Insurence scare

[flower]

I have been disabled since March 23, 2011. I received a letter back then, that I was covered by my employer's insurance for the 2 1/2 years before I reach the age of 55, when railroad medicare kicks in.
Yesterday I got a letter from my dental insurance carrier that my coverage stopped Jan 1 2013....my 55th birthday isn't until September...

The letter said that after some law passed called HIPAA, that they were obligated to give me a letter stating my coverage....what does that mean??? That they wouldn't tell me if HIPAA didn't force them to??? I see a doctor every two weeks because of the embolisms in my lungs.
The railroad bundles all insurance together, vision, dental, prescriptions and medical. If one stops it means they all do. I was in tears when I called the Railroad Retirement Board (RRB) the lady I first talked to, told me I wouldn't be covered by insurance until I was 65....and that I needed to go to the private sector to find insurance. The reason I was so panicked is that I have seen a heart specialist, a lung specialist and my personal doctor without knowing I wasn't covered. I also take a fist full of prescription medicines. That means my medical bills are through the roof before I even knew I needed insurance.
The RRB lady had me wait, she had to of heard me fighting tears...my voice was shaking. She became so nice when she talked to me, and then checked my file instead of giving me a blanket answer...and said she had some good news, my condition was approved for permanent disability and I would be covered for insurance by Railroad Medicare come Sept 1....I only need to find insurance for January through October.
I called United health care (our railroad insurance) I wanted to know for sure the date I was cut off..figuring the 1st of the year like the dental. Well United health Care told me I was covered until Dec. 31, 2013....I am not covered by dental and vision but my medical was a pre-existing condition that disabled me from the railroad, and all needed medications are covered and were also still in effect.... I wouldn't be dropped.
My insurance scare was short lived...but I know now how others must feel.... it's like being buried alive, all money is just poured into medical bills with no end in sight. Is there anyone here on the site with that kind of grief? What is the cost of purchasing medical insurance privately, and where do you begin to even look? I know those with limited low incomes can get state help (my daughter does, and for all her kids) but what about people with an income? What do you pay out, and how did you decide on where to go for insurance?

 

[beth]

A bit of a scare but the letter did say only dental?
Aren't you eligible for SSD as well as your railroad disability?

 

[flower]

Quote:
Originally Posted by Beth http:///t/394376/insurence-scare#post_3510218
A bit of a scare but the letter did say only dental?
Aren't you eligible for SSD as well as your railroad disability?
I knew the insurances were bundled when I worked for the RR, so I called the RRB to see if it was indeed only the dental...which I can't use anyway, because of my blood being made thin for the blood clots in my lungs, to break down and melt away. I had hoped it was just the dental. Fingers crossed, I called the Railroad Retirement Board.
The RRB lady told me I was indeed without any insurance as of 1,1 2013 until I was 65 (blanket answer)....then when I started to really break down and cry, (because I had already seen a ton of doctors since the first of the year) Her tone of voice changed to really nice and caring, and she put me on hold and looked at my file. Then she told me she had good news...I was eligible for RR medicare on Sept 1 of this year. But that I had to find insurance on my own until then.
I would have purchased insurance if had known, since the first of the year seeing so many doctors... I was big time in the hole already. One regular doctor office visit is $170.00, and who knows what the lung and heart specialist charged.
I am not eligible for any SSD because I only worked outside of the railroad for 6 months, when I worked at Taco bell as a teenager. I had stayed with the railroad job for over 35 years. I'm in bad shape now, I see so many doctors it's hard to keep up. Once I went to the lung doctor, and was told I didn't have an appointment. I called all my doctors to see who had me scheduled, it turned out that I had an appointment with the heart doctor on the other side of town.
I decided to call the insurance themselves to find out the exact date I became uninsured so I could calculate how much money was owed out of pocket already...I was hopeful that it wasn't the 1st of the month, but the end of January. That way I figured I could buy insurance for starting February....it turned out I'm still covered, and will be covered until my RR medicare kicks in.
The whole thing has me a nervous wreck, I don't know the first thing about how a person could even find private insurance. Some place called Cobra wanted $600.00 a month. It's still cheaper than paying out $170.00 + for each doctor visit every two weeks.
Oh and I found out that Obama made it impossible for insurances to turn folks like me down for pre-existing conditions. I guess insurances didn't want to insure people who are already sick, and don't have insurance through work....What the heck did people do before then? Welfare only takes care of the poor who have no income. I guess if you have an income, it wouldn't do you any good before Obama's insurance thing...the companies wouldn't cover you anyway. I think that's what the HIPAA law is.

 

[beth]

Quote:
Originally Posted by Flower http:///t/394376/insurence-scare#post_3510221
.What the heck did people do before then? Welfare only takes care of the poor who have no income. I guess if you have an income, it wouldn't do you any good before Obama's insurance thing...the companies wouldn't cover you anyway. I think that's what the HIPAA law is.
What did they do? Out of luck unless they worked for an employer who had policies that would cover after a period of time. That is one thing I liked about the new law. HIPAA pertains to medical privacy laws protecting confidential info.

 

[flower]

Quote:
Originally Posted by Beth http:///t/394376/insurence-scare#post_3510222
What did they do? Out of luck unless they worked for an employer who had policies that would cover after a period of time. That is one thing I liked about the new law. HIPAA pertains to medical privacy laws protecting confidential info.
I wonder why the HIPAA was even mentioned as a reason for the dental insurance sending me a letter explaining why I was no longer covered. The letter said to keep it for proof that I was covered until that point.

I just don't get it.

 

[reefraff]

The pre existing deal doesn't kick in for adults until next year.
COBRA is Continuation of Benefits something something. It means if you are separated from your employer you can keep your same insurance at your expense for up to 18 months.
I know a guy who was paying 345.00 a month for his blue cross insurance in 2008. Last year his premiums were up to 615. He's a big 0bama supporter and believe me, I never let him forget why his insurance skyrocketed. From 2001 until 2008 it had increased from the high two's to 345 and since 0bama started pushing health care "reform" it's close to doubled. Don't know how much they jacked it up this year.
I am going to have to deal with the junk this year because of "reform". I have a medicare advantage account and I am not sure how they will deal with it. right now it's like 100 a month. Not sure if they will drop it or add an additional premium. As a fallback I can go on my wife's. She currently pays 45 a month. Life's rough LOL! I have to pay an additional 2.45 a month for medicare because I didn't have prescription drug coverage when I first became eligible, what a scam. Not sure if my wife's prescription plan meets the requirements or not but I will try.

 

[flower]

Quote:
Originally Posted by reefraff http:///t/394376/insurence-scare#post_3510239
The pre existing deal doesn't kick in for adults until next year.
COBRA is Continuation of Benefits something something. It means if you are separated from your employer you can keep your same insurance at your expense for up to 18 months.
I know a guy who was paying 345.00 a month for his blue cross insurance in 2008. Last year his premiums were up to 615. He's a big 0bama supporter and believe me, I never let him forget why his insurance skyrocketed. From 2001 until 2008 it had increased from the high two's to 345 and since 0bama started pushing health care "reform" it's close to doubled. Don't know how much they jacked it up this year.
I am going to have to deal with the junk this year because of "reform". I have a medicare advantage account and I am not sure how they will deal with it. right now it's like 100 a month. Not sure if they will drop it or add an additional premium. As a fallback I can go on my wife's. She currently pays 45 a month. Life's rough LOL! I have to pay an additional 2.45 a month for medicare because I didn't have prescription drug coverage when I first became eligible, what a scam. Not sure if my wife's prescription plan meets the requirements or not but I will try.
For $600.00 a month Cobra said they will take me up as soon as my doctor released me from the medical problems I had when I took my disability...silly people, why would I do that? As long as I have the pre-existing medical condition my medical insurance is free. If my knees, back and feet could be made well I wouldn't have taken disability, just a medical leave of absence.
Tuesday I have a fellow coming to the house to talk to me about Omaha (spelling??) Anyway, I'm going to need supplemental insurance to the RR medicare, so that everything is covered. My Mother has that one, so I will talk to him first. I want everything set up for the 1st of September so there are no gaps in coverage. As it is right now, I have a copay, and it's draining me to death with $35.00 every time I see a doctor....I have already seen 4 different doctors and my regular physician 3xs this month alone and there is still a week to go before the 1st of February.
I had good news from the lung and heart doctors, they say I'm doing well, and I won't have to see them again for 6 months. My blood pressure is down, my cholesterol is now showing good numbers, and my breathing is a steady 98, my bipap machine is working great for me. Now if my blood work would be stabilized, I could go to see my regular doctor once a month instead of every week or so. They want my INR to be 3 so the blood clots will break up and clear...but it just keeps going down to 1.8 (not good enough) then to 5.9 (I could bleed to death) and everything in between....except the desired 3, the closest I came to 3 was a 2.8...then it jumped to 5.9 the next week.

If I had to pay out of pocket for all that...I wouldn't have a penny to my name....for years. LOL...I want to spend my money on seahorses!

 

[reefraff]

Other than being crippled and fat I am incredibly health thank god. Just gotta drop the weight. My doc gets frustrated because all I ever see him for is work comp related issues. He keeps pushing me to have medicare based visits. My Medicare Advantage plan is through united health care and I suspect there is some sort of financial reason he wants to increase those visits. He's about to lose a patient. Next time he starts flipping through my chart and complaining he's going to get told to ##$% off!!

 

[flower]

Quote:
Originally Posted by reefraff http:///t/394376/insurence-scare#post_3510259
Other than being crippled and fat I am incredibly health thank god. Just gotta drop the weight. My doc gets frustrated because all I ever see him for is work comp related issues. He keeps pushing me to have medicare based visits. My Medicare Advantage plan is through united health care and I suspect there is some sort of financial reason he wants to increase those visits. He's about to lose a patient. Next time he starts flipping through my chart and complaining he's going to get told to ##$% off!!
What is a medicare based visit? I thought you go to the doctor when your sick, and whatever insurance you have helps to foot the bill. Work comp related issues??? Isn't "WORK" the reason we are crippled up and on disability?

 

[reefraff]

Quote:
Originally Posted by Flower http:///t/394376/insurence-scare#post_3510273
What is a medicare based visit? I thought you go to the doctor when your sick, and whatever insurance you have helps to foot the bill. Work comp related issues??? Isn't "WORK" the reason we are crippled up and on disability?
I have to go in once a month or so for a blood test for warfarin. That and any other accident related stuff is on workers comp. General health stuff goes to medicare.

 

[flower]

Quote:
Originally Posted by reefraff http:///t/394376/insurence-scare#post_3510283
I have to go in once a month or so for a blood test for warfarin. That and any other accident related stuff is on workers comp. General health stuff goes to medicare.
I'm on Warfarin as well, they can't get it regulated, so I have to go once a week...then twice a week...then changed to once a week again...it drives me to tears. If my numbers would be where it should 2xs in a row...I can come in once a month. It hasn't happened yet.

 

[kiefers]

what were your last numbers?

 

[flower]

Quote:
Originally Posted by Kiefers http:///t/394376/insurence-scare#post_3510292
what were your last numbers?
2.1 and it's supposed to be at 3...I see the doctor again on Tuesday. My Warfarin dose is 7.5
From eating aspirin for 25 years, my blood has extra platelets and it clots really easy, thinning it out is proving to be a challenge for the doctors. I was on pure heparin for 2 solid weeks in the hospital, and the highest my INR would go was 2.3. The doctor said 2 was therapeutic, so after 2 weeks he let me go home and wanted me to be tested once a day when I first got out... I need to get rid of the blood clots in my lungs....he wants it at 3...it will get close to 3 (2.8) and jump to 5.9. This has been going on since July.

 

[beth]

I thought aspirin thins the blood, which is why people take baby aspirin to prevent stroke.

 

[ironeagle2006]

The INR Threaputic range is 2-3 and that is from the Boys at St Johns Hospital in Springfield the Guys that in the 50-60's where doing more work with Cumadin aka Warafin than anyone Else. Sorry I got thrown on it when I went into Afib in November. Heck they have me sitting at 2.4 and they are happy as can be. Now the cost of Private Insurance do not get me Started on that one. Lets just say my Brother in AR saw his Insurance DOUBLE this year for his wife and kid. Went from 400 a month to 800 a month for the Same Plan from his Employeer.

 

[reefraff]

Quote:
Originally Posted by Flower http:///t/394376/insurence-scare#post_3510290
I'm on Warfarin as well, they can't get it regulated, so I have to go once a week...then twice a week...then changed to once a week again...it drives me to tears. If my numbers would be where it should 2xs in a row...I can come in once a month. It hasn't happened yet.
It took me about 2 months for it to get pretty much stabilized. If I am losing weight it has to be tweaked but basically 4 mg a day for the last 10 years. Sometimes I have to step up to 6 one or two days a week. I haven't been checked in nearly 2 months, gotta get in this week.
If you are on antibiotics or eat a lot of certain veggies it will screw with your levels. I assume they've already talked to you about that.

 

[flower]

Quote:
Originally Posted by reefraff http:///t/394376/insurence-scare#post_3510308
It took me about 2 months for it to get pretty much stabilized. If I am losing weight it has to be tweaked but basically 4 mg a day for the last 10 years. Sometimes I have to step up to 6 one or two days a week. I haven't been checked in nearly 2 months, gotta get in this week.
If you are on antibiotics or eat a lot of certain veggies it will screw with your levels. I assume they've already talked to you about that.
LOL...The doctor accuses me of eating leafy green veggies. I do eat salads, but Romain lettuce isn't exactly spinach or broccoli. Also if you eat the same thing constantly it isn't supposed to mess with the numbers. I even quit taking a multi vitamin because it had K in it.

 

[beth]

This is somewhat off topic, but, Flower, how does your RR disability work? Most people who are on disability from work can also apply for disability SSD, in addition to that which they get from work. Sounds like yours doesn't work that way?

 

[reefraff]

I believe you have to select one or the other. I know someone who is in a union that doesn't have to participate in SS and that's how it works for them.

 

[flower]

Quote:
Originally Posted by reefraff http:///t/394376/insurence-scare#post_3510316
I believe you have to select one or the other. I know someone who is in a union that doesn't have to participate in SS and that's how it works for them.
I never even tried SS...because I had since my youth, worked on the RR.
I don't know anyone on SS that receives the money I get from RRB. My only real debt is the house note and my van. Well, doctors get their share, but at this moment I'm all caught up on those bills. The fish tanks drain me...but that's by choice..LOL I'm getting two new potbelly horses come the first of the month....I'm replacing Fred who died months ago, and I couldn't resist another female.
My mother and father both worked (him-18yrs, her 16yrs) on the RR and she gets 1/2 of his benefits after he died. The thing is, she retired over 25 years ago, and now her "double" annuity doesn't even add up to what I'm getting. I'm sure after 25 years (should I live that long) My annuity won't be much compared to others. Cost of living is almost an insult but money is money. For my mother, every time they give her a cost of living raise...the extra from my fathers portion lowers. Her annuity income is always the same, the RRB told her that once the "extra" annuity has dwindled completely her money will start to climb a little each year...How wrong is that?.