| medicaid question |
[Sep. 17th, 2009|10:33 am] |
Can someone qualify for medicaid if they already have insurance (that is to say, as secondary insurance if they're covered under a spouse's policy)?
*disclaimer - not for myself, I'm asking for a friend, she's been diagnosed with MS. I'm assuming she'll get the answer from a gov't agency eventually. I've just never heard of such a thing, I thought it was for people who didn't have insurance* |
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| Newbie with a question |
[Jul. 25th, 2009|04:01 pm] |
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Hello all! I have been having abdominal pains mixed with constipation. I got an x-ray done, and in the results the doctor said no evidence of bowel obstruction. Their impression was: "non-obstructive bowel gas pattern." I have tried my google ninja skills, and have not gotten any sort of idea what that is. Anybody here have a clue? Thanks! |
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| Swine flu update |
[Apr. 29th, 2009|11:25 pm] |
I apologize for being too sick to cut and paste (I've got acute bronchitis and could not be more tired.) But I want to get info out there! Excuse the chatty blog entry, too, please :) |
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| Insurance deductibles |
[Feb. 16th, 2009|02:44 pm] |
I recently posted here regarding my anxiety/depression medications. So I'm back on Lexapro, but according to my insurance..Lexapro is regular $105, with insurance $91 and change. Some co workers have been telling me that I have a deductible of like $150. Once I spend that on prescriptions it should be cheaper. I'm like wth?! $91 on 30 pills..Anyone heard of this before? |
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| Scary! |
[Jan. 28th, 2009|12:27 am] |
I'm trying to remember when in the Presidential race it was that some dim bulb in the McCain camp said that Americans do not need to enact universal health care, since in his mind we already have it, since we can go to hospital emergency rooms. I remember being shocked that anyone these days would not know what a terrible and expensive misallocation of scarce resources it would be if all of the people uncovered and undercovered by health insurance now would use ERs for all of their medical care. And the bill we would all rack up....
Anyway, what I did not know is that in my very own bankrupt state, the emergency rooms were already facing, well, an emergency:
http://www.latimes.com/news/local/la-me-erdoctors28-2009jan28,0,7632115.story?track=rss
As someone who legitimately has to be taken to these facilities every once in awhile in order to keep on living, it's a bit worrying.... |
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| Ask a rheumatologist a question, for free |
[Mar. 8th, 2008|11:58 pm] |
BAY AREA LUPUS FOUNDATION
SEMI-ANNUAL DIAL-A-DOCTOR NIGHT ANNOUNCED
Monday Night, March 10, 2008
(408) 954-8600, 1-800-523-3363
If you would benefit from our ever-popular Dial-A-Doctor Night, please mark your calendar now to call in your medical question. Questions will be accepted during regular office hours on Monday and only calls on the statewide toll-free telephone line will be accepted anytime prior to 7-9 p.m.(Pacific Standard Time) while doctors are returning calls.
E-Mail Option: You may e-mail your question to frontdesk@balf.org: Please e-mail your question to the Foundation by 4:30 p.m., Monday, March 10th . To receive a call, you need to leave a number where you can be reached between 7-9 p.m. and supply your name and mailing address so we can send medical information to you after your discussion with a doctor.
Here is an overview of Dial-a-Doctor Night practices:
you may call or email your question anytime prior to March 10th (see above instructions)
three to four rheumatologists will return calls Monday evening between 7-9 p.m.
any medical question will be addressed
you will receive information about your concern in the mail following your conversation with a doctor
we do accept Spanish-speaking callers. They may call 408.954.8600 weekdays between 1-5 p.m. with their question. A Spanish-speaking physician will return their call.
We are very grateful to the following rheumatologists who plan to be on call at the Foundation for this important semi-annual event: Drs. Tzielan Lee, Alan Lash Tom Bush, and Gabby Schmajuk. Also assisting will be Ron Garcia, P.A. |
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| raked over by medical insurance and physicians |
[Jan. 23rd, 2008|07:47 pm] |
| [ | Current Location |
| | Cambridge, MA | ] |
| [ | Current Mood |
| | bitter | ] |
| [ | Current Music |
| | "Tara Shakti Mantra", Oliver Shanti | ] |
So, I've posted related entries elsewhere, primarily my own blog, but I've just been abused big time by the medical insurance system, and needed to vent.
My wife's health is not good, hasn't been good for a long time. I married her in 1996 knowing that, but she was getting better at the time. Anyway, it turned serious the last few years, culminating in a doctor almost killing her. (Synopsis? She was going in for a procedure involving general anesthesia, and was nauseous the night before. She threw up at midnight, at 4 a.m., and while at hospital before anesthesia. Doc decided to go with procedure anyway. She threw up under anesthesia, aspirated vomit, and spent the next two weeks unconscious and at death's door because of ARDS.) I did not like this doctor. I did not like this other doctor. The first was a psychiatrist. The other was an internal medicine person. I complained. But my wife said they were helping, and, so, I could do nothing except refuse to pay, or to leave her, claiming I was no longer financially responsible, or go along. So, I love her. I went along.
I had medical insurance through my small business, bought through a group which did that kind of thing. The insurance I got was an HMO, all we could afford given my wife's health, especially for Rx. She also had Medicare, as secondary, or so we thought.
Indeed, it was secondary, according to the HMO, according to the group. Medicare went along. My wife had all kinds of special medical care, and psychiatric hospitalizations. In retrospect I believe the treatments the psychiatrist was putting her through were the cause of her condition and the hospitalizations, especially the mix of medications, a combo of powerful pain killers and psych drugs, plus ECT treatments, which is what she had when she aspirated.
So, 2006 rolled around, and she deteriorated, spending more days in hospital than not, of all kinds. Thusfar, all worked out, with the HMO being billed primary, then Medicare picking up the balance.
But come July of 2006, the HMO announced that they "discovered" they were actually secondary, because the group size was too small for a the special case of Medicare disability. This resulted over the course of half a subsequent year in the HMO withdrawing payment from all health care providers indicating they were secondary now. Medicare followed suit, since they now had to be primary. We're talking well over a billing churn of one million dollars, retroactive back to 2004.
So, decisions regarding affordability and billing in the first part of 2006 had been made, primarily by me, based upon the original claimed situation, advised by both group and by the HMO itself. After midyear, inquiries about whether things were fully covered were met with answers of "We don't know, the billing is unsettled because of the switch to secondary status." Finally, there was a point of concern in September, as my wife's hospitalizations continued where there was a question of having adequate numbers of days from Medicare to cover her hospitalizations. I was assured by the doctor and the hospital representatives that according to their records there would be sufficient days. See, I was concerned about that. They said my co-pay exposure might be $2000, and given my wife's condition, I thought that fine.
Given the thing which the HMO did, I insisted we quit it come 1st January 2007, with my wife getting an enhanced Medigap coverage, and I another plan, basically an HSA. But, then, the billings began. The hospital claimed that, after all the dust had settled, there were 45+ full hospital days which had no coverage from anyone. This was investigated, queried, quizzled. Now, finally, the bill is at hand, and we're talkin' $50,000 maybe $60,000. The psychiatrist says "Oh, I didn't know about the rules of the HMO" and "I was only counting psychiatric hospital days." They have sent the bill to collection.
So, our choices are:- Pay in full, and wipe out savings we've put together for a few years, and a safety net in case I lose my current job.
- Ignore the bill and take the ding on the credit report, something which may have repercussions for my current job.
- Try to negotiate some reduced payment amount and pay that, using an attorney. This is going to be tough if pursued, since the hospital and everyone has huge workload overages because of the billing and rebilling needed to handle what the HMO did.
- Hire an attorney and file suit against one or more parties to get the money.
Any input from the Hive Mind? You can post here or at my blog on the entry linked at the top of this posting. If you'd like to send me your opinion off the blog record, post anonymously with your email address, and I'll get back to you, or use LJ's record of my own email to send it to me.
Thanks for any help.
Wonderment, ain't it?
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| Health insurance |
[Nov. 17th, 2007|10:22 pm] |
I signed up at a clinic and had lied on my health insurance info, saying that I don't have health insurance so I can get free medication from the pharmacy. It has been a month since I have picked up anything from them (for free), but just today they called and left a message on my phone, saying, "This message is for so-and-so. Please call us back. Our number is this-and-that and our hours of operation today and tomorrow are this-and-that." Although they left a casual message like that, I became suspicious and a little paranoid that I didn't have the guts to call them back, but I will have to tomorrow. I have the biggest notion that it's because they caught my lie--that I really DO have health insurance. I don't know what to tell them if I were to confront them because I'm messing with the law--note that I do go to a UC, but I don't know if that makes any difference.
Thanks. |
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| Announcement! |
[Sep. 24th, 2007|08:23 pm] |
Announcing the Santa Maria Lupus and Rheumatic Diseases Group Special Event for October, Lupus Awareness Month
Tuesday, October 23, 2007
7:00 PM
Knollwood Village Mobile Home Park Clubhouse
4012 South Bradley Road (cross street Larch)
Santa Maria, CA 93455
"What's Up, Doc?"
Latest Developments in Rheumatic Disease treatment
Speaker: Timothy Spiegel, M.D. M.P.H. rheumatologist, visiting us from Santa Barbara
Other Special Guests: Jaime Umphenour of the Alliance for Lupus Research, San Luis Obispo Walk to Cure Lupus, and Joyce Hulsebos, President, Santa Barbara Lupus and Rheumatic Diseases Group
This event is free and open to anyone with an interest in the rheumatic/autoimmune diseases. There are over 100 of these conditions, which include lupus, rheumatoid arthritis, scleroderma, fibromyalgia, dermatomyositis, celiac disease, Crohn's disease, Sjogren's syndrome and Hashimoto's thyroiditis.
For more information please contact Pamela Gross, President of the Santa Maria Lupus and Rheumatic Diseases Group, at smlupus@gmail.com.
Please help us get the word out about this event and contact friends, family, media, and doctor's offices. Also, if you would like some flyers to distribute, please let us know! |
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| health insurance issue |
[Sep. 17th, 2007|04:05 pm] |
I apologize if this is inappropriate for this community; feel free to delete if so.
I've been having a lot of problems with my (individual, PPO) health insurance. It's a long story, but basically, they dropped my policy because I had bought it in a state that they no longer offer coverage in. I couldn't get any other coverage because of my "pre-existing conditions." I complained a lot and the original company took me back. Now they're treating me like a brand new applicant.
They sent me a form which requires me to list every physician I have seen in the last FIVE YEARS. Not only do I have to list them, but I also have to list their address, phone numbers and the DATES on which I saw them.
Being that I have multiple chronic health problems (which first developed a few years ago), I have seen innumerable doctors over this time period. I have kept some of the records, but not all.
I have contacted the insurance company about the questions this raises ("Shouldn't YOU have these records? How the hell am I supposed to remember? Why should I, a long-time policy holder, be subjected to this? OMGWTF?" etc.)
but they either ignore me (email) or tell me it's "not their department" and transfer me to someone else who says the same thing and so on (phone).
I'm just wondering if anyone else has had an experience like this? Anyone had to fill out this "5 years" form? And any advice on the overall situation would be great too.
(x-posted to ![[info]](http://l-stat.livejournal.com/img/community.gif) chronic_pain |
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| Lyme Disease |
[Aug. 17th, 2007|11:54 pm] |
Hi, this is my first visit to this community so be gentle. I apologise if any of this has been asked before.
Last summer I got some unusual bites on my arm while on holiday in the United States. Since then i've had a possible/probable diagnosis from my doctor of Lyme Disease.
I'm curious if anyone on the board suffers from Lyme because although some of my physical symptoms have been unsettling the worst thing i've noticed is how its changed my personality.
I've become extremely short tempered and will snap at the smallest thing. This has been putting strain on my relationship and upsetting friends and family. Although I never had a huge social circle i've found myself increasing withdrawn.
Does anyone know if this is depression linked to the disease or an actual physical symptom of lymes? If anyone can suggest anything I might be able to ask my doctor about that could reverse of limit these symptoms that would be great.
Thank you for your time |
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| Really interesting discussion on weight |
[Jul. 9th, 2007|01:45 pm] |
| [ | Current Mood |
| | determined | ] |
I know I've made my own goal to just get more fit and no longer worry so much about what weight my body insists on clinging to :) I'm hoping that eventually I will lose the massive amount I ended up carrying around from predinsone treatment and from undiagnosed hypothyroidism, but I now refuse to kill myself if that doesn't happen! I'm slowly learning to tell people who don't like the way I look to just look elsewhere or close their eyes.
Your mileage may vary...
http://cache.libsyn.com/sciencefriday/scifri-2007062924.mp3
x-posted to: no_to_sizeism
x-posted to: healthtalk |
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| Help! |
[Jul. 8th, 2007|09:32 pm] |
Okay, I have a problem but I don't know what it is.
About two weeks ago I was doing workouts at the gym five days a week. Jogging, resistance bike training, weight lifting, about a two hour workout. Have been doing these workouts for about a year and have been very physically active/fit. Also swam and hiked regularly.
Then I started experiencing extreme fatigue and very very bad dizziness. I'm a shell of what I was two weeks ago and I'm in danger of losing my job because I cannot make the three minute uphill walk to the store that I work at. I have had a blood test to check my protein and electrolites and everything is in order. My doctor is trying to convince me it's all in my head. I am positive that it is not. I have been through periods of depression and have had fatigue because of my mood in the past, but this is entirely more severe and I have not been depressed lately.
My symptoms are:
- Extreme fatigue. Sleep about 10 hours a day. Deep sleep, not having trouble sleeping.
- Fainting (twice in past two weeks).
- No coordination. Drop items, bump into things, knock things over.
- Extreme dizziness. Room is always spinning, even when laying down with eyes closed I have the sensation of spinning.
- Sick to my stomach but no vomiting.
- Tingling/numbness in my hands.
- Extreme muscle weakness.
- Sweating.
- Blurred vision.
- Headaches. Tense feeling in head (feels like brain is too big for skull).
- Shortness of breath/anxiety attacks. This may be brought on by worry from other symptoms, however.
Thanks for reading, any suggestions/advice is welcome.
Cross posted to other advice communities. |
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