, instead of continuing to try and struggle through and putting myself in the hospital several times a year. If I figure in the extra O2 I have to buy, the transportation to and from work, since I can't drive myself, the extra meds I have to take to make it through a work-day. Actually, I'd just about break even if I went on disability instead. And I'd be healthier and stay out of the hospital easier too, which would be a definite money-saver. lol
I have no idea what I'd do at home all day though. Hmmmm *ponders*
grayceworks
Well-Known Member
Well, we did the QTC exam thing yesterday for the VA. Had a former family doc lady for the examiner, who tried to tell hubby everything he did wrong, from choosing the wrong cancer treatments to experiencing the wrong side effects. Geez. I think he and his specialist he's been working with for years now know just a wee bit more about what's going on with his body than a non-specialist who's never seen him before.
Then she tried to say he'd never win his claim, since his PSA was in the 'normal' range, and that she 'sees at least 3 prostate cancer claims per day and the VA never listens to you, and they never listen to me, they just go on test results they already have, and they already have yours here in the file', but that 'she'd do what she could'.
And then she suddenly shut up when he told her that he already HAD won his claim, had already been approved and rated on not only the side effects but the active cancer that the VA had already determined was still active in spite of the 'normal' PSA, and that those test results she was looking at were the ones he brought with him from his doc, done the same day his doc stated his cancer is still active, (they weren't even close to looking like a lab report from Quest Diagnostics who QTC uses for their tests, and she wasn't even looking at the right lab test, she told him a number for his cholesterol, not his PSA) and finally, that this was just a re-exam to see if any new test results showed either remission or worsening of the cancer, and to see if the side effects they'd already rated him on had changed. We weren't there for her to try and prove or disprove a brand new claim. She just turned all red and left the room.
I wonder how many Veteran's with cancer have had their claims screwed up by her attitude and the way she tries to invalidate their diagnosis like she just tried to do.
I really wonder what her report will look like, and I had just gotten hubby calmed down about the whole thing but now he's freaked thinking they're going to try and reduce his benefits if she writes a report anything like the crap she was telling him. Grr.
On a good note, got all the paperwork done with the lawyer about getting all our medical bills discharged. They decided it has to be a ch7 after all because the amount of medical bills is over the limit for a ch13. It will be a huge relief to have that stress gone. Hubby says, well now I can say you're "One in (almost) a Million" lol. Yeah it really was almost that much in hospital bills. Craziness.
Found a health plan we want to sign up for, but the website crashed when we tried to sign up. Submitted our email like it said to, still haven't been told its up and running yet. I'm so impatient lol. I keep checking my email.
Then she tried to say he'd never win his claim, since his PSA was in the 'normal' range, and that she 'sees at least 3 prostate cancer claims per day and the VA never listens to you, and they never listen to me, they just go on test results they already have, and they already have yours here in the file', but that 'she'd do what she could'.
And then she suddenly shut up when he told her that he already HAD won his claim, had already been approved and rated on not only the side effects but the active cancer that the VA had already determined was still active in spite of the 'normal' PSA, and that those test results she was looking at were the ones he brought with him from his doc, done the same day his doc stated his cancer is still active, (they weren't even close to looking like a lab report from Quest Diagnostics who QTC uses for their tests, and she wasn't even looking at the right lab test, she told him a number for his cholesterol, not his PSA) and finally, that this was just a re-exam to see if any new test results showed either remission or worsening of the cancer, and to see if the side effects they'd already rated him on had changed. We weren't there for her to try and prove or disprove a brand new claim. She just turned all red and left the room.
I wonder how many Veteran's with cancer have had their claims screwed up by her attitude and the way she tries to invalidate their diagnosis like she just tried to do.
I really wonder what her report will look like, and I had just gotten hubby calmed down about the whole thing but now he's freaked thinking they're going to try and reduce his benefits if she writes a report anything like the crap she was telling him. Grr.
On a good note, got all the paperwork done with the lawyer about getting all our medical bills discharged. They decided it has to be a ch7 after all because the amount of medical bills is over the limit for a ch13. It will be a huge relief to have that stress gone. Hubby says, well now I can say you're "One in (almost) a Million" lol. Yeah it really was almost that much in hospital bills. Craziness.
Found a health plan we want to sign up for, but the website crashed when we tried to sign up. Submitted our email like it said to, still haven't been told its up and running yet. I'm so impatient lol. I keep checking my email.
SoapAddict415
Well-Known Member
All that talk about ice cream is making want to run out & grab some! My thoughts and prayers are with you too. I went thru a similar situation with my hubby 10 years ago. The VA was wonderful when they gave us our home loan but when he developed lung cancer it was a different story. I hope everything works out for you!
grayceworks
Well-Known Member
Ohhhh. That reminds me, I have some blueberry cheesecake ice cream left in the freezer....
Lin
Well-Known Member
Can I have some ice cream? I just got off the phone about trying to fix my insurance.
Indiana medicaid is split up into multiple programs. One of them is called Care Select, and only those with certain types of chronic health problems are allowed in the program and there are certain reasons why the program is better for them, like they handle certain things for you so you don't have to do it yourself. Only, for my case there are too many negatives like its set up HMO like and more difficult to find providers who accept it. For that reason it doesn't work for me because I have too many specialists and have multiple rare disorders so its incredibly hard to find the RIGHT specialist, especially because for the most part people refuse my case saying its too complicated so I'm stuck with major teaching hospital based physicians. And then once I've found one it usually takes quite a long time for them to become familiar with my case and my disorders because they have to put in extra effort themselves to become educated. At that point, I can't start over its just too much work.
So, every time they ask me if I want to be put into Care Select I decline. However, for the third or fourth time they've put me into it anyway. I have a lot going on right now, I had to miss my appointment with my primary physician because she doesn't take care select and that appointment was pretty important plus there I was supposed to get 2 referrals to new specialists because of one who is a complete **** and the other a second opinion before deciding on what surgery. So I'm pretty effin pissed at the timing of this. Due to paperwork, now that I'm done (hah, I say that like anything is ever "done" with these people) its still going to take TWO WEEKS before I can see my primary while waiting for me to show up as traditional medicaid again.
One of the things I tried to address on the phone was WHY I keep being put into care select again and again. I was told a lot of bogus reasons, along with "you need to talk to x." One was that after re-determining eligibility they decide if people are applicable to the care select program. My redetermination doesn't come until late July. Another is that sometimes people are put in the system and it shows NO program, and so the computer automatically assigns them to something. I have Drs appointments at least weekly, and for them to bill these appointments they must run my number and bill me under a specific plan.
Pièce de résistance though.... Traditional medicaid told me they couldn't help stopping this from happening, I needed to talk to the care select people. Care select people told me they couldn't help and I needed to talk to the advantage enrollment people. Advantage enrollment people told me they couldn't help, I needed to talk to traditional medicaid and do I have something to write the number down on...
Indiana medicaid is split up into multiple programs. One of them is called Care Select, and only those with certain types of chronic health problems are allowed in the program and there are certain reasons why the program is better for them, like they handle certain things for you so you don't have to do it yourself. Only, for my case there are too many negatives like its set up HMO like and more difficult to find providers who accept it. For that reason it doesn't work for me because I have too many specialists and have multiple rare disorders so its incredibly hard to find the RIGHT specialist, especially because for the most part people refuse my case saying its too complicated so I'm stuck with major teaching hospital based physicians. And then once I've found one it usually takes quite a long time for them to become familiar with my case and my disorders because they have to put in extra effort themselves to become educated. At that point, I can't start over its just too much work.
So, every time they ask me if I want to be put into Care Select I decline. However, for the third or fourth time they've put me into it anyway. I have a lot going on right now, I had to miss my appointment with my primary physician because she doesn't take care select and that appointment was pretty important plus there I was supposed to get 2 referrals to new specialists because of one who is a complete **** and the other a second opinion before deciding on what surgery. So I'm pretty effin pissed at the timing of this. Due to paperwork, now that I'm done (hah, I say that like anything is ever "done" with these people) its still going to take TWO WEEKS before I can see my primary while waiting for me to show up as traditional medicaid again.
One of the things I tried to address on the phone was WHY I keep being put into care select again and again. I was told a lot of bogus reasons, along with "you need to talk to x." One was that after re-determining eligibility they decide if people are applicable to the care select program. My redetermination doesn't come until late July. Another is that sometimes people are put in the system and it shows NO program, and so the computer automatically assigns them to something. I have Drs appointments at least weekly, and for them to bill these appointments they must run my number and bill me under a specific plan.
Pièce de résistance though.... Traditional medicaid told me they couldn't help stopping this from happening, I needed to talk to the care select people. Care select people told me they couldn't help and I needed to talk to the advantage enrollment people. Advantage enrollment people told me they couldn't help, I needed to talk to traditional medicaid and do I have something to write the number down on...
grayceworks
Well-Known Member
Lordy lordy lordy. I have been on that merry-go-round before. Both with insurances and with finding the right docs. I've been turned away for having too many complex issues too. I was sooo fortunate to find my primary care doc that I've been with for almost 8 yrs now. Took a while to put together my current team of specialists though.
Here's some ice cream!
Here's some ice cream!
grayceworks
Well-Known Member
Today, I ran out of spoons. *sigh* I'm running on tomorrow's supply of spoons.
goji_fries
Well-Known Member
I jst saw this post, going through something similar. Hope things are liveable and at least one level better for you guys.
