Our terrible health insurance

[emzhengjiu]

I live in Texas as well.  It is extremely difficult for adults to qualify for medicaid.  Otherwise, your insurance sounds average to me. 

[Janeway]

What the heck was the point of that whole furniture post if you would never ever spend that much on a bed?

 

It's like you expect everyone to get selective amnesia when you post. I'm sorry, but it doesn't work that way. You ranted and complained about "being forced" to have Medicaid and offended the people here who use it. Now you're bitching and moaning about having the same employer insurance as everyone else. I really don't understand what you expect from everyone. If neither of those options are acceptable to you, start working toward pushing Congress to enact single payer coverage for the rest of us. Sign petitions, make phone calls, get out there and try to help make it happen.

did you even read the post? Go back and read it, it seems you have not read it. Or you have amnesia. I would expect that someone who wants to comment on a post would have actually read the post.

[emzhengjiu]

Please no back & forth comments directed toward individual posters!

[mamaraby]

Edited to add: But since she's not doing either one, it's a moo point. It's like a cow's opinion.

lol, I see what you did there. No, this has nothing to do with the topic so everyone else can carry on. :)

[Spryte]

It's a touchy time, janeway, for some of us to hear these complaints, because children we love are at risk of losing their health care coverage right now. This week. These past months. Forever? I don't know, it's an ongoing concern. They may be college students with preexisting conditions, or teens with cystic fibrosis whose care their parents could never afford.

 

So to whine about an average plan for lower priced treatment ($2k for a pain shot for an adult v. $14k for one month's meds to keep a teen alive)...it shows a lack of awareness.

This.

[unsinkable]

. Umm, wtf did you get the idea that I have ever bought a 2k bed for my daughter? Or even considered it??? You must be confusing me with someone else.

Why are you swearing at me?

 

I was quoting mergath who mentioned the $2000.

 

Anyway, it was more of a theory...that moms would spend money on a tangible object like a bed for their child over (or instead of) a healthcare procedure that only works for a finite period of time.

 

I know mom who bought her kid a computer instead of going to physical therapy.

 

But anyway, moo point etc...

[unsinkable]

lol, I see what you did there. No, this has nothing to do with the topic so everyone else can carry on. :)

It's a rented tux. I'm not going commando in another man's fatigues.

[chiguirre]

Janeway, since you're in Texas, I'd check the price of the medicine they're going to inject in Mexico. You can also see if you can order from Canada, but if it needs refrigeration it's probably easier to drive to the border with a cooler than fool around with FedEx. Just an FYI, we bought my MIL's chemo meds in Colombia (because dh was going to be there anyway) for less than 10% of what they cost in the US. It can be a massive savings--in our case a couple thousand dollars.

Edited July 26, 2017 by chiguirre

[QueenCat]

Janeway, since you're in Texas, I'd check the price of the medicine they're going to inject in Mexico. You can also see if you can order from Canada, but if it needs refrigeration it's probably easier to drive to the border with a cooler than fool around with FedEx. Just an FYI, we bought my MIL's chemo meds in Colombia (because dh was going to be there anyway) for less than 10% of what they cost in the US. It can be a massive savings.

 

Would an American doctor inject someone with something they bought on their own, in another country?

[Alessandra]

It's a touchy time, janeway, for some of us to hear these complaints, because children we love are at risk of losing their health care coverage right now. This week. These past months. Forever? I don't know, it's an ongoing concern. They may be college students with preexisting conditions, or teens with cystic fibrosis whose care their parents could never afford.

 

So to whine about an average plan for lower priced treatment ($2k for a pain shot for an adult v. $14k for one month's meds to keep a teen alive)...it shows a lack of awareness.

This.

 

People who have to buy individual insurance are in a tough spot. A small percentage of population -- 7% according to Kaiser Family Foundation -- means no bargaining power, no political clout.

 

http://www.kff.org/other/state-indicator/total-population/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D

 

Listen to Tibbie.

 

And read this for some perspective.

 

https://www.washingtonpost.com/local/virginia-politics/thousands-flock-to-free-medical-clinic-as-washington-dithers-on-health-care/2017/07/21/07b7d1f2-6d80-11e7-96ab-5f38140b38cc_story.html?utm_term=.9f97f8a92a12

Edited July 26, 2017 by Alessandra

[chiguirre]

Would an American doctor inject someone with something they bought on their own, in another country?

 

 

If you need a skilled person to inject it, I'd go to a clinic in Mexico. Although I am sure that a doctor that sees lots of people in financial straits would be more willing to send a patient across the border to buy the meds if it's a choice between getting them or going without.

[SparklyUnicorn]

I must be insanely lucky, but our insurance isn't that lousy.  This would be a definite hardship for us to have such insurance.

 

 

[Butter]

Would an American doctor inject someone with something they bought on their own, in another country?

 

Some will.  Usually close to the border.  I don't know where in TX she is, but it's a possibility, but would probably require a bit of asking around (or just have a doctor in Mexico do the injection).

Edited July 26, 2017 by Butter

[QueenCat]

If you need a skilled person to inject it, I'd go to a clinic in Mexico. Although I am sure that a doctor that sees lots of people in financial straits would be more willing to send a patient across the border to buy the meds if it's a choice between getting them or going without.

 

I was wondering about the risk to the doctor for his license, for injecting something from an unknown source. Can you imagine what would happen if something went wrong due to the injection?  I get the savings but injecting something that didn't come from a known pharmacy?

[Crimson Wife]

If you need a skilled person to inject it, I'd go to a clinic in Mexico. Although I am sure that a doctor that sees lots of people in financial straits would be more willing to send a patient across the border to buy the meds if it's a choice between getting them or going without.

 

I would pay the deductible and have it done by a physician licensed in the U.S. using a medicine made to U.S. manufacturing standards and who can be sued in U.S. courts if God forbid something bad happened. Go outside the U.S. and you may save money but at high risk.

 

I looked into taking my special needs child for stem cell therapy abroad (since it's not yet FDA-approved) but there were several cases where patients DIED.

[extendedforecast]

A $2000 bed is a tangible object, that she is giving to her DD.

 

 

A $2000 procedure, that will only provide temporary relief, for herself, is different.

 

I know a ton of moms who'd buy their kids anything before they'd spend money on themselves, even a medical procedure.

 

Edited to add: But since she's not doing either one, it's a moo point. It's like a cow's opinion.

 

Love the last two sentences!

[extendedforecast]

Since you have a high deductible plan, you should withhold money into a HSA.

Can you explain how this would be helpful? I know the money can be used tax free toward medical expenses. Is there any other advantage?

[QueenCat]

Can you explain how this would be helpful? I know the money can be used tax free toward medical expenses. Is there any other advantage?

 

It's normally done as pre-tax deductions. The other advantage is that the money is budgeted, set aside, so that it is there to meet the eventual need.

[extendedforecast]

If that is true (I still think you are mistaken) you should be contacting your state legislature to protest and demand a single payer system.

I know there are cities where doctors only take so many new patients with Medicaid, so one would have to get on the waiting list for when the doctor is accepting new Medicaid patients. Until then, patients have use the county clinic for any medical needs.

 

ETA: this happens to be in Texas. Either way, there is access to medical care using Medicaid, just not many options in some cities.

Edited July 26, 2017 by extendedforecast

[extendedforecast]

It's normally done as pre-tax deductions. The other advantage is that the money is budgeted, set aside, so that it is there to meet the eventual need.

Got it.

[unsinkable]

 

Wow. Nasty. :glare:

 

If you read unsinkable' post, she was DEFENDING you, and QueenCat already apologized for having made a mistake.

 

Maybe you're being nasty with them because you're angry that people aren't sympathizing with you about your insurance issue, but part of the problem might be that you have started so many threads complaining about both Medicaid and the cost of your husband's private insurance plan that people are losing patience for reading the same complaints over and over again.

 

Nobody likes to have to pay for health insurance. Nobody likes having to pay a deductible. But please try to be thankful that apparently you can afford to pay that deductible and that you are also able to afford to pay for your health insurance plan. Many people are not so fortunate.

Why thank you.

 

It was more of a defense of motherhood, than Janeway. And of cows. And perhaps Pottery Barn.

[Janeway]

First off, my complaints about Medicaid have been that the system should be better for people on it, not that it should go away. Considering I had to put in at least 40 hrs of time on the applications, and the only reason I was doing the applications was to avoid a punishment for not doing it. And, there was so much paperwork that came in the mail that the mailman had carry it to the door rather than putting it in the oversized mailbox. And then the phone calls. Most case workers were nice, but some where nasty. I refused to answer questions about our homeschool and got yelled at by one case worker. I counted... 15 calls a month to ask about well check ups and vaccinations where I had to remind them that they have no doctors in our area, until I stopped answering. Medical care should be available to people without all this. Private health insurance doesn't call to demand information on what is happening in homeschool. And the disability thing..,that is even more maddening. If I admitted my child had autism, they were going to reject the Medicaid but I was still legally required to do something. I asked..isn't there some sort of Medicaid specific to kids with autism and got told there might be, don't know, by every single case worker I asked. Their incompetence is shocking and the fact that Medicaid cannot be used where I live, except for the ER, but we would be fined if I didn't go through the hours upon hours of invasive interviewing and testing, and worrying I will be criminally prosecuted if I make any mistakes, and knowing that I lied and did not disclose the autism or learning disabilities, and refused to discuss what we do in homeschool, I wonder if the police will show up and arrest me over it.

[Janeway]

Why thank you.

 

It was more of a defense of motherhood, than Janeway. And of cows. And perhaps Pottery Barn.

Well I was originally posting from my phone and not completely adept at quoting or even liking or anything else a post.

 

I would go back and make corrections but I only got back on to try to post this one part..that it was from the phone. Sorry for that.

[HomeAgain]

Texas was one of those states that chose not to expand Medicare under the AHA.  It left a lot of people out.

 

This, however, sounds normal. You have a deductible, you meet it.  You have co-pays.  It's standard.  We just moved our insurance.  At first we were given an option to be seen 2 hours away for regular visits, farther if it's a specialist.  They just switched us to a primary care in our town.  We called to set up first visits and found out they've closed. :huh: 3 months ago. :lol: All I can do is laugh.  We searched around and found someone who took our insurance and has openings, and then called the insurance company to make sure they were listed as providers.  I have a 10 page questionnaire to fill out for each one of us, but now we have doctors! :hurray:  Our first visits are scheduled for Feb, 2018 and after that we'll be established patients. Yippee!

[Scarlett]

It is interesting that you have had such trouble filling out paperwork for Medicaid.....I live in OK and dh and I qualified for a form of Medicaid (for low income adults) earlier in the year when he was out of work.....It was an on line application that took about 15 minutes total.  I didn't even have to send any documentation in.  

[Guest]

It is interesting that you have had such trouble filling out paperwork for Medicaid.....I live in OK and dh and I qualified for a form of Medicaid (for low income adults) earlier in the year when he was out of work.....It was an on line application that took about 15 minutes total. I didn't even have to send any documentation in.

Given the attitudes in Texas, I wonder if all the paperwork is in place to discourage applicants?

Edited July 26, 2017 by Moxie

[gstharr]

Hang in there. Any day now, congress will repeal the ACA and replace it with a plan that provides for more coverage at a lower rate.

[AmandaVT]

First off, my complaints about Medicaid have been that the system should be better for people on it, not that it should go away. Considering I had to put in at least 40 hrs of time on the applications, and the only reason I was doing the applications was to avoid a punishment for not doing it. And, there was so much paperwork that came in the mail that the mailman had carry it to the door rather than putting it in the oversized mailbox. And then the phone calls. Most case workers were nice, but some where nasty. I refused to answer questions about our homeschool and got yelled at by one case worker. I counted... 15 calls a month to ask about well check ups and vaccinations where I had to remind them that they have no doctors in our area, until I stopped answering. Medical care should be available to people without all this. Private health insurance doesn't call to demand information on what is happening in homeschool. And the disability thing..,that is even more maddening. If I admitted my child had autism, they were going to reject the Medicaid but I was still legally required to do something. I asked..isn't there some sort of Medicaid specific to kids with autism and got told there might be, don't know, by every single case worker I asked. Their incompetence is shocking and the fact that Medicaid cannot be used where I live, except for the ER, but we would be fined if I didn't go through the hours upon hours of invasive interviewing and testing, and worrying I will be criminally prosecuted if I make any mistakes, and knowing that I lied and did not disclose the autism or learning disabilities, and refused to discuss what we do in homeschool, I wonder if the police will show up and arrest me over it.

 

If you need Medicaid again - here's the application for Texas. It's not that long. 

 

https://yourtexasbenefits.hhsc.texas.gov/sites/howtogethelp/files/docs/1205-eng.pdf

 

Also, how to find a doctor: https://www.myamerigroup.com/TX/Pages/find-a-doctor.aspx

[winterbaby]

First off, my complaints about Medicaid have been that the system should be better for people on it, not that it should go away. Considering I had to put in at least 40 hrs of time on the applications, and the only reason I was doing the applications was to avoid a punishment for not doing it. And, there was so much paperwork that came in the mail that the mailman had carry it to the door rather than putting it in the oversized mailbox. And then the phone calls. Most case workers were nice, but some where nasty. I refused to answer questions about our homeschool and got yelled at by one case worker. I counted... 15 calls a month to ask about well check ups and vaccinations where I had to remind them that they have no doctors in our area, until I stopped answering. Medical care should be available to people without all this. Private health insurance doesn't call to demand information on what is happening in homeschool. And the disability thing..,that is even more maddening. If I admitted my child had autism, they were going to reject the Medicaid but I was still legally required to do something. I asked..isn't there some sort of Medicaid specific to kids with autism and got told there might be, don't know, by every single case worker I asked. Their incompetence is shocking and the fact that Medicaid cannot be used where I live, except for the ER, but we would be fined if I didn't go through the hours upon hours of invasive interviewing and testing, and worrying I will be criminally prosecuted if I make any mistakes, and knowing that I lied and did not disclose the autism or learning disabilities, and refused to discuss what we do in homeschool, I wonder if the police will show up and arrest me over it.

 

I think it was pretty well hashed out in the Medicaid thread that you were overinterpreting a lot of your interactions with the bureaucracy, and somewhere between misinformed and wildly paranoid about the rationale behind the questions and the level of power - or inclination - to interfere with your life on the part of the people working in the system. Many people told you that they were on Medicaid while homeschooling and/or with disabled kids and that the idea that it would lead to arrest for homeschooling, or for making your own choices about your kids' treatment, is completely fantasial. While these systems aren't pleasant to deal with, your sense that you are being personally persecuted by them is out of touch with reality. I think you would benefit from some counseling.

[emzhengjiu]

I'm so sorry your experience with medicaid has been terrible.  I don't know where in Texas you live, but my experience with medicaid is nothing like yours.  When I lost my job during the economic downturn, my daughters qualified for Texas medicaid.  It took a bit a paperwork, but nothing unusual.  Once they were on, I had to submit updated information yearly.  Homeschooling never came up.  I was asked if they were in school and their grade level.  Since homeschools in Texas are considered private schools, I answered truthfully that they were in school.  Of course, I couldn't qualify unless I was pregnant.  Health care is so important.  I'm strongly in favor of universal health care.

[QueenCat]

Considering I had to put in at least 40 hrs of time on the applications, and the only reason I was doing the applications was to avoid a punishment for not doing it. And, there was so much paperwork that came in the mail that the mailman had carry it to the door rather than putting it in the oversized mailbox. And then the phone calls. Most case workers were nice, but some where nasty. I refused to answer questions about our homeschool and got yelled at by one case worker. I counted... 15 calls a month to ask about well check ups and vaccinations where I had to remind them that they have no doctors in our area, until I stopped answering. Medical care should be available to people without all this. Private health insurance doesn't call to demand information on what is happening in homeschool. And the disability thing..,that is even more maddening. If I admitted my child had autism, they were going to reject the Medicaid but I was still legally required to do something. I asked..isn't there some sort of Medicaid specific to kids with autism and got told there might be, don't know, by every single case worker I asked. Their incompetence is shocking and the fact that Medicaid cannot be used where I live, except for the ER, but we would be fined if I didn't go through the hours upon hours of invasive interviewing and testing, and worrying I will be criminally prosecuted if I make any mistakes, and knowing that I lied and did not disclose the autism or learning disabilities, and refused to discuss what we do in homeschool, I wonder if the police will show up and arrest me over it.

 

I have researched high and low for this "required to put my kid on Medicaid" that you talk about. I looked for it today and I looked for it when you previously posted about it. Please provide a link showing us this law that forced you to put your kids on Medicaid. I would like to write legislatures my thoughts on it, especially if it's federal and my elected officials have a say in it. I know for ACA, the fine would be waived if you are low income and can't buy insurance so I know this is not what you are talking about.

[QueenCat]

I think it was pretty well hashed out in the Medicaid thread that you were overinterpreting a lot of your interactions with the bureaucracy, and somewhere between misinformed and wildly paranoid about the rationale behind the questions and the level of power - or inclination - to interfere with your life on the part of the people working in the system. Many people told you that they were on Medicaid while homeschooling and/or with disabled kids and that the idea that it would lead to arrest for homeschooling, or for making your own choices about your kids' treatment, is completely fantasial. While these systems aren't pleasant to deal with, your sense that you are being personally persecuted by them is out of touch with reality. I think you would benefit from some counseling.

 

Yes. Correct.

[QueenCat]

I'm so sorry your experience with medicaid has been terrible.  I don't know where in Texas you live, but my experience with medicaid is nothing like yours.  When I lost my job during the economic downturn, my daughters qualified for Texas medicaid.  It took a bit a paperwork, but nothing unusual.  Once they were on, I had to submit updated information yearly.  Homeschooling never came up.  I was asked if they were in school and their grade level.  Since homeschools in Texas are considered private schools, I answered truthfully that they were in school.  Of course, I couldn't qualify unless I was pregnant.  Health care is so important.  I'm strongly in favor of universal health care.

 

I'm really glad to hear that your experience was different. It sounds more like I would expect it to be.

[Guest]

Ha! That's cow-pie in the sky thinking.

I'll send you a thousand dollars if this Congress repeals and replace with More coverage at a lower rate.

I'll add another thousand!!

[Guest]

It is interesting that you have had such trouble filling out paperwork for Medicaid.....I live in OK and dh and I qualified for a form of Medicaid (for low income adults) earlier in the year when he was out of work.....It was an on line application that took about 15 minutes total. I didn't even have to send any documentation in.

Medicaid for Benjamin, complete with provider recommendations and obvious diagnoses, took me about 60 sheets of diagnostic information, six provider records releases, a third party liaison, and almost three months before approval.

 

It's not straightforward unless you're under the income guidelines around here. For poor kids? Easy. For the disabled? Nightmare time. I am crossing all my fingers that Ohio doesn't stink with regard to the filing process.

[Butter]

Hang in there. Any day now, congress will repeal the ACA and replace it with a plan that provides for more coverage at a lower rate.

 

Ummm... you seriously think that?  The lower rate, yes, but that for *less* coverage and *higher* deductibles.

[nixpix5]

I know it is tough right now for people who make a middle class income because of the high cost of buying an insurance plan and then having it not be very good. It is estimated that 1 million Americans fall in this bracket where they have endured sky rocketing insurance costs for less insurance over the past few years. It does need to be fixed. My husband luckily is provided amazing insurance through his job. We pay about $500 per month for both of us and 5 kids with no deductible. He really wants to go solo with his buddy and do a biotech start up but I have been begging him to reconsider. Any extra he would end up making would go to sky high insurance and student loans (since he has forgiveness at 10 years and is 3 years away in current job). Reading some of the posts here about what people are going through is sobering.

[kewb]

Hang in there. Any day now, congress will repeal the ACA and replace it with a plan that provides for more coverage at a lower rate.

Are you serious?

[regentrude]

Ha! That's cow-pie in the sky thinking.

I'll send you a thousand dollars if this Congress repeals and replace with More coverage at a lower rate.

 

Oh, more coverage at a lower rate can easily be done - if we just let the insurance companies pick whom to insure and don't require them to insure people with pre-existing conditions. Which is what they'd love to do. Just think about how low the premiums would be if only thoroughly healthy people were insured. 

 

I cannot find the right emoticon to express how I feel about the entire mess of healthcare in this country.

 

Edited July 26, 2017 by regentrude

[gstharr]

I know it is tough right now for people who make a middle class income because of the high cost of buying an insurance plan and then having it not be very good. It is estimated that 1 million Americans fall in this bracket where they have endured sky rocketing insurance costs for less insurance over the past few years. It does need to be fixed. My husband luckily is provided amazing insurance through his job. We pay about $500 per month for both of us and 5 kids with no deductible. He really wants to go solo with his buddy and do a biotech start up but I have been begging him to reconsider. Any extra he would end up making would go to sky high insurance and student loans (since he has forgiveness at 10 years and is 3 years away in current job). Reading some of the posts here about what people are going through is sobering.

 

 

My s/o has a government job with great benefits. She receives several  job offers every year that would double, sometimes, near triple her salary.  I always have to explain that the net/net loss of government  benefits (including ,a real  pension and union protection)  and job security makes the offer ridiculous .

[shawthorne44]

:iagree:

 

Janeway starts a lot of negative threads on health insurance and while I understand her frustration, I'm not sure what she's expecting from her insurance company.

 

Deductibles are no fun and can be a hardship, but unfortunately they are to be expected.

 

I hope she decides to have her procedure done, because depending on the problem, things could get worse if she doesn't get it taken care of, and she could end up having to go out of pocket for a much higher amount later on.

 

I think expecting the cost to be not more than with insurance than without is a very reasonable expectation.  

[shawthorne44]

Oh, more coverage at a lower rate can easily be done - if we just let the insurance companies pick whom to insure and don't require them to insure people with pre-existing conditions. Which is what they'd love to do. Just think about how low the premiums would be if only thoroughly healthy people were insured. 

 

I cannot find the right emoticon to express how I feel about the entire mess of healthcare in this country.

 

Or let people pick what is covered.   For example, I would be happy to eliminate mental health coverage.  

[EKS]

When we had high deductible insurance, back when we had an individual plan before Obamacare, I simply factored the deductible into the annual cost for the insurance.

 

Insurance companies have deductibles to discourage people from using the insurance for things that aren't really necessary.

[Lang Syne Boardie]

Or let people pick what is covered.   For example, I would be happy to eliminate mental health coverage.

 

You would??????????????????

[Mergath]

Or let people pick what is covered. For example, I would be happy to eliminate mental health coverage.

Insurance doesn't work like that. Not if you expect the insurance companies to make enough of a profit to keep the lights on and pay their employees.

[QueenCat]

Or let people pick what is covered.   For example, I would be happy to eliminate mental health coverage.  

 

Trying not to be facetious but why would you want people to not have mental health needs covered? Mental health issues are medical issues, they aren't the product of sin or being weak.

 

[Guest]

You would??????????????????

Right?!? Seems like a gamble to me.

[Mergath]

You would??????????????????

It must be nice to be so certain that no one in your family will ever become mentally ill. I wonder how one goes about determining that?

[regentrude]

Or let people pick what is covered.   For example, I would be happy to eliminate mental health coverage.  

 

and hope that none of your kids develop a mental health condition?

 

Picking and choosing cannot work, because it will shrink the insured pool to a high risk pool which makes premiums unaffordably high. If only people who suffer from xyz condition buy "insurance", they might as well not have any insurance at all because they will pay as much premium as their care costs. The whole prinicple of any insurance only works through having enough people in the pool who will statistically NOT incur the insured event. If every insured house burns down, fire insurance will cost as much as a replacement house.

Edited July 26, 2017 by regentrude

[QueenCat]

It must be nice to be so certain that no one in your family will ever become mentally ill. I wonder how one goes about determining that?

 

Well, I don't know about the person that posted that they'd have mental health coverage dropped, but I do know people that don't think it's necessary because they really think mental illness is caused by weakness and/or sin. I really hope that's not what the poster was thinking. I'd really like to understand the "why" to that thought.