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Dale is right about being able to get COBRA. In fact you have 45

days after coverage was ended to let them know you want it. Your ex

may have gotten a letter to that affect. I'm so sorry you are

having to deal with that. A good lawyer will also collect their

fees from you ex. He could be held in contempt of court for what he

did. Sadly that does not fix the problem you now have. You also

may want to look into getting your daughter on medicaid. Your

income doesn't have to be as low as you might think. The nice thing

is if she qualifies, they may back date it so her last infusion is

covered. In addition once the coverage is reinstated, medicaid can

stay as a secondary. Hang in there,

Kris Mom to Konner and Keegan both with CVID

> > Ok, I now realize I have the biggest jerk of an ex-husband than

anyone I know. I realize this is not a support group for the

divorced but........he cancelled the health insurance as of May 31

and never told me. Not only is he responsible to maintain it but he

never told me and Hannah had an infusion last week that is not

covered now! I am so angry!!! The home healthcare company said to

appeal to the insurance company and see if it would be considered

a " qualifying event " . Has anyone heard of this at all? Please help?

> >

> >

> > (Hannah, 14, CVID, JRA, Lupus)

> >

> >

> >

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

> >

> >

> >

> > __________________________________________________

> >

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  • 4 months later...

Contact your State Insurance office. My state (Oregon) offers health

insurance (at a high price) to uninsurable folks.

Sally

insurance

How does one get health insurance if you're hep C positive? I'm self

employed, I've tried a few (Kaiser) and was told I'm uninsurable. Should I

just assume I'm not eligible for health care? Thank god we don't have

national health care, that socialist ruse.

It's a pleasure having you join in our conversations. We hope you have found

the support you need with us.

If you are using email for your posts, for easy access to our group, just

click the link-- Hepatitis C/

Happy Posting

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  • 2 weeks later...

I'm no insurance expert so anything I say may be incorrect but it is my

understanding that private insurance companies can do what they want as far as

pre-existing conditions are concerned. If you have a heart problem, for

example,

they can choose to not cover anything related to it at any time. Some

companies will offer higher rates or will agree to cover a condition after a

certain

length of time--a year for example. With group health insurance, if you do

not have a lapse in coverage--whether it be because your coverage starts

immediately after leaving one job and starting another or because you have

purchased

COBRA or have obtained insurance to cover the time between the old and the

new--it is against federal law to consider any of the conditions you were being

treated for as pre-existing. If there is a lapse, some companies make you wait

the length of the lapse before providing coverage. If you are uninsured for

three months, for example, some make you wait three months before providing

coverage for pre-existing things. We have been paying for COBRA for several

months now at a rate of $1,042.63 per month. We are allowed to keep it for

about

eight more months and then we will be forced to decide whether we will go

private and have everything pre-existing or if my husband will give up the

benefit-less job he really likes to return to retail (which he hates.) Kelley

in NV

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I'm no insurance expert so anything I say may be incorrect but it is my

understanding that private insurance companies can do what they want as far as

pre-existing conditions are concerned. If you have a heart problem, for

example,

they can choose to not cover anything related to it at any time. Some

companies will offer higher rates or will agree to cover a condition after a

certain

length of time--a year for example. With group health insurance, if you do

not have a lapse in coverage--whether it be because your coverage starts

immediately after leaving one job and starting another or because you have

purchased

COBRA or have obtained insurance to cover the time between the old and the

new--it is against federal law to consider any of the conditions you were being

treated for as pre-existing. If there is a lapse, some companies make you wait

the length of the lapse before providing coverage. If you are uninsured for

three months, for example, some make you wait three months before providing

coverage for pre-existing things. We have been paying for COBRA for several

months now at a rate of $1,042.63 per month. We are allowed to keep it for

about

eight more months and then we will be forced to decide whether we will go

private and have everything pre-existing or if my husband will give up the

benefit-less job he really likes to return to retail (which he hates.) Kelley

in NV

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This is true since the benefit scenario I described was employer

based, and when it is employer based, the employer gets tax incentives

to offer benefits and COBRA or bridge benefits. It's hard to imagine

that anyone can afford individual insurance policies these days. I

have a friend married to a lucrative doctor whose son has cerebral

palsy. She still works part-time to maintain her benefits for their

family because of the very high costs of therapy and remediation for

her son. They would not be able to save for his future otherwise.

WHen we talk about the kinds of things we give up as Americans - this

is a biggie that affects children and the elderly or infirmed the

most. Something to think about in this and future elections.

Bonnie

>

> OK, found the article (after all this time!). It's for when you look

> for your own coverage (not thru work). I did a copy/paste, so hope I

> took out all extras (ads, etc.) after, if you see something odd

> anywhere in the text.

>

> *******

>

> " Prozac may be hazardous to your health insurance "

>

>

> If you've had even a mild bout of depression, you may find buying an

> individual health insurance policy a challenge. Here's how to succeed

> in the process.

>

> Imagine many years ago you suffered mild depression when you broke up

> with your significant other and you briefly sought mental health

> help. Now you're happy and healthy, but you get a rude awakening when

> you try to buy individual health insurance: One by one your

> applications for individual health insurance are denied based on the

> six counseling sessions you had a decade ago, which are permanently

> recorded in your medical history.

>

> You've all but forgotten about your ex, so how can this seemingly

> insignificant episode be coming back to haunt you? Are you really on

> your way to becoming uninsured?

>

> You could be if you're trying to obtain individual health insurance,

> according to Pollitz, a town University researcher who co-

> authored a study on the individual health insurance market for the

> Kaiser Family Foundation (KFF) with Sorian and Kathy .

> Individual insurers might deny you coverage based on your medical

> history if it includes:$100? $200?

> $300?

>

> Use of prescription drugs to treat anxiety, depression, or a physical

> condition, including Ativan, Klonipin, Paxil, Prozac, Serzone,

> Zoloft, Xanax, and Wellbutrin.

>

> Counseling for anxiety, depression, grief, or an eating or sleep

> disorder. Even if you briefly sought counseling as a way to cope with

> the September 11th terrorist attacks, you could be denied individual

> health insurance, according to researchers with town's Health

> Privacy Project.

>

> " People who've always had group health insurance are completely

> unprepared when they're forced to seek coverage in this [individual

> health insurance] market, " says Pollitz. " They think they're going to

> get the same coverage they had in their jobs, except they'll just

> have to pay a little more money. It's absolutely not like that at

> all. The individual health insurance market is unpredictable,

> inconsistent, and expensive. "

>

> Dr. Deborah Peel has seen the unpredictability of the individual

> health insurance market up close. Peel, a former-president of the

> National Coalition of Mental Health Professionals and Consumers,

> recalls a young graduate student whose sleep apnea was treated with

> antidepressant medication. When he was dropped from his parents'

> group health insurance plan due to his age, he began applying for a

> policy in the individual market. He was turned down several times

> because his medical records showed he had taken an antidepressant --

> even though the medication was for a physical rather than mental

> condition.

>

> Peel says all doctors should give their patients a " Miranda-like

> warning " that anything they say or treatment they receive might be

> shared with a third-party payer (such as an insurer). " Ethically,

> doctors and all mental health professionals are responsible to

> disclose anything that might possibly harm their patients, including

> the fact that information they share with you might possibly be cause

> for an insurance denial later on. "

>

> Unpredictable, inconsistent, and expensive

> A number of everyday circumstances can force someone to seek

> individual health insurance coverage. They include: losing status as

> a dependent on a parent's health plan; getting a job that doesn't

> offer group health insurance benefits; becoming self-employed;

> retiring before age 65; and coming to the end of your health

> insurance benefits under COBRA, the federal health insurance safety

> net for families in the midst of crisis, such as unemployment,

> divorce or death.

>

> One of the biggest shocks you might encounter when moving from a

> group health insurance policy to an individual policy is the

> individual health insurer will consider more than just your age and

> personal medical history when deciding whether to offer you a policy.

>

> In their study " How Accessible is Individual Health Insurance for

> Consumers in Less-than-Perfect Health? " Pollitz and her co-authors

> say 90% of the time, the less-healthy health insurance applicants in

> their study were unable to buy policies from individual insurers at

> standard rates, and 37% were rejected. Of the 63% who were accepted,

> most had benefit restrictions placed on them (28%), or premium

> surcharges (13 percent), or both (12%).

>

> KFF warns even if you're in perfect health, you might still face

> barriers to getting a policy, based on your age. KFF's study found

> premiums for a healthy 62-year-old man were three to six times higher

> than for a healthy 24-year-old woman.

>

> Another shock you might encounter when buying an individual health

> policy is health insurance is often not subject to any kind of rate

> regulation. Only five states (Maine, New Hampshire, New Jersey, New

> York, and Vermont) guarantee you access to the individual market at

> community-rated premiums that are not based on your health status.

> These states also limit coverage exclusions that insurers can impose

> because of pre-existing conditions.

>

> Very few consumers who seek individual health insurance have

> protection through federal law. The Health Insurance Portability and

> Accountability Act (HIPAA) requires insurers to sell a health

> insurance policy without coverage limits to you if you have had at

> least 18 months of continuous coverage and are moving from one group

> health insurance policy to another group policy. HIPAA does not limit

> what health insurers can charge for such coverage.

>

> Why are individual health insurers so picky about whom they choose to

> insure? According to , the statistics tell the story: " The

> sickest 1% of your policyholders can comprise between 40 to 50% of

> all your claims. That's what makes health insurance such a risky

> business. "

> While life insurers only have to pay out a death claim once, health

> insurers may have to pay out numerous claims over many years for one

> sick person. Individual insurers can't spread out that risk among

> groups of many people the way group health insurers or self-insured

> employers do.

>

> The impact on consumers

> Approximately 18.8 million adult Americans suffer from some form of

> depression in any given year, according to the National Institute of

> Mental Health. Statistics show one in five of us will experience a

> major episode of depression during our lives. Mental health

> professionals and privacy advocates say people who need mental health

> help should not go untreated for fear that they might be denied

> health insurance in the future. Even so, there is evidence some

> people are already putting off treatment for fear of being penalized.

>

> According to the California Health Care Council's " Medical Privacy

> and Confidentiality " survey, 15% of American adults say they have

> done something " out of the ordinary " to keep their personal medical

> information confidential. The steps they have taken to protect their

> medical privacy include:

>

> Paying out-of-pocket when they already have health insurance in order

> to avoid disclosure.

>

> Not seeking care to avoid disclosure to an employer.

>

> Giving inaccurate or incomplete information on a medical history

> form.

>

> Asking a doctor to not write down a health problem or to record a

> less serious or embarrassing condition.

>

> Child psychiatrist Dr. Barry Herman says many of his patients'

> parents, who he says tend to be well-educated and financially stable,

> understand the possible ramifications of having their child's

> treatment disclosed to a third party. " It's not at all unusual for

> them to pay cash or ask for free samples of medication [instead of a

> prescription], " says Herman. " They don't want a paper trail. "

>

> What about the paper trail you create when you complete an

> application for individual health insurance? A standard application

> will ask you more than 20 specific questions about your medical

> history, going back 10 or more years. Not only are you asked to

> disclose whether you have ever had any " symptoms of, diagnosis of, or

> treatment or medication for " such obvious health problems as cancer,

> diabetes, high blood pressure, and HIV, but you must also inform the

> insurer about any allergies, anxiety, benign cysts, breast

> augmentation, depression, earaches or sexually transmitted diseases.

>

> While you might be tempted to lie, this is never a good idea. Lying

> on your health insurance application is fraud. If you are caught, the

> health insurer can cancel your policy. If you don't think you can be

> easily caught, think again. Select individual and small group health

> insurers now have access to medical information on more than 16

> million people contained in files warehoused by the Medical

> Information Bureau (MIB).

>

> The MIB provides medical information that insurers use to compare

> notes on applicants.

>

> What can you do?

> What if it's already too late for you to pay cash for your

> antidepressants or counseling sessions. Can you still get individual

> health insurance? It's possible, say the KFF study's authors, but it

> will probably take a great deal of persistence and there are no

> guarantees. Even if you are offered a policy, it will inevitably be

> more expensive than group health insurance and it will no doubt limit

> or even exclude certain coverages.

>

> The best you can do is to fill out any applications for individual

> health insurance to the best of your ability and be truthful. An

> experienced health insurance broker who knows the underwriting

> criteria of several individual insurers might increase your chances

> of acceptance.

>

> If you're denied, ask your doctor to write a letter supporting your

> re-application, particularly if you are no longer taking medication

> or receiving mental health treatment. " When we did the study, we

> found that there aren't any hard and fast underwriting rules, " says

> Pollitz. " There's a great deal of variability from insurer to

> insurer. "

>

> Additionally, once you are denied, you will have to answer " Yes " to

> the question that asks you to disclose whether you -- or anyone to be

> covered under your policy -- has ever had an application for life,

> disability, or health insurance " declined, postponed, rated up,

> modified, or terminated. "

>

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This is true since the benefit scenario I described was employer

based, and when it is employer based, the employer gets tax incentives

to offer benefits and COBRA or bridge benefits. It's hard to imagine

that anyone can afford individual insurance policies these days. I

have a friend married to a lucrative doctor whose son has cerebral

palsy. She still works part-time to maintain her benefits for their

family because of the very high costs of therapy and remediation for

her son. They would not be able to save for his future otherwise.

WHen we talk about the kinds of things we give up as Americans - this

is a biggie that affects children and the elderly or infirmed the

most. Something to think about in this and future elections.

Bonnie

>

> OK, found the article (after all this time!). It's for when you look

> for your own coverage (not thru work). I did a copy/paste, so hope I

> took out all extras (ads, etc.) after, if you see something odd

> anywhere in the text.

>

> *******

>

> " Prozac may be hazardous to your health insurance "

>

>

> If you've had even a mild bout of depression, you may find buying an

> individual health insurance policy a challenge. Here's how to succeed

> in the process.

>

> Imagine many years ago you suffered mild depression when you broke up

> with your significant other and you briefly sought mental health

> help. Now you're happy and healthy, but you get a rude awakening when

> you try to buy individual health insurance: One by one your

> applications for individual health insurance are denied based on the

> six counseling sessions you had a decade ago, which are permanently

> recorded in your medical history.

>

> You've all but forgotten about your ex, so how can this seemingly

> insignificant episode be coming back to haunt you? Are you really on

> your way to becoming uninsured?

>

> You could be if you're trying to obtain individual health insurance,

> according to Pollitz, a town University researcher who co-

> authored a study on the individual health insurance market for the

> Kaiser Family Foundation (KFF) with Sorian and Kathy .

> Individual insurers might deny you coverage based on your medical

> history if it includes:$100? $200?

> $300?

>

> Use of prescription drugs to treat anxiety, depression, or a physical

> condition, including Ativan, Klonipin, Paxil, Prozac, Serzone,

> Zoloft, Xanax, and Wellbutrin.

>

> Counseling for anxiety, depression, grief, or an eating or sleep

> disorder. Even if you briefly sought counseling as a way to cope with

> the September 11th terrorist attacks, you could be denied individual

> health insurance, according to researchers with town's Health

> Privacy Project.

>

> " People who've always had group health insurance are completely

> unprepared when they're forced to seek coverage in this [individual

> health insurance] market, " says Pollitz. " They think they're going to

> get the same coverage they had in their jobs, except they'll just

> have to pay a little more money. It's absolutely not like that at

> all. The individual health insurance market is unpredictable,

> inconsistent, and expensive. "

>

> Dr. Deborah Peel has seen the unpredictability of the individual

> health insurance market up close. Peel, a former-president of the

> National Coalition of Mental Health Professionals and Consumers,

> recalls a young graduate student whose sleep apnea was treated with

> antidepressant medication. When he was dropped from his parents'

> group health insurance plan due to his age, he began applying for a

> policy in the individual market. He was turned down several times

> because his medical records showed he had taken an antidepressant --

> even though the medication was for a physical rather than mental

> condition.

>

> Peel says all doctors should give their patients a " Miranda-like

> warning " that anything they say or treatment they receive might be

> shared with a third-party payer (such as an insurer). " Ethically,

> doctors and all mental health professionals are responsible to

> disclose anything that might possibly harm their patients, including

> the fact that information they share with you might possibly be cause

> for an insurance denial later on. "

>

> Unpredictable, inconsistent, and expensive

> A number of everyday circumstances can force someone to seek

> individual health insurance coverage. They include: losing status as

> a dependent on a parent's health plan; getting a job that doesn't

> offer group health insurance benefits; becoming self-employed;

> retiring before age 65; and coming to the end of your health

> insurance benefits under COBRA, the federal health insurance safety

> net for families in the midst of crisis, such as unemployment,

> divorce or death.

>

> One of the biggest shocks you might encounter when moving from a

> group health insurance policy to an individual policy is the

> individual health insurer will consider more than just your age and

> personal medical history when deciding whether to offer you a policy.

>

> In their study " How Accessible is Individual Health Insurance for

> Consumers in Less-than-Perfect Health? " Pollitz and her co-authors

> say 90% of the time, the less-healthy health insurance applicants in

> their study were unable to buy policies from individual insurers at

> standard rates, and 37% were rejected. Of the 63% who were accepted,

> most had benefit restrictions placed on them (28%), or premium

> surcharges (13 percent), or both (12%).

>

> KFF warns even if you're in perfect health, you might still face

> barriers to getting a policy, based on your age. KFF's study found

> premiums for a healthy 62-year-old man were three to six times higher

> than for a healthy 24-year-old woman.

>

> Another shock you might encounter when buying an individual health

> policy is health insurance is often not subject to any kind of rate

> regulation. Only five states (Maine, New Hampshire, New Jersey, New

> York, and Vermont) guarantee you access to the individual market at

> community-rated premiums that are not based on your health status.

> These states also limit coverage exclusions that insurers can impose

> because of pre-existing conditions.

>

> Very few consumers who seek individual health insurance have

> protection through federal law. The Health Insurance Portability and

> Accountability Act (HIPAA) requires insurers to sell a health

> insurance policy without coverage limits to you if you have had at

> least 18 months of continuous coverage and are moving from one group

> health insurance policy to another group policy. HIPAA does not limit

> what health insurers can charge for such coverage.

>

> Why are individual health insurers so picky about whom they choose to

> insure? According to , the statistics tell the story: " The

> sickest 1% of your policyholders can comprise between 40 to 50% of

> all your claims. That's what makes health insurance such a risky

> business. "

> While life insurers only have to pay out a death claim once, health

> insurers may have to pay out numerous claims over many years for one

> sick person. Individual insurers can't spread out that risk among

> groups of many people the way group health insurers or self-insured

> employers do.

>

> The impact on consumers

> Approximately 18.8 million adult Americans suffer from some form of

> depression in any given year, according to the National Institute of

> Mental Health. Statistics show one in five of us will experience a

> major episode of depression during our lives. Mental health

> professionals and privacy advocates say people who need mental health

> help should not go untreated for fear that they might be denied

> health insurance in the future. Even so, there is evidence some

> people are already putting off treatment for fear of being penalized.

>

> According to the California Health Care Council's " Medical Privacy

> and Confidentiality " survey, 15% of American adults say they have

> done something " out of the ordinary " to keep their personal medical

> information confidential. The steps they have taken to protect their

> medical privacy include:

>

> Paying out-of-pocket when they already have health insurance in order

> to avoid disclosure.

>

> Not seeking care to avoid disclosure to an employer.

>

> Giving inaccurate or incomplete information on a medical history

> form.

>

> Asking a doctor to not write down a health problem or to record a

> less serious or embarrassing condition.

>

> Child psychiatrist Dr. Barry Herman says many of his patients'

> parents, who he says tend to be well-educated and financially stable,

> understand the possible ramifications of having their child's

> treatment disclosed to a third party. " It's not at all unusual for

> them to pay cash or ask for free samples of medication [instead of a

> prescription], " says Herman. " They don't want a paper trail. "

>

> What about the paper trail you create when you complete an

> application for individual health insurance? A standard application

> will ask you more than 20 specific questions about your medical

> history, going back 10 or more years. Not only are you asked to

> disclose whether you have ever had any " symptoms of, diagnosis of, or

> treatment or medication for " such obvious health problems as cancer,

> diabetes, high blood pressure, and HIV, but you must also inform the

> insurer about any allergies, anxiety, benign cysts, breast

> augmentation, depression, earaches or sexually transmitted diseases.

>

> While you might be tempted to lie, this is never a good idea. Lying

> on your health insurance application is fraud. If you are caught, the

> health insurer can cancel your policy. If you don't think you can be

> easily caught, think again. Select individual and small group health

> insurers now have access to medical information on more than 16

> million people contained in files warehoused by the Medical

> Information Bureau (MIB).

>

> The MIB provides medical information that insurers use to compare

> notes on applicants.

>

> What can you do?

> What if it's already too late for you to pay cash for your

> antidepressants or counseling sessions. Can you still get individual

> health insurance? It's possible, say the KFF study's authors, but it

> will probably take a great deal of persistence and there are no

> guarantees. Even if you are offered a policy, it will inevitably be

> more expensive than group health insurance and it will no doubt limit

> or even exclude certain coverages.

>

> The best you can do is to fill out any applications for individual

> health insurance to the best of your ability and be truthful. An

> experienced health insurance broker who knows the underwriting

> criteria of several individual insurers might increase your chances

> of acceptance.

>

> If you're denied, ask your doctor to write a letter supporting your

> re-application, particularly if you are no longer taking medication

> or receiving mental health treatment. " When we did the study, we

> found that there aren't any hard and fast underwriting rules, " says

> Pollitz. " There's a great deal of variability from insurer to

> insurer. "

>

> Additionally, once you are denied, you will have to answer " Yes " to

> the question that asks you to disclose whether you -- or anyone to be

> covered under your policy -- has ever had an application for life,

> disability, or health insurance " declined, postponed, rated up,

> modified, or terminated. "

>

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> " Prozac may be hazardous to your health insurance "

Thanks for finding that article for us. And to think I could have saved all that

time I spent trying to get all the preferred providers! :-s It's sad to find

after all the work our kids are doing, they are going to have to keep this in

mind when they are older.

Maybe things will get changed before then.

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> " Prozac may be hazardous to your health insurance "

Thanks for finding that article for us. And to think I could have saved all that

time I spent trying to get all the preferred providers! :-s It's sad to find

after all the work our kids are doing, they are going to have to keep this in

mind when they are older.

Maybe things will get changed before then.

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  • 10 months later...

I am sorry Tim!

--- Hillbilly Tim <knoxweb1@...> wrote:

> _,___ yep they can raise it theres nothing the great

> state of tennessee can do.raise those prem.

>

> Tim Parsons

>

> knoxville,tn 37931

>

> 865-588-2465 x107 work

>

>

> www.knoxville1.com

>

>

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

> Talk is cheap. Use Messenger to make

> PC-to-Phone calls. Great rates starting at 1¢/min.

__________________________________________________

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  • 5 months later...

Tasha,

I can tell you from our experience with our insurance company...that is does

NOT pay on casting. I spoke with Dr. Prince briefly before she left Erie and

discussed possibly coming to consult with her thinking if she was trained in the

casting and was using the proper frame, it would be cheaper for us to drive to

Austin rather than fly to Erie every 3 months. She of course told me that she

would have been happy to discuss taking over Lexi's treatment, but just know

insurance more than likely does not cover. When we returned from that ETTP trip,

I spoke to 4 different people through our insurance over a 2 hour time and they

did not pay for that...stating, it was basically an " elective " procedure. I

think this goes in hand in hand with the free hospitals such as Shriner's doing

the treatment. You will not find alot of private practice docs doing casting and

the ones you do you may have to overcome the insurance battle. Not to say

insurance won't pay and if they do, you may have to fight for it. Of course

every insurance company is different, and you would have to just talk to yours.

Tracey

Insurance

Is there anyone who does not go to a " free " hospital for their child's

treatment?

I am wondering if insurance pays for most, anything or none of the treatment?

Where we go now for 's treatment is like Shriners..........we do not pay.

I have not called our insurance yet I am just wondering.

I will call on Monday to find out what if anything is covered and find a doc

for a 2nd opinion.

Thanks,

Tasha

Tasha

Mommy to twin boys- and 21 months

Fort Worth, Texas

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

Bored stiff? Loosen up...

Download and play hundreds of games for free on Games.

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Hi Tasha:

We are casted at Children's Hospital of Wisconsin and our insurance pays for

everything.

E

________________________________

From: infantile scoliosis treatment on behalf of Tasha Fontenot

Sent: Sat 2/24/2007 9:35 PM

infantile scoliosis treatment

Subject: Insurance

Is there anyone who does not go to a " free " hospital for their child's

treatment?

I am wondering if insurance pays for most, anything or none of the treatment?

Where we go now for 's treatment is like Shriners..........we do not pay.

I have not called our insurance yet I am just wondering.

I will call on Monday to find out what if anything is covered and find a doc for

a 2nd opinion.

Thanks,

Tasha

Tasha

Mommy to twin boys- and 21 months

Fort Worth, Texas

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

Bored stiff? Loosen up...

Download and play hundreds of games for free on Games.

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,

That is good to know. I will call our insurance today.

Thanks,

Tasha

" D. Esser " <cesser@...> wrote:

Hi Tasha:

We are casted at Children's Hospital of Wisconsin and our insurance pays for

everything.

E

________________________________

From: infantile scoliosis treatment on behalf of Tasha Fontenot

Sent: Sat 2/24/2007 9:35 PM

infantile scoliosis treatment

Subject: Insurance

Is there anyone who does not go to a " free " hospital for their child's

treatment?

I am wondering if insurance pays for most, anything or none of the treatment?

Where we go now for 's treatment is like Shriners..........we do not pay.

I have not called our insurance yet I am just wondering.

I will call on Monday to find out what if anything is covered and find a doc for

a 2nd opinion.

Thanks,

Tasha

Tasha

Mommy to twin boys- and 21 months

Fort Worth, Texas

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

Bored stiff? Loosen up...

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Tracey,

I appreciate you sharing your experience. I plan to call our

insurance today. I truly HATE dealing with insurance or anyone for

that matter over stuff like this.

We are willing to pay for a consult for a 2nd opinion, but then it may

come to the fact that needs better treatment than what he is

getting now. So where do we go?

How much do you know about Dr. Prince? Do you have any idea how many

children she has treated for infantile scoliosis?

Thanks again,

Tasha

>

> Tasha,

>

> I can tell you from our experience with our insurance

company...that is does NOT pay on casting. I spoke with Dr. Prince

briefly before she left Erie and discussed possibly coming to consult

with her thinking if she was trained in the casting and was using the

proper frame, it would be cheaper for us to drive to Austin rather

than fly to Erie every 3 months. She of course told me that she would

have been happy to discuss taking over Lexi's treatment, but just know

insurance more than likely does not cover. When we returned from that

ETTP trip, I spoke to 4 different people through our insurance over a

2 hour time and they did not pay for that...stating, it was basically

an " elective " procedure. I think this goes in hand in hand with the

free hospitals such as Shriner's doing the treatment. You will not

find alot of private practice docs doing casting and the ones you do

you may have to overcome the insurance battle. Not to say insurance

won't pay and if they do, you may have to fight for it. Of course

every insurance company is different, and you would have to just talk

to yours.

>

> Tracey

> Insurance

>

>

> Is there anyone who does not go to a " free " hospital for their

child's treatment?

> I am wondering if insurance pays for most, anything or none of the

treatment? Where we go now for 's treatment is like

Shriners..........we do not pay.

> I have not called our insurance yet I am just wondering.

> I will call on Monday to find out what if anything is covered and

find a doc for a 2nd opinion.

> Thanks,

> Tasha

>

> Tasha

> Mommy to twin boys- and 21 months

> Fort Worth, Texas

>

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

> Bored stiff? Loosen up...

> Download and play hundreds of games for free on Games.

>

>

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Tasha,

I'm with you...I hate dealing with insurance as well, but a necessary evil. We

are lucky to have a company that pays for literally everything Lexi has had

done, but the casting was not one of them. That worked out for us since we were

going to Erie anyway...and then changed to bracing.

As far as Dr. Prince, I do not know much about her practice or how many

children she has treated. Perhaps someone on here knows who that other mother is

( user name on group even?) and you could contact her to start and perhaps

discuss their experience with her. You could also just call Dr. Prince's office,

state your case ( ask to speak to a nurse) and maybe you could get Dr. Prince to

contact you back. Sorry, I couldn't be of more help, but I just don't know her

:-(

Tracey

Insurance

>

>

> Is there anyone who does not go to a " free " hospital for their

child's treatment?

> I am wondering if insurance pays for most, anything or none of the

treatment? Where we go now for 's treatment is like

Shriners..........we do not pay.

> I have not called our insurance yet I am just wondering.

> I will call on Monday to find out what if anything is covered and

find a doc for a 2nd opinion.

> Thanks,

> Tasha

>

> Tasha

> Mommy to twin boys- and 21 months

> Fort Worth, Texas

>

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

> Bored stiff? Loosen up...

> Download and play hundreds of games for free on Games.

>

>

Link to comment
Share on other sites

Thanks Tracey.

I actually learned from that she does not have the correct frame.

Did talk to insurance and the 2nd opinion/office visit would be covered. IF

surgery/treatment is required by the doctor they said it would be reviewed to

see if it is necessary.

Not sure what to do. Still trying to process all this.

Thanks, Tasha

Tracey <pthahn@...> wrote: Tasha,

I'm with you...I hate dealing with insurance as well, but a necessary evil. We

are lucky to have a company that pays for literally everything Lexi has had

done, but the casting was not one of them. That worked out for us since we were

going to Erie anyway...and then changed to bracing.

As far as Dr. Prince, I do not know much about her practice or how many

children she has treated. Perhaps someone on here knows who that other mother is

( user name on group even?) and you could contact her to start and perhaps

discuss their experience with her. You could also just call Dr. Prince's office,

state your case ( ask to speak to a nurse) and maybe you could get Dr. Prince to

contact you back. Sorry, I couldn't be of more help, but I just don't know her

:-(

Tracey

Insurance

>

>

> Is there anyone who does not go to a " free " hospital for their

child's treatment?

> I am wondering if insurance pays for most, anything or none of the

treatment? Where we go now for 's treatment is like

Shriners..........we do not pay.

> I have not called our insurance yet I am just wondering.

> I will call on Monday to find out what if anything is covered and

find a doc for a 2nd opinion.

> Thanks,

> Tasha

>

> Tasha

> Mommy to twin boys- and 21 months

> Fort Worth, Texas

>

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

> Bored stiff? Loosen up...

> Download and play hundreds of games for free on Games.

>

>

Link to comment
Share on other sites

I am sorry to hear Dr. Prince is not using the correct frame. Good news on

insurance covering 2nd and visit though. I would ask when the time comes who

reviews whether a certain treatment is covered. Make sure it is someone with

experience in the medical field. I know our insurance company uses RN's and when

need be MD's from that particular field being reviewed. I know when Lexi's brace

was being reviewed, I asked to speak the person doing it personally. I got a

call back within 5 hours and stated our case to them. They of course did not

deny it, but I wanted to get my case in there anyway. All I am saying is just

keep up with the insurance...if it comes to that point, keep in contact with

them and find out in what steps the review is in and fight like hell if you have

to.

Tracey

Insurance

>

>

> Is there anyone who does not go to a " free " hospital for their

child's treatment?

> I am wondering if insurance pays for most, anything or none of the

treatment? Where we go now for 's treatment is like

Shriners..........we do not pay.

> I have not called our insurance yet I am just wondering.

> I will call on Monday to find out what if anything is covered and

find a doc for a 2nd opinion.

> Thanks,

> Tasha

>

> Tasha

> Mommy to twin boys- and 21 months

> Fort Worth, Texas

>

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

> Bored stiff? Loosen up...

> Download and play hundreds of games for free on Games.

>

>

Link to comment
Share on other sites

Hi Tasha,

I'm sorry to hear that you're having difficulty with 's casts

and doctors. I went to see 4 orthopedic surgreons before I found

Shriners Chicago.

About the insurance question. I deal with insurance companies on a

regular basis. Please keep in mind everyone's insurance plan is

different. I thought you mentioned your husband is self-employed?

Please read the fine print in your insurance plan there can be many

exclusions in the insurance plan you have.

Before gets any treatment from the doctor you have selected ask

them to submitt a pre-estimate of the treatment. You should then get

a copy of the estimate response and then follow-up accordingly.

Unfortunately, needs immediate care and estimates and

insurances companies can take awhile. Insurance companies have 90

days to respond a claim/pre-estimate. And a response can be equal a

merely letter saying we received your request and need more

information. They don't have to send that to you if they choose

until day 89.

Also, keep in mind insurance companies want to pay the least amount

they have to and will find any way not to cover a service/claim. So

read the fine print.

I know this may sound extreme, but this all can happen and I've seen

it. It can be very frustrating to deal with insurance companies, but

keep at it and kill them with kindness, you'll be amazed the

channels you can get through. When you are on the phone with an

insurance company ALWAYS write down the date and time and the name

of the person you spoke with. Insurance companies record phone

calls and if something ever becomes questionable they can easily go

back to the telephone contact you had.

As a first time mother, Max is my life. I'd sell my house, car, and

everything I own to give him the best possible health care and

education. As my dad always said, it's not always about the money.

Keep us posted on your progress. And I will keep and family in

our thoughts.

Aekta

>

> Is there anyone who does not go to a " free " hospital for their

child's treatment?

> I am wondering if insurance pays for most, anything or none of the

treatment? Where we go now for 's treatment is like

Shriners..........we do not pay.

> I have not called our insurance yet I am just wondering.

> I will call on Monday to find out what if anything is covered and

find a doc for a 2nd opinion.

> Thanks,

> Tasha

>

>

> Tasha

> Mommy to twin boys- and 21 months

> Fort Worth, Texas

>

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

> Bored stiff? Loosen up...

> Download and play hundreds of games for free on Games.

>

>

Link to comment
Share on other sites

Tasha,

We don't go to a " free " hospital. We only go to TXSRH to participate in

research, we receive absolutely no treatment what-so-ever there. Our insurance

does cover everything; however, it was a VERY difficult battle that required

EXTREME diligence.

,

Yes. I just checked my e-mail for the first time in about two weeks I think.

(I had over 3000 emails, YIKES!) My life is in turmoil right now. We had a

death in our family last week and I am in the process of opening a scrap booking

store right now. (Grand Opening is Friday) Needless to say, my life has been

very chaotic lately. Hopefully, things will calm down for me Sunday. Please

send me your addy again and I will get them in the mail to you ASAP. I

apologize for the extreme delay.

Whomever else I said I would send shirts, please send me your addy again too.

Sorry,

Jen

Tasha Fontenot <ryanswalk@...> wrote:

Is there anyone who does not go to a " free " hospital for their child's

treatment?

I am wondering if insurance pays for most, anything or none of the treatment?

Where we go now for 's treatment is like Shriners..........we do not pay.

I have not called our insurance yet I am just wondering.

I will call on Monday to find out what if anything is covered and find a doc for

a 2nd opinion.

Thanks,

Tasha

Tasha

Mommy to twin boys- and 21 months

Fort Worth, Texas

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

Bored stiff? Loosen up...

Download and play hundreds of games for free on Games.

Link to comment
Share on other sites

Aekta,

Thanks for all your suggestions regarding insurance.

I actually called Shriner's in Erie and am just waiting on a call back.

I know there are other doctors we could see(Denver and Texas)and battle with

insurance.................BUT we think at this point in the game deserves

to see a really experienced doctor and I know Shriner's in Erie has at least

one. Maybe 2???

His next cast change is early May so hopefully we can get to Erie before that.

I will let you know what we find out. Hopefully in the next day or 2.

Thanks for your help,

Tasha

babymaxpd <babymaxpd@...> wrote:

Hi Tasha,

I'm sorry to hear that you're having difficulty with 's casts

and doctors. I went to see 4 orthopedic surgreons before I found

Shriners Chicago.

About the insurance question. I deal with insurance companies on a

regular basis. Please keep in mind everyone's insurance plan is

different. I thought you mentioned your husband is self-employed?

Please read the fine print in your insurance plan there can be many

exclusions in the insurance plan you have.

Before gets any treatment from the doctor you have selected ask

them to submitt a pre-estimate of the treatment. You should then get

a copy of the estimate response and then follow-up accordingly.

Unfortunately, needs immediate care and estimates and

insurances companies can take awhile. Insurance companies have 90

days to respond a claim/pre-estimate. And a response can be equal a

merely letter saying we received your request and need more

information. They don't have to send that to you if they choose

until day 89.

Also, keep in mind insurance companies want to pay the least amount

they have to and will find any way not to cover a service/claim. So

read the fine print.

I know this may sound extreme, but this all can happen and I've seen

it. It can be very frustrating to deal with insurance companies, but

keep at it and kill them with kindness, you'll be amazed the

channels you can get through. When you are on the phone with an

insurance company ALWAYS write down the date and time and the name

of the person you spoke with. Insurance companies record phone

calls and if something ever becomes questionable they can easily go

back to the telephone contact you had.

As a first time mother, Max is my life. I'd sell my house, car, and

everything I own to give him the best possible health care and

education. As my dad always said, it's not always about the money.

Keep us posted on your progress. And I will keep and family in

our thoughts.

Aekta

>

> Is there anyone who does not go to a " free " hospital for their

child's treatment?

> I am wondering if insurance pays for most, anything or none of the

treatment? Where we go now for 's treatment is like

Shriners..........we do not pay.

> I have not called our insurance yet I am just wondering.

> I will call on Monday to find out what if anything is covered and

find a doc for a 2nd opinion.

> Thanks,

> Tasha

>

>

> Tasha

> Mommy to twin boys- and 21 months

> Fort Worth, Texas

>

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

> Bored stiff? Loosen up...

> Download and play hundreds of games for free on Games.

>

>

Link to comment
Share on other sites

Tasha,

There are two docs that do the casting in Erie - Drs. and Khoury. Both

are great!

Noelle (12-2-01)

Ian (8-15-04)

Re: Re: Insurance

Aekta,

Thanks for all your suggestions regarding insurance.

I actually called Shriner's in Erie and am just waiting on a call back.

I know there are other doctors we could see(Denver and Texas)and battle with

insurance.................BUT we think at this point in the game deserves

to see a really experienced doctor and I know Shriner's in Erie has at least

one. Maybe 2???

His next cast change is early May so hopefully we can get to Erie before that.

I will let you know what we find out. Hopefully in the next day or 2.

Thanks for your help,

Tasha

babymaxpd <babymaxpd@...> wrote:

Hi Tasha,

I'm sorry to hear that you're having difficulty with 's casts

and doctors. I went to see 4 orthopedic surgreons before I found

Shriners Chicago.

About the insurance question. I deal with insurance companies on a

regular basis. Please keep in mind everyone's insurance plan is

different. I thought you mentioned your husband is self-employed?

Please read the fine print in your insurance plan there can be many

exclusions in the insurance plan you have.

Before gets any treatment from the doctor you have selected ask

them to submitt a pre-estimate of the treatment. You should then get

a copy of the estimate response and then follow-up accordingly.

Unfortunately, needs immediate care and estimates and

insurances companies can take awhile. Insurance companies have 90

days to respond a claim/pre-estimate. And a response can be equal a

merely letter saying we received your request and need more

information. They don't have to send that to you if they choose

until day 89.

Also, keep in mind insurance companies want to pay the least amount

they have to and will find any way not to cover a service/claim. So

read the fine print.

I know this may sound extreme, but this all can happen and I've seen

it. It can be very frustrating to deal with insurance companies, but

keep at it and kill them with kindness, you'll be amazed the

channels you can get through. When you are on the phone with an

insurance company ALWAYS write down the date and time and the name

of the person you spoke with. Insurance companies record phone

calls and if something ever becomes questionable they can easily go

back to the telephone contact you had.

As a first time mother, Max is my life. I'd sell my house, car, and

everything I own to give him the best possible health care and

education. As my dad always said, it's not always about the money.

Keep us posted on your progress. And I will keep and family in

our thoughts.

Aekta

>

> Is there anyone who does not go to a " free " hospital for their

child's treatment?

> I am wondering if insurance pays for most, anything or none of the

treatment? Where we go now for 's treatment is like

Shriners..........we do not pay.

> I have not called our insurance yet I am just wondering.

> I will call on Monday to find out what if anything is covered and

find a doc for a 2nd opinion.

> Thanks,

> Tasha

>

>

> Tasha

> Mommy to twin boys- and 21 months

> Fort Worth, Texas

>

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

> Bored stiff? Loosen up...

> Download and play hundreds of games for free on Games.

>

>

Link to comment
Share on other sites

I thought so, but wasn't for sure.

You guys see Dr.Khoury.........right?

Claflin <noellesmommy@...> wrote:

Tasha,

There are two docs that do the casting in Erie - Drs. and Khoury. Both

are great!

Noelle (12-2-01)

Ian (8-15-04)

Re: Re: Insurance

Aekta,

Thanks for all your suggestions regarding insurance.

I actually called Shriner's in Erie and am just waiting on a call back.

I know there are other doctors we could see(Denver and Texas)and battle with

insurance.................BUT we think at this point in the game deserves

to see a really experienced doctor and I know Shriner's in Erie has at least

one. Maybe 2???

His next cast change is early May so hopefully we can get to Erie before

that.

I will let you know what we find out. Hopefully in the next day or 2.

Thanks for your help,

Tasha

babymaxpd <babymaxpd@...> wrote:

Hi Tasha,

I'm sorry to hear that you're having difficulty with 's casts

and doctors. I went to see 4 orthopedic surgreons before I found

Shriners Chicago.

About the insurance question. I deal with insurance companies on a

regular basis. Please keep in mind everyone's insurance plan is

different. I thought you mentioned your husband is self-employed?

Please read the fine print in your insurance plan there can be many

exclusions in the insurance plan you have.

Before gets any treatment from the doctor you have selected ask

them to submitt a pre-estimate of the treatment. You should then get

a copy of the estimate response and then follow-up accordingly.

Unfortunately, needs immediate care and estimates and

insurances companies can take awhile. Insurance companies have 90

days to respond a claim/pre-estimate. And a response can be equal a

merely letter saying we received your request and need more

information. They don't have to send that to you if they choose

until day 89.

Also, keep in mind insurance companies want to pay the least amount

they have to and will find any way not to cover a service/claim. So

read the fine print.

I know this may sound extreme, but this all can happen and I've seen

it. It can be very frustrating to deal with insurance companies, but

keep at it and kill them with kindness, you'll be amazed the

channels you can get through. When you are on the phone with an

insurance company ALWAYS write down the date and time and the name

of the person you spoke with. Insurance companies record phone

calls and if something ever becomes questionable they can easily go

back to the telephone contact you had.

As a first time mother, Max is my life. I'd sell my house, car, and

everything I own to give him the best possible health care and

education. As my dad always said, it's not always about the money.

Keep us posted on your progress. And I will keep and family in

our thoughts.

Aekta

>

> Is there anyone who does not go to a " free " hospital for their

child's treatment?

> I am wondering if insurance pays for most, anything or none of the

treatment? Where we go now for 's treatment is like

Shriners..........we do not pay.

> I have not called our insurance yet I am just wondering.

> I will call on Monday to find out what if anything is covered and

find a doc for a 2nd opinion.

> Thanks,

> Tasha

>

>

> Tasha

> Mommy to twin boys- and 21 months

> Fort Worth, Texas

>

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

> Bored stiff? Loosen up...

> Download and play hundreds of games for free on Games.

>

>

Link to comment
Share on other sites

Guest guest

Tasha,

I think you are going the best route for . I hadn't joined this

group before Shriners-Chicago recommended casting. I too would have

considered the other 2 hospitals.

Keep us posted on what you here back.

I'll be crossing my fingers ofr you!

Aekta

> >

> > Is there anyone who does not go to a " free " hospital for their

> child's treatment?

> > I am wondering if insurance pays for most, anything or none of

the

> treatment? Where we go now for 's treatment is like

> Shriners..........we do not pay.

> > I have not called our insurance yet I am just wondering.

> > I will call on Monday to find out what if anything is covered

and

> find a doc for a 2nd opinion.

> > Thanks,

> > Tasha

> >

> >

> > Tasha

> > Mommy to twin boys- and 21 months

> > Fort Worth, Texas

> >

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

> > Bored stiff? Loosen up...

> > Download and play hundreds of games for free on Games.

> >

> >

Link to comment
Share on other sites

  • 6 months later...

, The same thing happened to me when buying a car, though I'm poz. I was asked if I want insurance in case I became disabled, but they exclude pre-existing conditions, including HIV. Couldn't get the insurance. If your partner is still neg, he'll have no problem getting the insurance though. If he happens to be newly poz even (hopefully he's still neg), not only will he not get this mortgage insurance, but he'll now have a pre-existing condition and may not get any type of health insurance at all. Insurance companies share info. I'd go online and try an insurance like Blue Cross Blue Shield, something well known at least. Does his employer not offer medical insurance? Some larger corporations are now including same sex domestic partners to share insurance, though the premiums are a fortune. My partner is neg too, so we share some of the same challenges.

<whatyouwish4@...> wrote: My partner and I decided to get mortgage insurance, should he predecease me the mortgage would be paid. They sent out a nurse yesterday for an extremely long eval. I tried to stay out of the way because this was his responsibility, though it affected me. I see now that that was a mistake.He signed a whole bunch of forms which the nurse didn't explain. It was only when we found instructions about the urinalysis for HIV-1 in the trash can that we knew he was going to be tested. He freaked b/c he

hasn't been tested since I've been diagnosed. That may sound dangerous to many of you but, trust me, my partner is the Poster Boy for Safe Sex. There is NO WAY he can be poz. Problem is, he has no health insurance and doesn't qualify for medical assistance b/c he owns property. (In MD, you have to be poor to get any assistance which means you have to sell your house and spend all the money.) Impossible.Better plan is to find health insurance IMMEDIATELY, just in case. Don't really need much just an 80/20, hospitalization plan, maybe a drug and dental, depending. Anyone have any suggestions?Sorry for it being off topic, but I figured all of you would have some ideas. I think that the way this company acted was too slick and I would like to really shake someone there warmly by the throat. Mostly, I'm sorry I didn't sit there and read all the damn forms!

SEIZE THE DAY! ENJOY TODAY, SMELL THE ROSES AND HUG YOURSELF

Need a vacation? Get great deals to amazing places on Travel.

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  • 1 year later...

contact me offlist. I live in Tulsa and can help you.

BARBIE

________________________________

From: bo_swoman <bo_swoman@...>

Sent: Thursday, February 5, 2009 2:19:55 PM

Subject: insurance

My daugter and I live in Oklahoma. My ex-husband told me today his

company is going to have to drop health insurance due to economy. She

is on what they call " Soonercare " . I believe it is thru the state.

She's always gotten her infusions in Dallas. Does anyone know if the

state will pay for her infusions if we switch her to a doc in

Oklahoma ? Where would I begin on getting information of what doctor to

find, if the state will pay etc. If they don't pay, what happens if we

have to stop her infusions altogether ?

Bo--mom to Sis, Igg def. subclasses low, pseudo tumor cerebri,

asthma,,,,,, ,

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