First on-line rant/whine...please indulge me

[Geo]

I would like to start with saying that I am 55 years old and have never had health insurance in my life. Twenty-three years ago I had a domestic "accident" and tore my rotator cuff very badly. We had no insurance, so I sucked it up and took ibuprofen and let time heal the injury...I mean it only took a couple of years for the ball of my humerus to stop falling out of the socket when I bent over, and only seven years for it to be weight bearing without pain. Well, this weekend I was doing some moderately vigorous house decluttering that involved lifting boxes of books and such (2014 is our 27th year homeschooling). Well, I really did it big this time. I'm in agony-no exaggeration.

 

I had 2 hours of sleep until my shoulder woke me up and kept me up all night. Ibuprofen doesn't touch it, nor does the tramadol I begged off my husband. He is disabled after a work accident,

and is on Medicare...which puts my kids on Medicaid. I however, have no coverage. I have gone to the health care Marketplace on-line and they want thousands for insurance just for me...and I can't even afford the deductible, let alone the premium. I'm SOL....and I don't swear for the most part.

Supposedly, I Do qualify for a fine for not signing up for something I can't pay for.

 

I have 2 special needs children and a disabled husband...and I don't qualify for a lick of assistance.

Because of my age and no health care for this injury I am at serious risk for developing " frozen shoulder" on my right side. I'm right handed.

 

I'd totally make payments to the doctor on a monthly basis for the rest of my life if I could. But of course, they don't do that. Credit cards are out of the question; interest and all.

A loan against our house is out because disability isn't considered "income" by the banks (we've tried before). So, I shall sit here and wither.

 

I feel trapped, in pain, and I'm pissed. Those who pray, please pray for me.

 

Thanks for listening,

 

Geo

[Mrs Mungo]

Do you have a job? If neither you nor your husband work, can you sell your house and move to a state where you could qualify for better healthcare assistance (assuming you don't qualify because your state did not expand medicaid)? The Medicaid expansion specifically helps parents and caretaker relatives. 

 

Or, could you get a job at a place that offers healthcare? I know several moms who work part-time at Starbucks for the benefits. Have you talked to the office of a specialist? I know some of them have sliding scales? 

 

Just thinking out loud. No judgment from me. I'm sorry you're going through this. I can't imagine. :(

 

eta: Can you qualify for disability? Or have you not worked enough? 

[MomtoCandJ]

Did your state expand Medicaid? I would look into that first.

[Lawana]

I am so sorry for the pain you are in. Is there some reason you don't qualify for Medicaid yourself.

[Wildiris]

n/m

[rmtzc2009]

I'm sorry for what your going through! :grouphug:   I would call around and try to find a doctor that will work with you.  In my experience I've had three doctors in the past few years that had I needed offered it a lower self pay option as well as payment plans.  

[RanchGirl]

so sorry you are in pain.  You might want to reconsider your stance on credit cards and interest.  CC debt and interest to fix this now might be a wise investment over letting it get worse.

[Geo]

Do you have a job? If neither you nor your husband work, can you sell your house and move to a state where you could qualify for better healthcare assistance (assuming you don't qualify because your state did not expand medicaid)? The Medicaid expansion specifically helps parents and caretaker relatives.

 

Or, could you get a job at a place that offers healthcare? I know several moms who work part-time at Starbucks for the benefits. Have you talked to the office of a specialist? I know some of them have sliding scales?

 

Just thinking out loud. No judgment from me. I'm sorry you're going through this. I can't imagine. :(

 

Thank you Mrs. Mungo. Don't worry, your questions are just plain common sense questions. I haven't worked since 1979. I used to work for Paine Webber, but quit working while pregnant with child number 2. Dh made enough to support us, just not the insurance company. We had homebirths so we always paid cash for our midwife...in one instance dh bartered his labor toward an addition to her house. Over the years, construction took it's toll on dh body (arthritis) and he had to change what he did for a living at 40. He became an electrical contractor and subcontracted

the work. When he was injured, we were ok for about a year, but then the recession hit. Construction all but ceased in our region, and we lost the business while dh recovered from four successive surgeries. Since I haven't worked for 35 years, I don't even qualify for social security retirement benefits. I have considered a part-time job more recently, but I have put off the decision for the following reasons: Ds has Nonverbal Learning Disorder (looks like asperger's, but it's not)..and these kids get extremely stressed out very easily. They can get "lost inside a house"...forget navigating the halls of middle school. Public school would be a nightmare for him, seriously. The clinician who tested him was surprised at how well he is coping as, "these kids are usually depressed, angry, and have little or no positive self-esteem". He is incapable output, other than verbally. They are also at high risk for bullying and (gulp) suicide. Dd has ADHD/bi-polar depression and emotionally fragile...she is predisposed to "risky behaviors". I don't feel ps is even a serious option

for them. Besides, even if I made the decision to go back to work today, I'm basically unemployable

with my shoulder at this time. Personally, I really don't want to go back to work at 55, I have enough on my plate already, kwim?

 

Anyone can apply for disability, but it is a long road to travel to get there, about two years. I don't even know if my shoulder would even qualify as a disability, unless it's frozen...especially since I haven't been in the work force for over three decades.

 

I'd rather die than sell our house. Dh built it with his own two hands...all by himself...while he worked full-time in construction. This house has more sweat and blood in it than money.

 

Now I really feel like a whiner, so I'll just stop here. ;P

 

 

 

 

eta: Can you qualify for disability? Or have you not worked enough?

[shawthorne44]

Have you looked into the County hospital?   Years ago I had to go to one because I had no insurance.  They charged on a sliding scale, and because of a very recent major financial setup they put me at the lowest rung, which meant I only had to pay for supplies.  

[Catwoman]

I don't have any advice for you, but I wanted to send you a :grouphug:

[Geo]

Did your state expand Medicaid? I would look into that first.

No, NC declined to expand.

[Geo]

I am so sorry for the pain you are in. Is there some reason you don't qualify for Medicaid yourself.

They didn't say why. I could ask, but that probably won't change my status. Our annual disability income is $24,000 for our family of four. I was told by Marketplace (on-line)I did not qualify for any subsidy,

Including Medicaid.

 

Affordable Healthcare my hiney.

[Geo]

I'm sorry for what your going through! :grouphug: I would call around and try to find a doctor that will work with you. In my experience I've had three doctors in the past few years that had I needed offered it a lower self pay option as well as payment plans.

Thank you. This does seem like my best option...I will try tomorrow.

[Mrs Mungo]

I would try calling medical offices and hospitals until I found one that could help me find immediate relief. But you also need a longer term plan. 

 

I didn't mean to suggest putting the kids in school. But, if your dh is not working, then couldn't you work part-time while he managed the kids part-time? I understand your predicament. I haven't worked since we had our first baby (who is now 18). But, like I said, I do know quite a few moms who work part-time for the benefits. If you can't work, then it is probably worth checking into disability. 

[Geo]

Have you looked into the County hospital? Years ago I had to go to one because I had no insurance. They charged on a sliding scale, and because of a very recent major financial setup they put me at the lowest rung, which meant I only had to pay for supplies.

We don't have a county hospital. I do plan to call the health department tomorrow and see if they can help me, or direct me to help.

 

Thanks.

[Guest]

I would try doctors you have used in the past. My dentist grandfathered me and let me make payments when I was in very bad pain and couldn't afford an extraction.

 

I second rethinking credit card debt. I try to pay mine off every month too and understand how it would affect your self image, but sometimes you gotta do what you gotta do. People will judge you. People judge me. Most of them have no clue who we are and what our lives really are like, so their opinions don't affect reality any more than my kittycat's opinion that I'm being mean when i won't let him go play in traffic.

 

:grouphug:

 

I'm glad you posted.

[Mrs Mungo]

I second rethinking credit card debt. I try to pay mine off every month too and understand how it would affect your self image, but sometimes you gotta do what you gotta do. People will judge you. People judge me. Most of them have no clue who we are and what our lives really are like, so their opinions don't affect reality any more than my kittycat's opinion that I'm being mean when i won't let him go play in traffic.

I agree with this too. I think your health is worth going into debt for, if that's what you have to do. Especially if you are in terrible pain.

[Cera]

I would call an independent insurance agent and have them look for a plan for you.  They may be able to find you a higher deductible "catastrophic coverage plan" or a new obamacare bronze plan that you haven't seen.  If you can get any insurance coverage at all most docs will see you then accept payments toward your copay (even if it is very high).

 

And with Obamacare in effect you don't need to worry about it being a preexisting condition.

[AK_Mom4]

That is a very difficult position to be in - I'm so sorry.  Also try googling "low income health clinic <your town>" and also look at NeedyMeds.com for your state - here is the NC list https://www.needymeds.org/free_clinics.taf?_function=list&state=nc  Maybe you can find a doc or clinic that does sliding scale variable.  They usually have someone on staff who is super-good with the state program's for low income and Medicaid that might have some ideas on getting you covered.

 

I have a torn rotator as well and I find that cold packs help more than heat when it is just killing me.  Not too cold - just cooler than skin temp - seems to help when it is acting up.

 

Hope you are feeling better!

 

[Geo]

 

I would try calling medical offices and hospitals until I found one that could help me find immediate relief. But you also need a longer term plan.

 

I didn't mean to suggest putting the kids in school. But, if your dh is not working, then couldn't you work part-time while he managed the kids part-time? I understand your predicament. I haven't worked since we had our first baby (who is now 18). But, like I said, I do know quite a few moms who work part-time for the benefits. If you can't work, then it is probably worth checking into disability. [/q

 

 

You're right, I do need a longer term plan....

 

I just want the pain killers and anti-inflamatories first. :(

[Geo]

so sorry you are in pain. You might want to reconsider your stance on credit cards and interest. CC debt and interest to fix this now might be a wise investment over letting it get worse.

I don't have enough credit line for what I probably need: an arthroscopic procedure or open surgery. I've been reading on-line today rotator cuff injuries...it seems my symptoms point to rotator cuff impingement. Of course, I'm no doctor...but there was a physical test for it to do at home..and I failed it. It's pretty straight forward. I can pay for office visits, it's funding the surgery part that has me scared.

 

 

P

[Amy in NH]

The problem is that your state chose not to expand Medicaid.  In states like yours and mine, people who would have qualified for the expanded Medicaid don't qualify for any subsidies that are available to people in other states.  You are effectively locked out due to the SCOTUS ruling on ACA.  Thank those who brought the suit, and also those who voted not to expand in your state. 

 

Based on our income and family-size, DH and I qualify for a decent Silver Plan for less than $150/month.  If we made a couple thousand per year less we would be locked out like the OP. 

 

OP - If your income and family size enable your children to qualify for Medicaid then you should qualify for free or greatly-reduced health care at your local hospital (as we do).  Talk to the people in the billing department and get a hardship application.

[bibliophile]

So sorry you are in so much pain! 

 

I would also recommend checking with an insurance agent. It seems like you should be qualifying for some kind of subsidy. These websites have been a bit unreliable.

 

I went to healthcare.gov and plugged in: individual, health plan, NC, random county, 55 years (covering only one person), no other coverage available, 4 people in your household, income $24000.

 

This came up: 

Blue Value Silver 3000

$29 per month

$500/year deductible

$700/year out of pocket maximum

 

Are you not seeing something similar to that?

 

I hope you find a solution soon!

[Tap]

Do you have a teaching hospital in your area or one that you can travel to?  They will often prorate or offer different options for those with lower incomes.

 

Because you have this injury, you may see if you qualify for Medicaid now.  Sometimes you won't qualify if you are a healthy adult, but with an debilitating injury you may.  I would call a local hospital and ask to speak with someone who helps people without insurance to see if they have any suggestions for people in your condition.

 

[Anne in CA]

I am sorry. Is there a Catholic hospital anywhere near you? In Portland, OR, Sisters of Providence would have done the operation for a very reduced rate (or free) for someone in your situation. I am not Catholic so I don't know the details, but I know many people who are not even Catholic who got emergency medical care from Sisters of Providence Hospitals when they needed it.

[In The Great White North]

I don't have enough credit line for what I probably need: an arthroscopic procedure or open surgery. I've been reading on-line today rotator cuff injuries...it seems my symptoms point to rotator cuff impingement. Of course, I'm no doctor...but there was a physical test for it to do at home..and I failed it. It's pretty straight forward. I can pay for office visits, it's funding the surgery part that has me scared. 

 

 

When I hurt my shoulder, I really didn't want to even discuss surgery.  So, I googled.  All the PT exercises are online too.  I found that this one helped immediately with the pain (scroll down to the Pendulum Swing):

 

http://janderson99.hubpages.com/hub/Shoulder-Pain-Exercise-Relief-Rotator-Cuff-Tendonitis-Exercises

 

I also iced it frequently. 

 

There are also lots of sites that show how to work on the muscles that stabilize the shoulder (ideally getting rid of the ball of the humerous falling out of the socket issue).  Besides googling rotator cuff injuries, try looking for baseball or swimming shoulder injuries and rehab, and Buchberger.

 

 

 

 

[Tmhearn]

Am I the only one who thought the craziest part of this post was the fact that the OP has been homeschooling for 27 years??!!

 

It seems that many hospitals that offer charitable programs don't always make the information easily accessible. You might try calling the nearest hospitals directly. Bigger hospitals in the nearest major city would be most likely to offer charitable services. Someone somewhere will help you. You just have to make it your mission to find them.

[Susan in TN]

I am so sorry. As much as I complain about our insurance, at least it is there. ((Hugs))

[Excelsior! Academy]

Praying.

 

Are you opposed to a chiropractor?  They are generally affordable, even without insurance, and have equipment to x-ray and such.

 

Hospitals and doctors will often work with you.  When my nephew broke his arm badly, as in a night at children's due to possible nerve damage bad, we told the hospital we had no insurance.  They kept him overnight anyway.  Every time we called we mentioned the no insurance.  The total bill, including overnight, cast, x-rays, specialist, etc. was only $1000. 

 

I am vehemently opposed to debt.  In your situation I would take on the debt.  Paying off interest for 10 years vs. a paralyzed, low functioning arm.  If necessary take the debt.

[mytwomonkeys]

I am praying for you, Geo. I had a frozen shoulder two years ago. It was absolutely horrible! My prayers are sincerely with you!

[Liz CA]

I don't have enough credit line for what I probably need: an arthroscopic procedure or open surgery. I've been reading on-line today rotator cuff injuries...it seems my symptoms point to rotator cuff impingement. Of course, I'm no doctor...but there was a physical test for it to do at home..and I failed it. It's pretty straight forward. I can pay for office visits, it's funding the surgery part that has me scared.

 

 

P

 

I'd call every orthopedic's office in my state and beyond to explain the situation. You will be talking to a lot of people. Ask to speak to the accounting department as well. Even if they won't let you make payments, they may suggest something they know because they work in the field.

Don't let it go this time. I bet someone will take you on and draw up a payment plan.

[Robin M]

Does your state have county or state indigent care office? Did you go to emergency room for treatment. Even without insurance they will treat you and you could at least get pain medicine.

 

 

I hate to say this but one of my technicians who works part time signed up long enough to get some surgery done, then says he will cancel in 6 months. Do what is necessary to save your shoulder.

[Geo]

I would try doctors you have used in the past. My dentist grandfathered me and let me make payments when I was in very bad pain and couldn't afford an extraction.

 

I second rethinking credit card debt. I try to pay mine off every month too and understand how it would affect your self image, but sometimes you gotta do what you gotta do. People will judge you. People judge me. Most of them have no clue who we are and what our lives really are like, so their opinions don't affect reality any more than my kittycat's opinion that I'm being mean when i won't let him go play in traffic.

 

 

 

 

 

:grouphug:

 

I'm glad you posted.

The credit card is out of the question because we lived on $16k a year for five years(workman's Comp) and the card was used as an emergency fund. We had no fun with it. We maxed it out. $10k at 10 percent interest. Minimum payment....it will be 20 something years before that's paid off. We have like $600 under our limit. We do not use it anymore, period. It's not pride. It's a more like a burden that just may accompany us to our grave. I'm 55yo. It could happen, you know? :/

[Geo]

Does your state have county or state indigent care office? Did you go to emergency room for treatment. Even without insurance they will treat you and you could at least get pain medicine.

 

 

I hate to say this but one of my technicians who works part time signed up long enough to get some surgery done, then says he will cancel in 6 months. Do what is necessary to save your shoulder.

I'll be calling an Ortho tomorrow. I'm feeling more positive tonight. Dh gave me one of his anti inflamatories and the throbbing stopped for the first time in almost 48 hours. I am much more comfortable right now. So much, I think I'll paste a smiley: :D ...and go to bed.

 

 

Geo

[Catwoman]

I'll be calling an Ortho tomorrow. I'm feeling more positive tonight. Dh gave me one of his anti inflamatories and the throbbing stopped for the first time in almost 48 hours. I am much more comfortable right now. So much, I think I'll paste a smiley: :D ...and go to bed.

 

 

Geo

I hope you're able to get some rest tonight and that you can find a doctor tomorrow.

 

I normally never suggest asking others for financial help, but is there any way a family member could help you out with your doctor bills so you can get your shoulder taken care of? Do you have a grown child who could help, or any other close family member? I know it's awkward to ask for help, but your circumstances are so tough right now and none of it seems to be of your own doing, so that's why I suggested it.

 

I'm worried that you haven't been taking good care of yourself. :grouphug:

[MercyA]

I  know you said no credit cards, but would you consider applying for a CareCredit card, which is specifically for medical expenses?

www.carecredit.com

 

Their website says:  "No interest will be charged on purchases of $200 or more if you make your minimum monthly payments and pay the full amount due by the end of the promotional period. Interest will be charged to your account from the purchase date if the promotional balance, including optional charges, is not paid in full within 6, 12, 18 or 24 months."

 

If you go to the website, you can search for doctors in your area who accept CareCredit.

 

I'm so sorry you're in such a bind. :grouphug: :grouphug: :grouphug:

[LMV]

 

So sorry you are in so much pain! 

 

I would also recommend checking with an insurance agent. It seems like you should be qualifying for some kind of subsidy. These websites have been a bit unreliable.

 

I went to healthcare.gov and plugged in: individual, health plan, NC, random county, 55 years (covering only one person), no other coverage available, 4 people in your household, income $24000.

 

This came up: 

Blue Value Silver 3000

$29 per month

$500/year deductible

$700/year out of pocket maximum

 

Are you not seeing something similar to that?

 

I hope you find a solution soon!

 

 

Since her signature says she has six children, (admittedly her oldest two must be over 30 now if she was pregnant with #2 in 1979) I'm presuming her family size is more than four.  This pushes her income below the poverty line so she doesn't qualify for any subsidies and is responsible for the full premium if she chooses to enroll.  Your hypothetical individual, in their hypothetical family, was likely receiving a large subsidy which reduced their premium down to $29/month.  I believe that there is also another subsidy that can be applied towards the deductible for those above the poverty level but not very far above so it is possible that even if she could pay the full premiums for your suggested policy her deductibles and OOP maximum would be higher than what you listed.

 

[LMV]

Geo,

 

I'm sorry you are suffering.  A few thoughts that may help you access care:

 

*Look for a FQHC (Federally Qualified Health Center).  These are offices/clinics that are required to offer an income based sliding fee for all patients.  You very well may qualify for free care with your income.  FQHCs also have prescription drug programs [340B Program] in conjunction with their own in house pharmacy or a local pharmacy that offer subsidized prescriptions for their patients.  Most FQHCs are primary care based but some do actually employ subspecialists and even if they don't they may have a relationship with a subspecialist who will take patients on a payment plan with their referral.  Fifty years ago many of these doctors probably would have written off the bill entirely but current health care finance regulations make that illegal unless you write off everyone's bill.  (Which may sound good but well doctors have families who need food, shelter, and clothing too.)

*Most states have some stop gap provision where Medicaid eligibility is expanded.  Sometimes this is referred to as "Emergency Medicaid" sometimes it is referred to as a "Medicaid Spenddown".  In general after you have incurred a pre-determined level of qualified health care expenses then you are eligible for Medicaid for a period of time (usually 6-12 months in most states).  Hospital social workers are often very adept with this process because they often help admitted patients who have no third party coverage apply during their stay (which often will retroactively pay for their hospital stay as well).

*If you have a true medical emergency, EMTALA affords you emergency medical care and treatment even if you are unable to pay. You can't be turned away due to inability to pay.

[bibliophile]

Since her signature says she has six children, (admittedly her oldest two must be over 30 now if she was pregnant with #2 in 1979) I'm presuming her family size is more than four.  This pushes her income below the poverty line so she doesn't qualify for any subsidies and is responsible for the full premium if she chooses to enroll.  Your hypothetical individual, in their hypothetical family, was likely receiving a large subsidy which reduced their premium down to $29/month.  I believe that there is also another subsidy that can be applied towards the deductible for those above the poverty level but not very far above so it is possible that even if she could pay the full premiums for your suggested policy her deductibles and OOP maximum would be higher than what you listed.

 

 

I apologize if I misunderstood. I was just using the info the OP provided in post #12 <<Our annual disability income is $24,000 for our family of four.>>

[Geo]

I hope you're able to get some rest tonight and that you can find a doctor tomorrow.

 

I normally never suggest asking others for financial help, but is there any way a family member could help you out with your doctor bills so you can get your shoulder taken care of? Do you have a grown child who could help, or any other close family member? I know it's awkward to ask for help, but your circumstances are so tough right now and none of it seems to be of your own doing, so that's why I suggested it.

 

I'm worried that you haven't been taking good care of yourself. :grouphug:

No parents, they've all passed away. I have a sister, but she's just holding her own these days.

Dh lost both his brother and sister two years ago. Actually, we were the most financially stable, until dh was injured. Our oldest daughter and her husband are moving into the basement next month. It's a full two bedroom apartment with a separate entrance. Dh & I plan to live there when we are elderly and can't use stairs anymore.

 

They want to start a family (she'll be 29), and she wants to be a stay at home mom. It's a real blessing to us because they want to help us with things like wood splitting, gardening, and property maintenance. They've been living too far away to be of much help before this. We want them to be

able to save $ towards a home of their own...and I want instant access to grandchildren. We really enjoy each other, so this will be a big bright spot in our lives. :)

 

You're right I haven't taken good care of myself. I will have to learn how...but thanks Catwoman, your concern makes me feel mothered. It's comforting. :)

[Geo]

The problem is that your state chose not to expand Medicaid. In states like yours and mine, people who would have qualified for the expanded Medicaid don't qualify for any subsidies that are available to people in other states. You are effectively locked out due to the SCOTUS ruling on ACA. Thank those who brought the suit, and also those who voted not to expand in your state.

 

Based on our income and family-size, DH and I qualify for a decent Silver Plan for less than $150/month. If we made a couple thousand per year less we would be locked out like the OP.

 

OP - If your income and family size enable your children to qualify for Medicaid then you should

 

qualify for free or greatly-reduced health care at your local hospital (as we do). Talk to the people in the billing department and get a hardship application.

Wow, thanks for the suggestion, I WILL look into that. :D

[unsinkable]

I apologize if I misunderstood. I was just using the info the OP provided in post #12 <<Our annual disability income is $24,000 for our family of four.>>

I think it was very nice of you to seek out that information for Geo!

 

Welcome to the boards!

[Geo]

I apologize if I misunderstood. I was just using the info the OP provided in post #12 <<Our annual disability income is $24,000 for our family of four.>>

We are a family of four now. We were always a little infertile. We had our first in my teens (16)...he'll be 40 -this year.. And then 9 years until number 2, 7 years between baby 3 and 4...I( I had baby 4 at 34). Then,

Baby 5 surprised us at 40yo...we thought that was a miracle and were thrilled. Baby 6 gobsmacked us at 43. It may have been the progesterone cream I was using for peri-menopause, if low progesterone was the cause of infertility...Which I now believe was the case.,:P I literally breast fed through menopause. I don't recommend starting again in your 40s, but I wouldn't send him back, either. :D

That's why I added the comment " spread out over a lifetime" in my signature".

[LMV]

I apologize if I misunderstood. I was just using the info the OP provided in post #12 <<Our annual disability income is $24,000 for our family of four.>>

 

No apology needed!  I actually didn't see the information in her post #12 so if they are really a family of four in all senses (perhaps her 21 YO still counts into the family size even though they may be away at school) then I'm not sure why they don't manage to squeak in just above the poverty line (which was $23,550 for 2013 which is what is used to calculate ACA subsidies for 2014).  The other caveat is that ACA calculations use MAGI and most of her husband's disability benefits are likely not taxed therefore they do not contribute to their AGI.  It is also possible that they have other deductions that reduce their MAGI (although most of the things that would do that it doesn't sound like they would be applicable for the OP).