Tuesday, July 1, 2008

The Dying Medicare Population

I've spent days in chaos via cell phone dealing with the state insurance program. My family is actually supposed to be automatically disqualified because my husband is a state employee (state trooper). Funny how they seem to think state employees must right away get good insurance; interest, since their self-funded insurance is not accountable to the state medical board or the dept of labor, so they can (and do) deny policies to anyone they damn well please. That includes me. They can also put notes on files saying to never pay claims of certain policyholders, to always deny them, and the boards can't do damn thing about it.

So I have Medicare and only Medicare which you already know. While in the hospital for 6 days a month ago the staff said to not worry about the state employee thing and required that I complete the application. I spent days on it, even one night spending a very painful 4 hours sitting up in a chair photocopying medical bills from the assigned two-month period. Yeah, there are that many and it doesn't matter what 2 month period they were to pick; it would all be the same.

I spoke to several people yesterday at the aid office who tried to figure out why my household showed 3 people instead of 4 (my daughter was missing), and 0.00 were allowed in medical expenses. "We can only count medical bills you MUST pay. Please speak with INSURANCE CARRIER to determine what you are responsible for."

Today I learned medical bills aren't counted at all.

Are not COUNTED?

What the FUCK?

(Sorry, if you know me personally you probably just had a heart attack by me typing that but there's no other suitable word I can pull out of my boiling soul right now.)

For Medicare patients, the state insurance assistance laws only allow them to count the premium that is taken out of our monthly Social Security Disability payment.

It didn't matter ultimately that they missed processing my daughter so we are down as a household of 3 (and much lowered the income guideline).

I became so angry I ended up crying like a baby, scared an employee half to death who transferred to me with no warning someone else.

Upon being asked what they COULD count if they can't include medical bills like 20% of 14 surgeries at typically $300,000 each (not including flights, hotels, transportation & food)?

They grew quiet by this point and apologized a few times, saying they wished there was something they could do.

There is an entire generation of people who had to go on SSDI in our 20's through no fault of our own, and we are turned down regularly by Medigap companies simply because of our age. I know full-well they deny us because obviously being approved in our 20's means there's something really wrong and if they were to provide us Medigap, they would have a great amount of expenses for the long-term.

And it's killing us and no one cares. How many besides me are also in need of surgery (in my case, plural) and they can't happen because of how the insurance industry in this country has gone from assuring us we would be taken care of to an attitude of "Fuck you, I'll deny you and approve some healthy person who will only have minimal cost to me so I can line my pockets some more!"

3 comments:

  1. sweetie i am so sorry they are such assholes(oops did i say a bad word hehe i don;t normally but in this case if the shoe fits ....) i have been very blessed with having the ins i do because while we pay for it monthly they cover sooo much more than i could afford. i find it outrageous that this country treats the very people who will be our leaders in a few years this way, because your young doesn;'t mean that you shoould not be given the treatment if anything it means you SHOULD . is there a study anywhere that maybe you could get on i know you research till your fingers turn blue cause thats how you are(and its a good thing) but i am wracking my brain to see what can be done. i am going to write to my senators and congressmen also , because is not just the state you live in. what would they do if you were not married? would they have to pay for it then? with medicade?is pretty sad that you have to suffer while the ins morons just keep racking up the profits. i am blessed to have the ins i have but i know when my hubby retires we will probably have to get a divorce in order for me to be abvkle to pay for my meds as they don't want to now but they do without griping, i wish there was something my friend i could do for you. i guess just pray you receive a miracle wether its a ins co that will pay or the all mighty one either way hope something changes soon if i can do ANYTHING keesh you know i am here for you my friend hugs and gentle squeezes. am plotting on your tote bag for your chair. any helpful hints? love ya honey take care

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  2. sweetie i am so sorry they are such assholes(oops did i say a bad word hehe i don;t normally but in this case if the shoe fits ....) i have been very blessed with having the ins i do because while we pay for it monthly they cover sooo much more than i could afford. i find it outrageous that this country treats the very people who will be our leaders in a few years this way, because your young doesn;'t mean that you shoould not be given the treatment if anything it means you SHOULD . is there a study anywhere that maybe you could get on i know you research till your fingers turn blue cause thats how you are(and its a good thing) but i am wracking my brain to see what can be done. i am going to write to my senators and congressmen also , because is not just the state you live in. what would they do if you were not married? would they have to pay for it then? with medicade?is pretty sad that you have to suffer while the ins morons just keep racking up the profits. i am blessed to have the ins i have but i know when my hubby retires we will probably have to get a divorce in order for me to be abvkle to pay for my meds as they don't want to now but they do without griping, i wish there was something my friend i could do for you. i guess just pray you receive a miracle wether its a ins co that will pay or the all mighty one either way hope something changes soon if i can do ANYTHING keesh you know i am here for you my friend hugs and gentle squeezes. am plotting on your tote bag for your chair. any helpful hints? love ya honey take care

    ReplyDelete
  3. Keesha,
    I have nothing to add to the insurance quandary... They are a business like anyother, run for the sole purpose of making miney from someone else's work... and for the greed of the owners. It is disgusting. I pray that some lyoung people who find themselves in situations like yours, where the outrageous costs of care are far beyond reasonable, and the need is great.
    On another thread, ( gloves), being a new wheelchair user, you might find a lot of interesting stuff on Dom's website ( www.extremeabilities). he and my daughter backpacked across europe last summer, and they checked out bike stores throughout Amsterdam, Paris, etc, in search of reasonably priced wheel chair parts. etc... like a replacement tire when he got a flat on the Spanish Stairs....Bike tire fit perfectly at 10% of the cost.... Pleae keep that source in mind. egislator will take compassion on the Maureen

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