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!"

Pincushion day

This morning I had my lumbar MRI. I haven't heard otherwise so I'm guessing the x-rays ruled out tumor etc. since I got the call to come in for an MRI. They ordered it without contrast but once the people at the imaging center saw how many spinal surgeries I've had, they showed the doc in charge and he did an override. So, contrast it was.

We headed over to my clinical trial check-up. I didn't realize visit 4 was a labs day. So, there went some blood. The lady didn't do as nice a job as the MRI girl, constantly shifting the needle around, wiggling it, pushing and pulling, trying to get me to bleed. Anyone who knows me knows I bleed like a stuck pig and my draws are notoriously easy...if you know what you're doing.

My chair is going to take longer than expected; it has an expected ship date of July 2.

I hate being stuck in this situation. I need all my brain stuff replaced, need my right subclavian artery fixed, and God only knows what I've messed up in my lumbar where they did the L2-3-4-5 laminectomies, tumor removal, and filum terminale release (followed by 4 month leak).

And of course I was denied a Medigap supplement by the only company that offers one here. Screwed. We can't pay 20% of all of those surgeries, not again. Not an option. Just doesn't seem right to live in America and not be able to get the care needed to live.

Methadone & Medigap

I saw Pain Man on Thursday and thanks to a combination of sleep deprivation, exhaustion, mind-boggling pain, and desperation, he ended up sitting with me for 40 minutes while I cried. Long story short, my current meds schedule (narcotics & muscle relaxers every 4 hours around the clock) is staying the same, but we added Methadone. Hopefully adding the latter to my regular dosage of other opioids will help take the edge off.

So far, there isn't any pain relief with the Methadone but I have been getting some rest here and there. It really isn't at night, which is nothing new, but instead I'm getting an hour here and there. I'm not complaining, I'm grateful. Those couple hours are already making a big difference in my mindset. It takes 5-7 days for the Methadone to build up in the body and reach the level it will stay at, and I only started taking it Friday night so I still have several days to go before I may see a difference in the pain.

On day 8 I add an additional dose at mid-day so I guess I'll go through another adjustment period. But if it works, that's ok.

I am currently in underwriting for a Medigap policy. I don't know how we're going to go without the $184 a month, that's more than our monthly grocery budget, but it's a necessary evil since the only other option is their no-deductible policy, which is $345 a month (the 184 a month has a $1900 deductible). I hope it'll come through and be approved--of course they had to ask if I had any brain disorders--as I need my CCF redone and extended, and it's looking like I'll need the right side taken care of for the bilateral arterial TOS. I knew it would have to come sooner or later but I was hoping for later! I think I ended up accelerating it a bit with all the crocheting I'm doing, but such is life. I'm not giving up my sanity saver.

Oh and boy has this been a great year for contests around here! I won those NHRA drag racing championships tickets a couple months ago, and last week DH won Rage in the Cage tickets! We are so excited! It's this Saturday. It's going to be awesome!