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Posted 4/26/2012 8:54 PM (GMT 0)
Hi all,

Folks have posted some of the Insurance woes, and Mike has had a doozie this week.

After 3 years on Medicaid, he got a letter saying April 30 was his LAST DAY.

He got a form about the renewal date, March 31 and a form to fill out, which can be done online.  And so he did...March 5th, the day after he got the notice for renewal.

Then when he got the notice on the 23rd about the cut off date! GASP.  NO meds as of May 1st. 

How did this happen?

He called and called and the Customer Service line is really really busy, you can wait an hour IF you get a PLEASE wait for the next Rep.  Most of the time the VRU just hangs up on you.

He went to the office in our county and they said he had to start over and apply and it would be 30-45 days. With no anti-rejection meds?

So he filled out the form on line again, sent it in and started making the calls again. When he got through he explained his tale of woe to the CSR and she said there was nothing to be done, that she saw his form in the system already and it would be processed in time.  He tried to argue that he had been cancelled because they made a mistake and she had no ears for his troubles.

He told her about the antirejection meds and asked for the form to be expedited.

He found out yesterday after waiting half the afternoon for the VRU to work, that he was approved.  No letter yet, but there is hope again!

He caught a good break this time.  We hope.

Thanks for listening. You have any insurance woes you'd like to get off your chest?   This is the place!

Mama Lama

Posted 4/26/2012 9:22 PM (GMT 0)
Carol, it totally makes no sense what happened to Mike. I'm sure they feel that most folks will not fight them. How long does Mike have until he can get Medicare? I get my post-transplant meds from a specialty pharmacy that bills Medicare or my Part D drug plan, depending on the medication, and deliver to me via UPS at no cost to me. I have a small co-pay for each drug, that they bill to me once a month. So far, so good, and I don't even have forms to fill out.

Hugs,
Connie
Posted 4/26/2012 9:30 PM (GMT 0)
wow... unbelievably stupid.... omg.... omg... reminds me of the fight I had with Medicare... over one of Mike's meds... they had a hearing the day after he died... fought it for months... finally finally got it turned around... wow.. Sandia
Posted 4/27/2012 1:55 AM (GMT 0)
O.K , I got a Medicare and SS gripe . I have been cut off completely as of yesterday and have 2 months worth of disability before it stops supposedly . Based on the opinion of a quack internal medicine doctor and a psychiatrist in far worse mental shape than I have ever been ( We talked more about him and his soon to be ex than we did me ) . Both nut jobs are bought lock stock and barrel by SS .

My wife is stressed about the mess but ya know honestly , I have been in worse financial straights and managed to wiggle through . I have reasonably good health at this time and for that I am thankful , Over the last day I have been thinking about what to do in the event I crash or problems arise . I woke this morning and told myself " No more worrying . What will be , will be ". No sense in letting petty things bog me down , I will just go back to work and do what has to be done . I don't think I will be going back to heavy equipment and steel work , Made a vow not to let my job run my life again . May give Jessie Jackson and AL Sharpton a call to see if they could use some help , Not sure what they do but it seems to be in high demand these days .

Ain't life peachy ,
A. Ziffle
Posted 4/27/2012 2:59 AM (GMT 0)
Rick, you can appeal the decision, you know. During an appeal of my SSD application, they sent me to their own Vocational physician. He said I could work. Thankfully, SS overrode their own guy's decision. I think my age had something to do with it. They also sent me to a shrink and an Internal Med guy. I don't know what those 2 had to say, but I did get approved. Maybe because I had already gone ahead and gotten early retirement at 62, though I only got one check before it changed to SSD. And thank God, as I would not have been able to live on that reduced amount of early retirement benefits.

With the govt. and SS being so broke these days, I think they are making it more difficult that ever to receive, or continue to receive, benefits. Obama Care's plan is to give everyone insurance (likely Medicaid) by 2014. So I think they're taking the money for this out of current benefits being paid or avoiding paying them.

One day at a time, remember to breathe, and also know that things could be a whole lot worse.

Hugs,
Connie
Posted 4/27/2012 2:59 AM (GMT 0)
Ziff,
What meds are you taking?
Posted 4/27/2012 3:04 AM (GMT 0)
Yes, let's not forget the Indigent Drug Program if you should need it.

Hugs,
Connie
Posted 4/27/2012 3:40 AM (GMT 0)
now Mr. A Zippidity Ziffle... that really hurts to hear that... news... omg... makes this old gal wanna use some bad words @#$% ... first of all appeal... secondly you should qualify for vocational rehabilitation programs... if that is the way you are leaning...but rushing to work... hmm appeal it... man oh man... but yes one day at a time... ticks me off is all I can say.. Mr. Z I know systems like the back of my hand... Master's in Voc Rehab... if you need help... my email in my profile... man oh man.. Sandia
Posted 4/27/2012 5:13 AM (GMT 0)
Hello all,
I also received my "Notice of Action" letter a few days ago. They say since I went back to work(part-time) I have my share of cost or spin down money now, which is fair, I understand because I am working. But in order for me to keep Medicaid I have to pay $445 a month for some other supplemental insurance. They don't care what it is, I just have to have it and pay by May 1st to keep it active. Well thanks for giving me all of a weeks notice. All of my SS and most of my earnings from work already goes to my ex-wife, now I have to dish out more. I would receive more money if I quit my job and stayed home. I can't do that. I have to work to keep myself sane and active, but I also can't risk not to pay it in the case that something would happen. Oh what to do?
Hope everyone can get some rest and sleep well,
Jeff
Posted 4/27/2012 12:00 PM (GMT 0)
Thanks for your sympathies . All my meds are covered by patient assistance because I never picked up a part D plan so hopefully they will allow me to keep getting the meds . I am in the process of looking what the financial limits of the program will allow .
I am focusing on trying to refinance the house with a lower interest rate to lower our payments , Not looking good considering my years of non employment . FHA and tax rates are increasing pushing what started out to be a 680.00 a month mortgage into present 745. 00 payment . Our interest rate was fixed at 5.5 but everything else has went up and no end in sight .

Employment has been spiraling down with plant closures in our area so people are forced to take less money or work 2 jobs . Vocational training has occurred to me and I will be checking our schedules for what they offer . Living in rural N.C isn't helping much with my options for that hurdle . The nearest school that has a large curriculum is about 30 minutes away , Lucky I have a gas sipping car I guess .

Oh don't get me wrong , I probably wouldn't have mentioned this whole situation but when I saw Carols post it gave me the opening to vent . We have a buffer of 2 months to figure this out and thats alot more notice than this disease had given me initially , I'm fine with what ever measures we have to take . Starting over from scratch doesn't bother me . I lived on beanie weenies and bread while sleeping in my truck when I first left home ions ago , Of course being much younger with a fully intact liver I survived . Going back to drinking hasn't occurred to me , I know my situation and if killing myself was on the table I would have done that long ago . Hey , This is just another page in life out of a endless novel as far as I'm concerned . Most of us here can relate to that sentence I'm sure . So just wish me luck and Godspeed , The piggy will be fine . wink wink


A. Ziffle ( Rick )
Posted 4/27/2012 11:55 PM (GMT 0)
just one last thought then Zippidty do a dah... ok... think about taking internet coursework... and working from home... check it out... Sandia
Posted 4/28/2012 12:46 AM (GMT 0)
Sandi, one has to be very cautious when looking at work at home schemes. So many are scams or false advertising. For example, you are not going to make $40,000 a year working from home as a medical transcriptionist. First of all, you have to have actual experience in order to be able to work on your own, with nobody to confer with. Most doctors' offices expect you to have experience and hit the ground running, or have such excellent training that they know you will be okay. That amount of money is not going to be earned by the average worker--yes, by the service company owner, but not the MT. Same goes for Medical Coding.

There are so many private "universities" or vocational schools popping up with slick advertising. Funding is difficult to obtain, except for a high-interest loan from the school itself. You will immediately be in debt with no job in sight. One's best bet is to go to the local library and look through the latest edition of the Vocational Outlook Handbook. Since this is a reference book, it cannot be checked out, but you can make copies of pages of particular interest or take notes. This book will list what training is required for a career of interest, the expected investment of time, the hire rate and other pertinent information.

If it seems to be too good to be true, it usually is.

Hugs,
Connie
Posted 4/28/2012 2:05 AM (GMT 0)
Ziff could do piggy **** online...
Posted 4/28/2012 3:15 AM (GMT 0)
Connie... because I have a background already... I know all of the above that you mentioned... my daughter has worked at home for years... beginning with an entry level position with a bank... the other daughter finished her Bachelor's Degree all online... myself Im headed back for a Phd... all online... beginning with Chemical Dependency Certification ... four classes then... Phd classes... some syposiums I will attend ... but mostly online... and an internship... the key is as you said Connie working from the vocation back..a good Voc Rehab counselor can also have some vocational testing done for aptitude and achievement... interest inventory etc... in fact one can take career interest tests online... free... it is best to do these things before... heading anywhere to look for a job... especially when making such a change... also with online college programs... one has to find out if the program is credentialed in the state one resides... or as like myself... I could be licensed or certified in the field I am entering... there are many programs out there but once finishing... you are not eligible to work in your state or be licensed from that school....

oh well... my grand daughters call this comment bombing...
Posted 4/28/2012 3:45 AM (GMT 0)
Sandi, not saying it can't work for some...but to be very cautious about what you sign up for, especially the financial part. And, as you mentioned, make sure the school is credentialed.

Hugs,
Connie
Posted 4/28/2012 11:20 PM (GMT 0)
Stay on topic eh Connie. Hate to see a thread shut down cause we may veer off topic a wee bit. Oh yeah... My SSI and May 1st switch over over to a 2,370.00 deductible had me scrambling. Got another bottle of Xifaxin for free for May, got my biopsy yesterday and my ammonia. I'm baffled. Oops off topic. Should I start an ammonia thread? Just asken? I now received a letter from State of California -Health and Human Services Agency and it states...

"The Department of Health Care Services (DHCS) is sending you this Medi-Cal notice to let you know that due to the Craig v Bonta lawsuits you are a part of a group of beneficiaries who will continue to receive full scope Medi-Cal benifets without a share of cost until further notice even if your SSI/SSP stops. You are receiving this notice because the Social Security Administration notified DHCS of changes in your SSI/SSP elegibility."

I receive my first check on May 3rd of 1,760.00 with a deductible of 2,370.00 in medical if I see doctors ot get drugs. This letter SEEMS to indicate I will continue on my ZERO pay I was getting before I got my SSI. I won't assume anything and will get at least 3 seperate people from SS telling me just exactly what this means.

Is there another ammonia thread, or shall I start one? Or is that not allowed??? Sorry I drifted a wee bit off topic where the hammer was dropped. You'll have to excuse me if I SEEM A LITTLE NUTS! 199 after a 114 can alter ones mood!
Posted 4/28/2012 11:47 PM (GMT 0)
Johnny, that sounds like good news for you! And it's not really off-topic as getting health care is crucial for those with liver disease. It's part of the whole. There is already a thread on ammonia levels. If you want to post about that, I'll look for the thread and bump it up for you.

Hugs,
Connie
Posted 4/29/2012 4:25 AM (GMT 0)
Thanks Connie. What is the name of the thread? Appreciate all you have done!
Posted 4/29/2012 5:56 AM (GMT 0)
High Ammonia Levels, Pt. 2 is the name of that thread.

Hugs,
Connie
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