I can't take it anymore!(a ins. vent kinda long)update

[kejoda]

Since Tim has been unemployed for the past 7 months we have had med. assistance for the boys health care. Mainly to pay for John's speech and occupational theraphy. Well now Tim started a job 2 weeks ago and we have been trying to find out if we can keep the ins. We know that the ins has income limits but if you go over you pay a portion of the premiums. Well after we have been playing alot of phone tag with them and having the wrongs forms sent out or not sent at all I have finally got someone on the phone who knew something about our case. Problem is now they say that they never had anyone be honest about getting a job and don't know what to do now! aaaaahhhhhhhhhhhhh!! Now we wait until they figure something out. I'm afraid that I messed up the ins. and we have to stop services for John. I do not have enough tylenol/advil in the house to deal with this today.

I just hate insurance!!!!!!!!!!!!!!!

 

[JasonLyons]

kinf of long post, but I hate insurance companys also

 

[EROS]

Our HMO insurance costs about $8700/year for family coverage..........RIDICULOUS

 

[browneyes]

Ask to talk to the supervisor. They can look at a pay grade chart to tell you if you still qualify. Get gruff with them.

 

[kejoda]

Well I just got a call back from them saying that its unlikely that the boys will be covered anymore. The good news is that we have the ins. until the end of September. Tims ins at work kicks in the middle of Sep and there is a new law that outlaws preexisting condictions. So I think everything has worked out. Yeah!!!!!!!!!!!!

We have been through 4 different ins. cos. this year. One sompany was still paying bills after we cancelled the ins.

I so agree with you on this one Jldriscoll!

 

[Serena]

I'm glad it's working out. I hate insurance companies too.

 

[browneyes]

I'm glad you have good news.

 

[mamajoan]

When dh lost his job, we kept up our COBRA payments of $880. a month to insure that we were continuously covered by medical insurance..BECAUSE if there is a lapse in coverage (even a short period) my Pre-existing conditions WOULD NOT be covered under when new job's insurance program would begin... This is what I was told by all the insurance companies regarding the new law for preexisting conditions.. You have to be covered to get new coverage... So DO NOT LET ANY TIME LAPSE OCCUR...

I think the insurance program you have for your boys will continue until the date new insurance coverage begins...
GET It in writing from current program. including the date service will no longer be covered.

I have a feeling but am not completely sure that you may be able to still qualify for assistance for your kids depending on your income and son's diagnosis..

Be firm, but patient.. sometimes you have to speak to a supervisor, then request it in writing.. if the supervisor balks, ask for the dept. manager. I will tell you from the service provider's end of the insurance maze that if it is not in writing.. you may be out of luck..
Insurance cost is out of sight.. and will continue to increase with companies requiring employees to pay a much larger portion of the premium.
Our healthcare system is in a big pickle.. they take huge losses every year by providing care to those who are not covered by insurance, Medi-CAL(medi-caid) pays pennies on the dollar for services rendered..The cost is then passed on to others..
Healthcare costs will continue to rise ..
I understand why perfectly healthy individuals and families and employers feel out raged by the cost of their insurance when companies are forced to cover people like me who have high medical costs. Believe me when I say I would rather be perfectly healthy...
hobbling off the soapbox now.. sorry kejoda if I got carried away.
Joan

 

[kejoda]

You didn't get carried away Joan. they lady I talked to spoke to her supervisor and based on what our income will be they don't think it can continue. We are going to sumit it anyway to make sure. She did say that there is no way to cancel the ins. before Oct 1. Our new ins. will start sep 20 or 21st and we know that they will cover John's pt/ot therpies.

We were paying 800 cobra ins. also until the boys got the med. assist. We needed the ins. since Johns bills come to over 2000 a month.

Of coursse with the mail this morning came a bill from the peds clinic and they still aren't billing the right ins. company. It never ends.

 

[Spinning]

Hi don't know if this will help or not but look into it.
Who is providing the speech & OT? Speak to them. They may know about early intervention. Most states cover these service free of charge (well taxes...)
If you child has a 25% delay (granted this is in PA) then your son would fall under early intervention or intermediate unit. Contact your child and welfare services Does he have a case worker? If so speak to her. Granted you may have to change from a private setting to school or even home based
I hope it all works out for you. But look into early intervention because they don't have the cap which many insurances do with the number of visits. The services con't until the child no longer has a delay.

 

[kejoda]

John already goes to a early education speech class 3 times a week. Has been for 3 years now. I shocked they heck out of them when we got the Med. assist. We've been turned down by a couple of different services since they cannot figure out what is wrong with John. We've been to 3 different places to have him evaluated and we get "He is a puzzle." there is much to be said for a label.

 

[helenabear]

Beccy, that sounds very frustrating. I do hope it works out good for all of you (and that the docs learn which insurance company to bill). Sending a little good luck PD your way just in case

 

[Kitty 34]

Good luck to you and if it makes you feel any better I don't care for insurance companies either!!!

 

[mamajoan]

I was wondering if you still might be able to be eligible if the did
income averaging for the year when they looked at your income.
Some agencies will do that, others no way.. but I guess it does not matter for now ...I am glad to hear that the new insurance will cover therapies with no problem



btw.. did you check to see if they had a limit on $ spent for therapy per year.. some policies do.. just a thought...

ahh my wandering mind.. it seems to wander alot without getting very far
Joan

 

[kejoda]

They base the ins. on monthly income.

On our new ins we are allowed 25 visits a year. Which will be fine for this year. Next year we might pay some sessions ourselves. I'm going to ask if we can get the discounts that the center give the ins. co. I got a stack of papers from them to go through to see whats available. So many hoops to go through.

 

[mamajoan]

You may even get a better discount than what they give the insurance.. just ask a few visits before the insurance is finished paying ... One of the private practice offices I worked in many moons ago did give cash private pay patients a big break..
Now thats a happy thought..

You are doing great muddling thru all the paperwork to get much needed therapy for your son.. GOOD JOB!!
Joan

 

[kejoda]

Thanks Joan. I should of bought stock in Tylenol though.

 

[mamajoan]

oooo don't say stock purchase too loudly.. my portfolio cringes everytime it hears the word 'stock' ... that is unless I could interest you a few shares of Intel.. LOL

 

[kejoda]

We have intel. We can share a doghouse. Probably not the roof though.

 

[mamajoan]

when dh lost his job at intel he had 90 days to sell his options...he sold them at 3pm on the 90th day.. he got less than 1.50 a share profit.. scary very scary... but better than my friends working at Cisco.. they are way under water...

btw does the doghouse have cable? I have to be able to see trading spaces and General Hospital or I would be crabby..

Thanks for offering to share..

I am headed out to Starbarks for coffee with my dh.. can I get you something?