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You absolutely can use SSI funds for your (adult) child's medical/dental bills

not covered by Medicaid.

Ellen - is it ok for me to post REP PAYEE DO'S & DON'T'S?

________________________________

From: THAIS PALLUAU <fpalluau@...>

IPADDUnite

Sent: Wednesday, September 16, 2009 8:50:45 AM

Subject: Re: Health Insurance

 

Sherri,

You told me to ask you for your list of dos and don't for representative payees.

Could you post it?I was wondering if we could use SSi funds to pay for dentists

or therapists not covered by medicaid.

Thais

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Health Benefits for Workers with Disabilities is Medicaid for individuals with a

disability that work at a job that pays into FICA. It allows the individual to

earn more money and save more money. Instead of a deductible (spend-down), you

purchase the Medicaid with a monthly premium:

TRADITIONAL MEDICAID                       HBWD MEDICAID

- Income - 1 person max $928 mo             - Income - 1 person max $ 3159 mo

- Assets - 1 person <$2000                       - Assets - 1 person  < $25,000

and qualified

                                                                                \

    retirement accounts are exempt

________________________________

From: Finato <cmfinato@...>

IPADDUnite

Sent: Wednesday, September 16, 2009 1:13:32 PM

Subject: Re: Health Insurance

 

You can check out the Health Benefits for Workers with Disabilities.  Their

website is:

http://www.hbwdillinois.com/

From: patrice607 <mitchpatcomcast (DOT) net>

Subject: Health Insurance

IPADDUnite@gro ups.com

Date: Wednesday, September 16, 2009, 7:05 AM

 

My 23 year old (ASD) son is about to lose the health insurance we have thru my

husband's work. They are exempt from the new law which requires them to insure

dependents to age 26 because they are self-insured. His prospects for obtaining

a job with benefits are poor.

Any suggestions? ??

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Health Benefits for Workers with Disabilities is Medicaid for individuals with a

disability that work at a job that pays into FICA. It allows the individual to

earn more money and save more money. Instead of a deductible (spend-down), you

purchase the Medicaid with a monthly premium:

TRADITIONAL MEDICAID                       HBWD MEDICAID

- Income - 1 person max $928 mo             - Income - 1 person max $ 3159 mo

- Assets - 1 person <$2000                       - Assets - 1 person  < $25,000

and qualified

                                                                                \

    retirement accounts are exempt

________________________________

From: Finato <cmfinato@...>

IPADDUnite

Sent: Wednesday, September 16, 2009 1:13:32 PM

Subject: Re: Health Insurance

 

You can check out the Health Benefits for Workers with Disabilities.  Their

website is:

http://www.hbwdillinois.com/

From: patrice607 <mitchpatcomcast (DOT) net>

Subject: Health Insurance

IPADDUnite@gro ups.com

Date: Wednesday, September 16, 2009, 7:05 AM

 

My 23 year old (ASD) son is about to lose the health insurance we have thru my

husband's work. They are exempt from the new law which requires them to insure

dependents to age 26 because they are self-insured. His prospects for obtaining

a job with benefits are poor.

Any suggestions? ??

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Self - insured companies can make their own rules     Unfortunately, they do not

always do what is right. You can always COBRA the insurance and then ask if it

can be converted to an individual policy. Both of these options, if allowed,

tend to be very costly.

________________________________

From: G Mrozak <mrsovaltine@...>

IPADDUnite

Sent: Wednesday, September 16, 2009 9:43:19 AM

Subject: Re: Health Insurance

 

If the company is self-insured, they can make an exception if they want to. 

Your son could be " grandfathered in " (covered because he's been covered by them

for some time), yet they could keep this rule in place for new employees.

My husband's employer changed insurance arrangements a year ago to be

self-insured, the folks they hired to administer the program told the company HR

that Neal should apply for Medicaid.

I called HR and gave them a sweet talk about how Neal was so very employable,

and that we didn't anticipate that he'd be on his father's plan much longer, and

that if he got a job, that Medicaid would drop him even if the job's insurance

hadn't started yet (I have to admit, I'm not totally sure if that is true, but I

was on a roll), and the HR exec said, " Oh, we can grandfather him in. "

-Gail

From: Sherri Schneider <benefithelpss>

Subject: Re: Health Insurance

IPADDUnite@gro ups.com

Date: Wednesday, September 16, 2009, 7:17 AM

 

I know of two things that insure individuals with pre-existing conditions:

1) IL Medicaid

2) ICHIP - Illinois Comprehensive Health Insurance Program - you can see this

program on the web. It tends to be expensive.

____________ _________ _________ __

From: patrice607 <mitchpatcomcast (DOT) net>

IPADDUnite@gro ups.com

Sent: Wednesday, September 16, 2009 7:05:36 AM

Subject: Health Insurance

 

My 23 year old (ASD) son is about to lose the health insurance we have thru my

husband's work. They are exempt from the new law which requires them to insure

dependents to age 26 because they are self-insured. His prospects for obtaining

a job with benefits are poor.

Any suggestions? ??

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Self - insured companies can make their own rules     Unfortunately, they do not

always do what is right. You can always COBRA the insurance and then ask if it

can be converted to an individual policy. Both of these options, if allowed,

tend to be very costly.

________________________________

From: G Mrozak <mrsovaltine@...>

IPADDUnite

Sent: Wednesday, September 16, 2009 9:43:19 AM

Subject: Re: Health Insurance

 

If the company is self-insured, they can make an exception if they want to. 

Your son could be " grandfathered in " (covered because he's been covered by them

for some time), yet they could keep this rule in place for new employees.

My husband's employer changed insurance arrangements a year ago to be

self-insured, the folks they hired to administer the program told the company HR

that Neal should apply for Medicaid.

I called HR and gave them a sweet talk about how Neal was so very employable,

and that we didn't anticipate that he'd be on his father's plan much longer, and

that if he got a job, that Medicaid would drop him even if the job's insurance

hadn't started yet (I have to admit, I'm not totally sure if that is true, but I

was on a roll), and the HR exec said, " Oh, we can grandfather him in. "

-Gail

From: Sherri Schneider <benefithelpss>

Subject: Re: Health Insurance

IPADDUnite@gro ups.com

Date: Wednesday, September 16, 2009, 7:17 AM

 

I know of two things that insure individuals with pre-existing conditions:

1) IL Medicaid

2) ICHIP - Illinois Comprehensive Health Insurance Program - you can see this

program on the web. It tends to be expensive.

____________ _________ _________ __

From: patrice607 <mitchpatcomcast (DOT) net>

IPADDUnite@gro ups.com

Sent: Wednesday, September 16, 2009 7:05:36 AM

Subject: Health Insurance

 

My 23 year old (ASD) son is about to lose the health insurance we have thru my

husband's work. They are exempt from the new law which requires them to insure

dependents to age 26 because they are self-insured. His prospects for obtaining

a job with benefits are poor.

Any suggestions? ??

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President Obama recently passed the law covering dependent children until age

26. (It used to be 23)   I called my insurance company and am having my other 2

children reinstated.

Ruthie can stay on my insurance as a dependent adult until I retire. (She can

stay on after I retire too, but again it's quite costly)

I was thinking of then getting her an individual policy from Blue Cross Blue

Shield. No one mentioned a policy like that.  Is there a problem with getting

her an individual health policy?

Pligge

From: jbergman51 <jbergman51@...>

Subject: Re: Health Insurance

IPADDUnite

Date: Wednesday, September 16, 2009, 9:31 AM

 

Could you clarify what you know and how you know it? Our

insurance through employment (Aetna) covers dependent children to age 23 and

qualified disabled dependent children without an age limit. Obviously, if the

law required to age 26, the 23 doesn't make sense, but I think you meant age 26

for disabled children -- in which case Aetna is going beyond the required.

Just checking facts in case I'm misunderstanding my coverage.

>

> My 23 year old (ASD) son is about to lose the health insurance we have thru my

husband's work. They are exempt from the new law which requires them to insure

dependents to age 26 because they are self-insured. His prospects for obtaining

a job with benefits are poor.

>

> Any suggestions? ??

>

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President Obama recently passed the law covering dependent children until age

26. (It used to be 23)   I called my insurance company and am having my other 2

children reinstated.

Ruthie can stay on my insurance as a dependent adult until I retire. (She can

stay on after I retire too, but again it's quite costly)

I was thinking of then getting her an individual policy from Blue Cross Blue

Shield. No one mentioned a policy like that.  Is there a problem with getting

her an individual health policy?

Pligge

From: jbergman51 <jbergman51@...>

Subject: Re: Health Insurance

IPADDUnite

Date: Wednesday, September 16, 2009, 9:31 AM

 

Could you clarify what you know and how you know it? Our

insurance through employment (Aetna) covers dependent children to age 23 and

qualified disabled dependent children without an age limit. Obviously, if the

law required to age 26, the 23 doesn't make sense, but I think you meant age 26

for disabled children -- in which case Aetna is going beyond the required.

Just checking facts in case I'm misunderstanding my coverage.

>

> My 23 year old (ASD) son is about to lose the health insurance we have thru my

husband's work. They are exempt from the new law which requires them to insure

dependents to age 26 because they are self-insured. His prospects for obtaining

a job with benefits are poor.

>

> Any suggestions? ??

>

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Yes, , BCBS will turn down a person with disabilities.  So will Aetna,

Humana One, Unicare, etc.  Before All Kids came out, I tried to get Angel on

every insurance on the planet.

From: jbergman51 <jbergman51 (DOT) com>

Subject: Re: Health Insurance

IPADDUnite@gro ups.com

Date: Wednesday, September 16, 2009, 9:31 AM

 

Could you clarify what you know and how you know it? Our insurance through

employment (Aetna) covers dependent children to age 23 and qualified disabled

dependent children without an age limit. Obviously, if the law required to age

26, the 23 doesn't make sense, but I think you meant age 26 for disabled

children -- in which case Aetna is going beyond the required.

Just checking facts in case I'm misunderstanding my coverage.

>

> My 23 year old (ASD) son is about to lose the health insurance we have thru my

husband's work. They are exempt from the new law which requires them to insure

dependents to age 26 because they are self-insured. His prospects for obtaining

a job with benefits are poor.

>

> Any suggestions? ??

>

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Yes, , BCBS will turn down a person with disabilities.  So will Aetna,

Humana One, Unicare, etc.  Before All Kids came out, I tried to get Angel on

every insurance on the planet.

From: jbergman51 <jbergman51 (DOT) com>

Subject: Re: Health Insurance

IPADDUnite@gro ups.com

Date: Wednesday, September 16, 2009, 9:31 AM

 

Could you clarify what you know and how you know it? Our insurance through

employment (Aetna) covers dependent children to age 23 and qualified disabled

dependent children without an age limit. Obviously, if the law required to age

26, the 23 doesn't make sense, but I think you meant age 26 for disabled

children -- in which case Aetna is going beyond the required.

Just checking facts in case I'm misunderstanding my coverage.

>

> My 23 year old (ASD) son is about to lose the health insurance we have thru my

husband's work. They are exempt from the new law which requires them to insure

dependents to age 26 because they are self-insured. His prospects for obtaining

a job with benefits are poor.

>

> Any suggestions? ??

>

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By individual health policy I assume you mean that you would apply for her alone

with BCBS as her private health insurance.

I know BCBS has slightly different rules, due to how they began.  However, when

an individual (or even a household) applies for a private insurance policy, the

insurance company has an application form that will ask questions something like

this:

Are there pre-existing conditions?  What are they?

What have you seen an MD for in the last 6, 12, 24 months?  (I don't know what

time frame they are asking, these days.)

Have you been hospitalized?  When, and for what?

Do you take medication?  What's it for?

As you can see, these kind of questions are to find out who is expensive.  If

you put yourself in their shoes for a minute, you'd see that you want mostly

heatlhy people in your plan, or your outfit will go broke.

Individuals with pre-existing health conditions applying for private insurance

usually get turned down.  (This is not like car insurance, where if you look

like a bad risk you just pay more.)

It used to be almost this bad with health insurance via employers.  A decade or

so ago, if you had a pre-existing condition, the employer's insurance wouldn't

cover the condition for the first 6-12 months.

Go ahead and ask BCBS, but be prepared for questions and have low expectations.

-Gail

From: jbergman51 <jbergman51 (DOT) com>

Subject: Re: Health Insurance

IPADDUnite@gro ups.com

Date: Wednesday, September 16, 2009, 9:31 AM

 

Could you clarify what you know and how you know it? Our insurance through

employment (Aetna) covers dependent children to age 23 and qualified disabled

dependent children without an age limit. Obviously, if the law required to age

26, the 23 doesn't make sense, but I think you meant age 26 for disabled

children -- in which case Aetna is going beyond the required.

Just checking facts in case I'm misunderstanding my coverage.

>

> My 23 year old (ASD) son is about to lose the health insurance we have thru my

husband's work. They are exempt from the new law which requires them to insure

dependents to age 26 because they are self-insured. His prospects for obtaining

a job with benefits are poor.

>

> Any suggestions? ??

>

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Share on other sites

By individual health policy I assume you mean that you would apply for her alone

with BCBS as her private health insurance.

I know BCBS has slightly different rules, due to how they began.  However, when

an individual (or even a household) applies for a private insurance policy, the

insurance company has an application form that will ask questions something like

this:

Are there pre-existing conditions?  What are they?

What have you seen an MD for in the last 6, 12, 24 months?  (I don't know what

time frame they are asking, these days.)

Have you been hospitalized?  When, and for what?

Do you take medication?  What's it for?

As you can see, these kind of questions are to find out who is expensive.  If

you put yourself in their shoes for a minute, you'd see that you want mostly

heatlhy people in your plan, or your outfit will go broke.

Individuals with pre-existing health conditions applying for private insurance

usually get turned down.  (This is not like car insurance, where if you look

like a bad risk you just pay more.)

It used to be almost this bad with health insurance via employers.  A decade or

so ago, if you had a pre-existing condition, the employer's insurance wouldn't

cover the condition for the first 6-12 months.

Go ahead and ask BCBS, but be prepared for questions and have low expectations.

-Gail

From: jbergman51 <jbergman51 (DOT) com>

Subject: Re: Health Insurance

IPADDUnite@gro ups.com

Date: Wednesday, September 16, 2009, 9:31 AM

 

Could you clarify what you know and how you know it? Our insurance through

employment (Aetna) covers dependent children to age 23 and qualified disabled

dependent children without an age limit. Obviously, if the law required to age

26, the 23 doesn't make sense, but I think you meant age 26 for disabled

children -- in which case Aetna is going beyond the required.

Just checking facts in case I'm misunderstanding my coverage.

>

> My 23 year old (ASD) son is about to lose the health insurance we have thru my

husband's work. They are exempt from the new law which requires them to insure

dependents to age 26 because they are self-insured. His prospects for obtaining

a job with benefits are poor.

>

> Any suggestions? ??

>

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I am a little confused.? Because I was always told Medicaid was always the payee

of less, meaning, if the person qualifies and is on Medicaid, but also is

covered under another insurance policy, then the other insurance policy is the

primary, not medicaid.

Thanks,

Diane

>

> From: Sherri Schneider <benefithelpss>

> Subject: Re: Health Insurance

> IPADDUnite@gro ups.com

> Date: Wednesday, September 16, 2009, 7:17 AM

>

>  

>

> I know of two things that insure individuals with pre-existing conditions:

>

> 1) IL Medicaid

>

> 2) ICHIP - Illinois Comprehensive Health Insurance Program - you can see this

program on the web. It tends to be expensive.

>

> ____________ _________ _________ __

>

> From: patrice607 <mitchpatcomcast (DOT) net>

>

> IPADDUnite@gro ups.com

>

> Sent: Wednesday, September 16, 2009 7:05:36 AM

>

> Subject: Health Insurance

>

>  

>

> My 23 year old (ASD) son is about to lose the health insurance we have thru my

husband's work. They are exempt from the new law which requires them to insure

dependents to age 26 because they are self-insured. His prospects for obtaining

a job with benefits are poor.

>

> Any suggestions? ??

>

>

Link to comment
Share on other sites

I am a little confused.? Because I was always told Medicaid was always the payee

of less, meaning, if the person qualifies and is on Medicaid, but also is

covered under another insurance policy, then the other insurance policy is the

primary, not medicaid.

Thanks,

Diane

>

> From: Sherri Schneider <benefithelpss>

> Subject: Re: Health Insurance

> IPADDUnite@gro ups.com

> Date: Wednesday, September 16, 2009, 7:17 AM

>

>  

>

> I know of two things that insure individuals with pre-existing conditions:

>

> 1) IL Medicaid

>

> 2) ICHIP - Illinois Comprehensive Health Insurance Program - you can see this

program on the web. It tends to be expensive.

>

> ____________ _________ _________ __

>

> From: patrice607 <mitchpatcomcast (DOT) net>

>

> IPADDUnite@gro ups.com

>

> Sent: Wednesday, September 16, 2009 7:05:36 AM

>

> Subject: Health Insurance

>

>  

>

> My 23 year old (ASD) son is about to lose the health insurance we have thru my

husband's work. They are exempt from the new law which requires them to insure

dependents to age 26 because they are self-insured. His prospects for obtaining

a job with benefits are poor.

>

> Any suggestions? ??

>

>

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Medicaid is ALWAYS the payor of last resort. ALL other insurances are primary.

________________________________

From: swedegrl2005 <swedegrl@...>

IPADDUnite

Sent: Saturday, September 19, 2009 2:28:04 PM

Subject: Re: Health Insurance

 

I am a little confused.? Because I was always told Medicaid was always the payee

of less, meaning, if the person qualifies and is on Medicaid, but also is

covered under another insurance policy, then the other insurance policy is the

primary, not medicaid.

Thanks,

Diane

>

> From: Sherri Schneider <benefithelpss>

> Subject: Re: Health Insurance

> IPADDUnite@gro ups.com

> Date: Wednesday, September 16, 2009, 7:17 AM

>

>  

>

> I know of two things that insure individuals with pre-existing conditions:

>

> 1) IL Medicaid

>

> 2) ICHIP - Illinois Comprehensive Health Insurance Program - you can see this

program on the web. It tends to be expensive.

>

> ____________ _________ _________ __

>

> From: patrice607 <mitchpatcomcast (DOT) net>

>

> IPADDUnite@gro ups.com

>

> Sent: Wednesday, September 16, 2009 7:05:36 AM

>

> Subject: Health Insurance

>

>  

>

> My 23 year old (ASD) son is about to lose the health insurance we have thru my

husband's work. They are exempt from the new law which requires them to insure

dependents to age 26 because they are self-insured. His prospects for obtaining

a job with benefits are poor.

>

> Any suggestions? ??

>

>

Link to comment
Share on other sites

Medicaid is ALWAYS the payor of last resort. ALL other insurances are primary.

________________________________

From: swedegrl2005 <swedegrl@...>

IPADDUnite

Sent: Saturday, September 19, 2009 2:28:04 PM

Subject: Re: Health Insurance

 

I am a little confused.? Because I was always told Medicaid was always the payee

of less, meaning, if the person qualifies and is on Medicaid, but also is

covered under another insurance policy, then the other insurance policy is the

primary, not medicaid.

Thanks,

Diane

>

> From: Sherri Schneider <benefithelpss>

> Subject: Re: Health Insurance

> IPADDUnite@gro ups.com

> Date: Wednesday, September 16, 2009, 7:17 AM

>

>  

>

> I know of two things that insure individuals with pre-existing conditions:

>

> 1) IL Medicaid

>

> 2) ICHIP - Illinois Comprehensive Health Insurance Program - you can see this

program on the web. It tends to be expensive.

>

> ____________ _________ _________ __

>

> From: patrice607 <mitchpatcomcast (DOT) net>

>

> IPADDUnite@gro ups.com

>

> Sent: Wednesday, September 16, 2009 7:05:36 AM

>

> Subject: Health Insurance

>

>  

>

> My 23 year old (ASD) son is about to lose the health insurance we have thru my

husband's work. They are exempt from the new law which requires them to insure

dependents to age 26 because they are self-insured. His prospects for obtaining

a job with benefits are poor.

>

> Any suggestions? ??

>

>

Link to comment
Share on other sites

  • 11 months later...

I am astounded at the problems some of you guys experience with health

insurance.

I can't believe that someone sitting in an office can dictate whether or not

you get treatment for whatever illness/ complaint.

Here in Australia we have medicare if you want free care hospital surgeon

etc is available to any one any age.

Although you will wait for years and you don't get to choose who does

whatever procedure.

With private health insurance if my doctor says I need XYZ I do research to

see who I want to do whatever procedure, and I get however many opinions I

want and then choose.

Its not up to someone sitting in an office some where trying to save the

insurance companies money, Its also up to the surgeon/doctor how long you

stay in hospital

I don't know how you fight these insurance companies when you are a low

state of mind with whatever ailment that's stressful enough without worrying

will they pay up.

Perhaps I am not on the right track here may be I am reading some of these

comments wrong.

-- Re: Re: Knee Help

Oh Lord, Mike, your health insurance issues are a nightmare. We went

through hell with insurance too, and two open heart surgeries and loss of

insurance and tons of bills... and finally got old enough for Medicare.....

finally relief. dash

------------------------------------

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No you're not reading it wrong.  It's ludicrous.  I'm Australian too but have

lived in California for 10 years.  I have good health insurance through my

employer and so am well covered but for those who don't have employer coverage

and can't get insurance because of preexisting conditions, I don't know how they

cope.  Absolutely unbelievable.  You should have heard the scare mongering

about

nationalized health systems going on when the " health reform " bill was being

debated in this country.  Those people had no clue what they were talking

about.  Give me a nationalized health system (with private coverage as an

option) any day.

 

 

 

________________________________

From: Waspe <mary.waspe@...>

Joint Replacement

Sent: Wed, September 1, 2010 4:00:17 PM

Subject: Health insurance

I am astounded at the problems some of you guys experience with health

insurance.

I can't believe that someone sitting in an office can dictate whether or not

you get treatment for whatever illness/ complaint.

Here in Australia we have medicare if you want free care hospital surgeon

etc is available to any one any age.

Although you will wait for years and you don't get to choose who does

whatever procedure.

With private health insurance if my doctor says I need XYZ I do research to

see who I want to do whatever procedure, and I get however many opinions I

want and then choose.

Its not up to someone sitting in an office some where trying to save the

insurance companies money, Its also up to the surgeon/doctor how long you

stay in hospital

I don't know how you fight these insurance companies when you are a low

state of mind with whatever ailment that's stressful enough without worrying

will they pay up.

Perhaps I am not on the right track here may be I am reading some of these

comments wrong.

-- Re: Re: Knee Help

Oh Lord, Mike, your health insurance issues are a nightmare. We went

through hell with insurance too, and two open heart surgeries and loss of

insurance and tons of bills... and finally got old enough for Medicare.....

finally relief. dash

------------------------------------

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Probably not a topic that should be discussed - a political nightmare no matter

which side you are on. But I defer to the list owner.

RTKR - 9/16/09

OS: Coon, St. Helena, CA

Re: Re: Knee Help

Oh Lord, Mike, your health insurance issues are a nightmare. We went

through hell with insurance too, and two open heart surgeries and loss of

insurance and tons of bills... and finally got old enough for Medicare.....

finally relief. dash

------------------------------------

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You and me both, . I have Medicare and like it just fine.

>

> From: Waspe <mary.waspe@...>

> Subject: Health insurance

> Joint Replacement

> Date: Wednesday, September 1, 2010, 6:00 PM

>

>

>

>

>

>

>

>  

>

>

>

>

>

>

>

>

>

>

>

> I am astounded at the problems some of you guys experience with health

>

> insurance.

>

> I can't believe that someone sitting in an office can dictate whether or not

>

> you get treatment for whatever illness/ complaint.

>

>

>

> Here in Australia we have medicare if you want free care hospital surgeon

>

> etc is available to any one any age.

>

> Although you will wait for years and you don't get to choose who does

>

> whatever procedure.

>

>

>

> With private health insurance if my doctor says I need XYZ I do research to

>

> see who I want to do whatever procedure, and I get however many opinions I

>

> want and then choose.

>

> Its not up to someone sitting in an office some where trying to save the

>

> insurance companies money, Its also up to the surgeon/doctor how long you

>

> stay in hospital

>

>

>

> I don't know how you fight these insurance companies when you are a low

>

> state of mind with whatever ailment that's stressful enough without worrying

>

> will they pay up.

>

>

>

> Perhaps I am not on the right track here may be I am reading some of these

>

> comments wrong.

>

>

>

>

>

>

>

> -- Re: Re: Knee Help

>

>

>

> Oh Lord, Mike, your health insurance issues are a nightmare. We went

>

> through hell with insurance too, and two open heart surgeries and loss of

>

> insurance and tons of bills... and finally got old enough for Medicare.....

>

> finally relief. dash

>

>

>

>

>

>

>

>

>

>

>

> ------------------------------------

>

>

>

>

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If only we all had this good coverage. Unfortunately, many have zero coverage

or very little. I want everyone to have at least what I have under Medicare --

or better yet what the US senators and congresspeople have.

Too bad those same people with such great government sponsored health cAre

denied it to others.

Jackie

Jackie on

Borntodrum.org

Womendrummers.org

Girightshotline.org

510-332-5998

On Sep 2, 2010, at 8:01 AM, " judymcglothlin " <dreamcatcherdoxi@...> wrote:

> You and me both, . I have Medicare and like it just fine.

>

>

> >

> > From: Waspe <mary.waspe@...>

> > Subject: Health insurance

> > Joint Replacement

> > Date: Wednesday, September 1, 2010, 6:00 PM

> >

> >

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> >

> >

> >

> > Â

> >

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> >

> >

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> >

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> > I am astounded at the problems some of you guys experience with health

> >

> > insurance.

> >

> > I can't believe that someone sitting in an office can dictate whether or not

> >

> > you get treatment for whatever illness/ complaint.

> >

> >

> >

> > Here in Australia we have medicare if you want free care hospital surgeon

> >

> > etc is available to any one any age.

> >

> > Although you will wait for years and you don't get to choose who does

> >

> > whatever procedure.

> >

> >

> >

> > With private health insurance if my doctor says I need XYZ I do research to

> >

> > see who I want to do whatever procedure, and I get however many opinions I

> >

> > want and then choose.

> >

> > Its not up to someone sitting in an office some where trying to save the

> >

> > insurance companies money, Its also up to the surgeon/doctor how long you

> >

> > stay in hospital

> >

> >

> >

> > I don't know how you fight these insurance companies when you are a low

> >

> > state of mind with whatever ailment that's stressful enough without worrying

> >

> > will they pay up.

> >

> >

> >

> > Perhaps I am not on the right track here may be I am reading some of these

> >

> > comments wrong.

> >

> >

> >

> >

> >

> >

> >

> > -- Re: Re: Knee Help

> >

> >

> >

> > Oh Lord, Mike, your health insurance issues are a nightmare. We went

> >

> > through hell with insurance too, and two open heart surgeries and loss of

> >

> > insurance and tons of bills... and finally got old enough for Medicare.....

> >

> > finally relief. dash

> >

> >

> >

> >

> >

> >

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> >

> >

> >

> >

> > ------------------------------------

> >

> >

> >

> >

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They have people in power that continually scare people about " socialized

medicine " and crap about capitalism. Fact is .... the fat greedy cats are

getting rich off the pain and suffering and death of many here in the states.

HC all over the world is often better and better run than in the US. dash

Re: Re: Knee Help

Oh Lord, Mike, your health insurance issues are a nightmare. We went

through hell with insurance too, and two open heart surgeries and loss of

insurance and tons of bills... and finally got old enough for Medicare.....

finally relief. dash

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I feared this topic would become just what it has. This is way too hot-button a

topic for me. I'm outta here. I wish you all the best with your surgeries and

recoveries.

RTKR - 9/16/09

OS: Coon, St. Helena, CA

Re: Re: Knee Help

Oh Lord, Mike, your health insurance issues are a nightmare. We went

through hell with insurance too, and two open heart surgeries and loss of

insurance and tons of bills... and finally got old enough for Medicare.....

finally relief. dash

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Do you have a supplemental policy with medicare??? Banks

From: judymcglothlin <dreamcatcherdoxi@...>

Subject: Re: Health insurance

Joint Replacement

Date: Thursday, September 2, 2010, 10:01 AM

 

You and me both, . I have Medicare and like it just fine.

>

> From: Waspe <mary.waspe@...>

> Subject: Health insurance

> Joint Replacement

> Date: Wednesday, September 1, 2010, 6:00 PM

>

>

>

>

>

>

>

>  

>

>

>

>

>

>

>

>

>

>

>

> I am astounded at the problems some of you guys experience with health

>

> insurance.

>

> I can't believe that someone sitting in an office can dictate whether or not

>

> you get treatment for whatever illness/ complaint.

>

>

>

> Here in Australia we have medicare if you want free care hospital surgeon

>

> etc is available to any one any age.

>

> Although you will wait for years and you don't get to choose who does

>

> whatever procedure.

>

>

>

> With private health insurance if my doctor says I need XYZ I do research to

>

> see who I want to do whatever procedure, and I get however many opinions I

>

> want and then choose.

>

> Its not up to someone sitting in an office some where trying to save the

>

> insurance companies money, Its also up to the surgeon/doctor how long you

>

> stay in hospital

>

>

>

> I don't know how you fight these insurance companies when you are a low

>

> state of mind with whatever ailment that's stressful enough without worrying

>

> will they pay up.

>

>

>

> Perhaps I am not on the right track here may be I am reading some of these

>

> comments wrong.

>

>

>

>

>

>

>

> -- Re: Re: Knee Help

>

>

>

> Oh Lord, Mike, your health insurance issues are a nightmare. We went

>

> through hell with insurance too, and two open heart surgeries and loss of

>

> insurance and tons of bills... and finally got old enough for Medicare.....

>

> finally relief. dash

>

>

>

>

>

>

>

>

>

>

>

> ------------------------------------

>

>

>

>

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When I first became eligible for Medicare I did sign up for an HMO...Secure

Horizons. I had Secure Horizons for several years until it became necessary to

have hip replacements. I found that no doctors except those who are willing to

accept Secure Horizons payments were available to me. Same thing with the

hospitals.

So I dropped Secure Horizons and went with straight Medicare. My surgeon

doesn't accept any insurance so he was out of pocket, but the hospital was paid

in full, minus the deduction.

Also, my optomotrist had been after me for some time to see an opthamologist

because of narrow angles in my eyes. I did not have insurance under Secure

Horizons for that...at least not for someone I trusted. But when I went to

straight Medicare I was able to go to Loma and under Medicare have the eye

surgery necessary to correct that problem.

Of course who knows what the future will bring now that the government is freely

giving away Medicare to all and cutting back on benefits.

Judy McG

> >

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A supplement policy keeps you in Medicare and pays all the odds and ends that

are left over.... after Medicare pays. It has really paid US money having these

private pay policies.

The Secure Horizons is an Advantage plan, I believe, which leaves the client

with many unfilled holes to fill, such as who you can see, what will be paid and

deductions and co-pays. This is the kind of change that the new HC is working

at.....changing these Advantage plans, which in MY opinion after studying them

carefully for ME in MY area (they are all different according to county many

different in a state even and no state the same) that I was much better with a

Medi-gap policy.

The Advantage plans take you OUT of the real Medicare system, put you into

private (Advantage plans are of privately owned insurance companies) plans. The

Medi-gap plans keep you in real Medi-care, but pay what Medicare leaves over.

You can go anywhere in the US you want to go for treatment under the Medi-gap

plans vs. Advantage plans, and you can add out of country insurance for a few

pennies a month. You stay in the Medicare system, so you are protected there,

vs. being at the whim of a private insurance company that decides it won't pay.

The Advantage plans are subsidized by the federal government (you and me) to the

tune of $700 per person per month..... if you use the plan or not. That is

where some of the billions of dollars Obama is going to pull.... because under

the plan that was in place, we have been paying for this and it is not right.

So the advantage plans premiums will go up, and the services down, because they

are run by private health insurance companies. Under Medi-gap, this will not

happen. Your premiums will increase as the costs go up, but not because of the

federal subsidy being taken away or decreased.

In my opinion, Medi-gap pays better in the long run, keeps you in real Medicare,

and is safer than taking the seemingly cheaper Advantage Plans.

We have just had several horrible surgeries in our lives.....and my husband just

had an abdominal aneurysm fixed and my knee surgery lately.......and I had

nothing to pay... no residuals, no co-pays no deductibles, only my monthly

premiums and I could go where I wanted to, what clinic and what doc I want to

see, not just those in the HMO. dash

Re: Health insurance

When I first became eligible for Medicare I did sign up for an HMO...Secure

Horizons. I had Secure Horizons for several years until it became necessary to

have hip replacements. I found that no doctors except those who are willing to

accept Secure Horizons payments were available to me. Same thing with the

hospitals.

So I dropped Secure Horizons and went with straight Medicare. My surgeon

doesn't accept any insurance so he was out of pocket, but the hospital was paid

in full, minus the deduction.

Also, my optomotrist had been after me for some time to see an opthamologist

because of narrow angles in my eyes. I did not have insurance under Secure

Horizons for that...at least not for someone I trusted. But when I went to

straight Medicare I was able to go to Loma and under Medicare have the eye

surgery necessary to correct that problem.

Of course who knows what the future will bring now that the government is freely

giving away Medicare to all and cutting back on benefits.

Judy McG

> >

------------------------------------

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