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Reply #30 posted 08/09/18 6:07pm

benni

XxAxX said:

benni said:


Yes, the deductibles for reasonable monthly payments are $12,500. If I want something with a low deductible, it's almost $400 per month. (Out of pocket insurance is $600 a month with a high deductible.) They also don't cover pre-existing conditions. Once I went to the ER for this condition, and the doctor prescribed medication, it became a pre-existing condition. :-/



sorry for being nosy and no need to reply here but have you had strep infection or other viral infection lately? https://www.mayoclinic.or...c-20352539


No, no infections. Outside of the history from clots, I'm pretty healthy.

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Reply #31 posted 08/10/18 7:48am

babynoz

Make sure to get a full exam and follow up. Try not to worry about the $$. I had to learn to make myself a priority in my own life.

When I didn't have coverage I went to County and they put me on an income based payment plan. I don't care for clinics but I gotta do what I gotta do.

Best of luck.

Prince, in you I found a kindred spirit...Rest In Paradise.
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Reply #32 posted 08/10/18 9:58am

Empress

Lianachan said:

It must be awful to endure a health care system where you have to stop, even for one second, to consider if you can afford to have things like that checked out. It's a disgrace people are put through that experience.

It certainly is a disgrace, especially in a country that claims to be the greatest country in the world. Obviously, I beg to differ, thanks to your dick of a president.

I feel terrible for Benni, but unfortunately, I don't have any suggestions, other than go to the ER and tell them you're having a heart attack. They won't turn you away and you can deal with the aftermath once you are well again.

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Reply #33 posted 08/10/18 5:35pm

XxAxX

avatar

Empress said:

Lianachan said:

It must be awful to endure a health care system where you have to stop, even for one second, to consider if you can afford to have things like that checked out. It's a disgrace people are put through that experience.

It certainly is a disgrace, especially in a country that claims to be the greatest country in the world. Obviously, I beg to differ, thanks to your dick of a president.

I feel terrible for Benni, but unfortunately, I don't have any suggestions, other than go to the ER and tell them you're having a heart attack. They won't turn you away and you can deal with the aftermath once you are well again.

he is. indeed he is. President Obama did a great job putting together a plan that mostly worked, but tRump is effing it all up. smh

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Reply #34 posted 08/16/18 11:31pm

benni

I lost my vision in my left eye two days ago, temporarily. It lasted about 20 minutes. I've had it happen about 3 or 4 times in the past 2 to 3 months, but it only lasts for about a minute or two and I didn't associate it with it my heart or anything. The doctor thinks I'm having TIAs (mini strokes), but wants me to go to the Cardiologist on Monday, tell him about my vision, and make sure he checks my carotid artery. He said with my history of deep vein thrombosis and pulmonary embolisms, I'm at a very high risk of having a stroke. I asked if a mini stroke could just impact your vision, and he said that it can, a clot can break lose, go the veins feeding my eye, and cause me to lose vision (partial or full - one eye), and once it works free from there, my vision returns. :-/ He's the same doctor that I saw at urgent care that wanted me to go to the ER that first time. He asked me, "So did they tell you that you were having a heart attack when you went to the ER that night?" Umm, doc, I didn't go that night, I went the next day though. eek "Brenda! I ought to spank you!" eek

[Edited 8/16/18 23:55pm]

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Reply #35 posted 08/17/18 6:27am

PennyPurple

avatar

benni said:

I lost my vision in my left eye two days ago, temporarily. It lasted about 20 minutes. I've had it happen about 3 or 4 times in the past 2 to 3 months, but it only lasts for about a minute or two and I didn't associate it with it my heart or anything. The doctor thinks I'm having TIAs (mini strokes), but wants me to go to the Cardiologist on Monday, tell him about my vision, and make sure he checks my carotid artery. He said with my history of deep vein thrombosis and pulmonary embolisms, I'm at a very high risk of having a stroke. I asked if a mini stroke could just impact your vision, and he said that it can, a clot can break lose, go the veins feeding my eye, and cause me to lose vision (partial or full - one eye), and once it works free from there, my vision returns. :-/ He's the same doctor that I saw at urgent care that wanted me to go to the ER that first time. He asked me, "So did they tell you that you were having a heart attack when you went to the ER that night?" Umm, doc, I didn't go that night, I went the next day though. eek "Brenda! I ought to spank you!" eek

[Edited 8/16/18 23:55pm]

Oh no benni! Prayers.

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Reply #36 posted 08/17/18 10:13am

babynoz

pray

Prince, in you I found a kindred spirit...Rest In Paradise.
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Reply #37 posted 08/17/18 5:03pm

XxAxX

avatar

benni said:

I lost my vision in my left eye two days ago, temporarily. It lasted about 20 minutes. I've had it happen about 3 or 4 times in the past 2 to 3 months, but it only lasts for about a minute or two and I didn't associate it with it my heart or anything. The doctor thinks I'm having TIAs (mini strokes), but wants me to go to the Cardiologist on Monday, tell him about my vision, and make sure he checks my carotid artery. He said with my history of deep vein thrombosis and pulmonary embolisms, I'm at a very high risk of having a stroke. I asked if a mini stroke could just impact your vision, and he said that it can, a clot can break lose, go the veins feeding my eye, and cause me to lose vision (partial or full - one eye), and once it works free from there, my vision returns. :-/ He's the same doctor that I saw at urgent care that wanted me to go to the ER that first time. He asked me, "So did they tell you that you were having a heart attack when you went to the ER that night?" Umm, doc, I didn't go that night, I went the next day though. eek "Brenda! I ought to spank you!" eek

[Edited 8/16/18 23:55pm]


pray

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Reply #38 posted 08/20/18 12:03pm

benni

I've gotten insurance! And at a reasonable (affordable) price. Cardiology gave me a number to call. Saw the cardiologist today, and he detected a heart murmur. Tried to schedule me for the holter monitor this week and a stress test, along with an echocardiogram and a bubble study for 9/6, but the insurance has a 30 day wait, so I had to push them off until after the insurance would pay for it.

The bubble study is to look for any holes in my heart that might have allowed a clot to move from one side of my heart to the other and caused a stroke (mini stroke). Since my BP is fine, he thinks there may be a hole. He does think I had a heart attack back in May, but we'll know more once I get the tests done. Tests are scheduled for 9/24 (holter monitor) and 9/26 - stress/echocardiogram w/ bubble study.

With the bubble study, they'll give me an IV with saline and a contrast solution and push tiny air bubbles in my veins, and that will let them see where the bubbles go, whether they move through a hole and go into the other side of my heart. It's a wait and see. He wants me trying to take it easy for awhile, because if I am having a TIA it can be a precursor to a major stroke.

But, at least I have insurance now, and I have a plan moving forward!

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Reply #39 posted 08/20/18 1:21pm

PennyPurple

avatar

benni said:

I've gotten insurance! And at a reasonable (affordable) price. Cardiology gave me a number to call. Saw the cardiologist today, and he detected a heart murmur. Tried to schedule me for the holter monitor this week and a stress test, along with an echocardiogram and a bubble study for 9/6, but the insurance has a 30 day wait, so I had to push them off until after the insurance would pay for it.

The bubble study is to look for any holes in my heart that might have allowed a clot to move from one side of my heart to the other and caused a stroke (mini stroke). Since my BP is fine, he thinks there may be a hole. He does think I had a heart attack back in May, but we'll know more once I get the tests done. Tests are scheduled for 9/24 (holter monitor) and 9/26 - stress/echocardiogram w/ bubble study.

With the bubble study, they'll give me an IV with saline and a contrast solution and push tiny air bubbles in my veins, and that will let them see where the bubbles go, whether they move through a hole and go into the other side of my heart. It's a wait and see. He wants me trying to take it easy for awhile, because if I am having a TIA it can be a precursor to a major stroke.

But, at least I have insurance now, and I have a plan moving forward!

Yay! Good news about the insurance. Just wish your tests were sooner.

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Reply #40 posted 08/20/18 5:41pm

XxAxX

avatar

i'm really glad benni. this is great news!

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Reply #41 posted 08/22/18 7:22am

ThatWhiteDude

I'm sorry to hear about the stroke risk benni, I was really hoping that it's just stress related sad But the insurance thing is good news.

"Like books and BLACK LIVES, Albums still MATTER."
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Reply #42 posted 09/03/18 8:16pm

XxAxX

avatar

benni how are you doing? hope all is well with you rose

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Reply #43 posted 09/09/18 10:39pm

happinessinits
uncutform

I'm very sorry to hear about your condition, but glad to hear that you got insurance now.

🎵
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Reply #44 posted 09/13/18 7:19pm

benni

XxAxX said:

benni how are you doing? hope all is well with you rose


Hey XxAxX, thanks for asking! I'm still getting the erratic heart beat and on 8/31/18, lost vision in my left eye again. But have an appointment on 9/21 with my primary care doctor (the 30 day wait for my insurance is up that day), on 9/24 I will get the Holtor monitor to wear for 48 hours, and then on 9/26 I'll get the stress test, echocardiogram with a bubble study. Doc did say that if my heart gets too erratic during the stress test they'll do a heart cath. Other than losing my voice (my kids have been sick and decided to share with mom), and when I'm able to get sound out sounding like a boy going through puberty, I feel okay. Tired and drained, but okay.


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Reply #45 posted 09/13/18 7:24pm

XxAxX

avatar

thanks for thr update benni. wishing you the best!

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Reply #46 posted 09/21/18 3:49pm

benni

Had to cancel the appointments. BIG issue with the insurance that sounded great. Needless to say, it did not work out. I'll look into inusrance again during open enrollment.

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Reply #47 posted 09/21/18 7:38pm

PennyPurple

avatar

benni said:

Had to cancel the appointments. BIG issue with the insurance that sounded great. Needless to say, it did not work out. I'll look into inusrance again during open enrollment.

Oh no Benni! That bums me out. sad

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Reply #48 posted 09/21/18 8:33pm

TD3

avatar

benni said:

Had to cancel the appointments. BIG issue with the insurance that sounded great. Needless to say, it did not work out. I'll look into insurance again during open enrollment.

Hopefully the lost vision in one eye won't occur again but if it does have someone drive to the hospital immediately! If you can ask family and a couple of friends could they be on standby if call for help. The hospital will have to run the test needed to see what's up. Benni the other thing you should do, is start researching your State Medic-Aid to see if they pay medical bills of people those whoo are under insured.

Another reason to go to E.R. if you ever experience lost of vision in one eye... is to have medical paper trail that will assist you in getting any assistance for State and Medic-Care Program. By the way, you can get on Medic-Aid even if you are employed.

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Reply #49 posted 09/21/18 8:53pm

purplethunder3
121

avatar

TD3 said:

benni said:

Had to cancel the appointments. BIG issue with the insurance that sounded great. Needless to say, it did not work out. I'll look into insurance again during open enrollment.

Hopefully the lost vision in one eye won't occur again but if it does have someone drive to the hospital immediately! If you can ask family and a couple of friends could they be on standby if call for help. The hospital will have to run the test needed to see what's up. Benni the other thing you should do, is start researching your State Medic-Aid to see if they pay medical bills of people those whoo are under insured.

Another reason to go to E.R. if you ever experience lost of vision in one eye... is to have medical paper trail that will assist you in getting any assistance for State and Medic-Care Program. By the way, you can get on Medic-Aid even if you are employed.

Please, take TD3's advice and check into the Medic-Aid program, that's what it's there for. Best wishes and prayers for your health.

"If you're living, you've got nothing left to prove..."
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Reply #50 posted 09/21/18 11:00pm

benni

TD3 said:

benni said:

Had to cancel the appointments. BIG issue with the insurance that sounded great. Needless to say, it did not work out. I'll look into insurance again during open enrollment.

Hopefully the lost vision in one eye won't occur again but if it does have someone drive to the hospital immediately! If you can ask family and a couple of friends could they be on standby if call for help. The hospital will have to run the test needed to see what's up. Benni the other thing you should do, is start researching your State Medic-Aid to see if they pay medical bills of people those whoo are under insured.

Another reason to go to E.R. if you ever experience lost of vision in one eye... is to have medical paper trail that will assist you in getting any assistance for State and Medic-Care Program. By the way, you can get on Medic-Aid even if you are employed.


I do have someone on standby just in case I need to be driven to the ER (ex husband said he would help). I don't have any other family that lives close to me (they're all 600+ miles away).

I work for a Medicaid provider - we get reimbursed for our services through Medicaid - and as such work closely with the Medicaid Eligibility people in my state for our clients. There are different kinds of Medicaid (long term care, women and children, etc) but they have an income guideline. I unfortunately earn too much to qualify for Medicaid. The problem I am running into with individual (out-of-pocket) insurance (my company doesn't offer because they are just too small, only 4 employees) is that it is too expensive with a pre-existing condition. I was looking at $500 to $1000 per month to get good coverage for what I would need. And I can't afford that.

This insurance that I found had two parts to it: cash benefit was where they would pay for emergency room visits, 3 doctor visits per year for illness, accidental death, and hospitalization up to a certain cost. The second part of the insurance was where it would cover everything else, no deductible, no co-pays, if the doctor is in their network, the doctor sends them the bill, the doctor has agreed to negotiate the cost of the visit. They decrease the cost, and the doctor agrees to that cost amount, then so much more is negotiated off of it, and I'm left with paying maybe 25% of the final cost or less. They told me that diagnostics, lab work, any doctor visits, medical surgical, hospital, it's all covered under that second part. When my doctor's office called the benefits department of the insurance to confirm coverage of the testing, the benefits people told them that I'm not covered - I'm only covered in an emergency, etc. I called them, they told me I was not covered for diagnostics through a doctor's office (only emergency settings). I call the other side, they tell me benefits don't know about the contracted rate with the doctor and have nothing to do with that. They mail the bill to them. This went back and forth like this for two days. Multiple phone calls, raised blood pressure, etc. The last straw came today when I went to my doctor's appointment (general practitioner to get back on all my medications finally) and I explained to the doctor's office that they mail the bill to the address, and don't call the benefits department, because they don't have anything to do with the second half of the insurance (multiplan half).

They call me back up to the window and tell me I have to be self-pay today and that I can send the bill to my insurance and get reimbursed for it. I told her it doesn't work that way, they don't reimburse, it's a negotiated cost with the doctor's office, that's all. She informed me they only do electronic billing and do not mail out bills to insurance companies and will not do so. I call the insurance people to find out how they would submit the bill electronically (as that is what most doctor offices do now) and they inform me they don't have it set up that way. They said if the doctor's office is in the multiplan (they are according to the multiplan website) that the doctor's office has agreed to mail them the bill. Interestingly enough, cardiology, my general doctor, none of them know about this.

I filed a complaint with the Insurance Commissioner in my state. I called them and told them they would reimburse me the money I have spent on this insurance, that if they didn't, I would be contacting the Attorney General in my state, and would be hiring a lawyer. He put his supervisor on, the supervisor told me I could cancel the policy but that I am beyond the 30 days and they would not reimburse me. I told them they would be reimbursing me. Went back and forth like that for 15 minutes, I finally hung up. I get an email from them telling me that my policy is being canclled but that it will be good until 10/20/18. I called them back, got a different representative this time, told him I had never used the policy, felt like it was sold to me under false pretenses, and that I did not want it to remain in effect until 10/20/18. That I had wanted to be reimbursed for what I had paid. He informed me that I am within my 30 day period, and that he would start the reimbursement procedure. I told him I wanted that in writing. He sent me a notice that my policy was cancelled as of 8/21/18 and that they are working on my reimbursement.

Thing is they tell you that there is a 30 day wait for going to the doctor. You don't know until you get to the doctor's office that benefits is going to say you aren't covered and that the insurance is worthless, and by that time, your 30 day period is passed and you can't get reimbursed. The insurance commissioner's office called after I filed the complaint, and I explained all of that, and she said, "Yes, that's how they get you with that 30 day wait, it's usually then that you find out you aren't covered and they take your money."


[Edited 9/21/18 23:04pm]

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Reply #51 posted 09/22/18 7:13am

ThatWhiteDude

benni said:

Had to cancel the appointments. BIG issue with the insurance that sounded great. Needless to say, it did not work out. I'll look into inusrance again during open enrollment.

I'm so sorry to hear that benni sad

"Like books and BLACK LIVES, Albums still MATTER."
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Reply #52 posted 09/24/18 1:40pm

TD3

avatar

benni said:

TD3 said:

Hopefully the lost vision in one eye won't occur again but if it does have someone drive to the hospital immediately! If you can ask family and a couple of friends could they be on standby if call for help. The hospital will have to run the test needed to see what's up. Benni the other thing you should do, is start researching your State Medic-Aid to see if they pay medical bills of people those whoo are under insured.

Another reason to go to E.R. if you ever experience lost of vision in one eye... is to have medical paper trail that will assist you in getting any assistance for State and Medic-Care Program. By the way, you can get on Medic-Aid even if you are employed.


I do have someone on standby just in case I need to be driven to the ER (ex husband said he would help). I don't have any other family that lives close to me (they're all 600+ miles away).

I work for a Medicaid provider - we get reimbursed for our services through Medicaid - and as such work closely with the Medicaid Eligibility people in my state for our clients. There are different kinds of Medicaid (long term care, women and children, etc) but they have an income guideline. I unfortunately earn too much to qualify for Medicaid. The problem I am running into with individual (out-of-pocket) insurance (my company doesn't offer because they are just too small, only 4 employees) is that it is too expensive with a pre-existing condition. I was looking at $500 to $1000 per month to get good coverage for what I would need. And I can't afford that.

This insurance that I found had two parts to it: cash benefit was where they would pay for emergency room visits, 3 doctor visits per year for illness, accidental death, and hospitalization up to a certain cost. The second part of the insurance was where it would cover everything else, no deductible, no co-pays, if the doctor is in their network, the doctor sends them the bill, the doctor has agreed to negotiate the cost of the visit. They decrease the cost, and the doctor agrees to that cost amount, then so much more is negotiated off of it, and I'm left with paying maybe 25% of the final cost or less. They told me that diagnostics, lab work, any doctor visits, medical surgical, hospital, it's all covered under that second part. When my doctor's office called the benefits department of the insurance to confirm coverage of the testing, the benefits people told them that I'm not covered - I'm only covered in an emergency, etc. I called them, they told me I was not covered for diagnostics through a doctor's office (only emergency settings). I call the other side, they tell me benefits don't know about the contracted rate with the doctor and have nothing to do with that. They mail the bill to them. This went back and forth like this for two days. Multiple phone calls, raised blood pressure, etc. The last straw came today when I went to my doctor's appointment (general practitioner to get back on all my medications finally) and I explained to the doctor's office that they mail the bill to the address, and don't call the benefits department, because they don't have anything to do with the second half of the insurance (multiplan half).

They call me back up to the window and tell me I have to be self-pay today and that I can send the bill to my insurance and get reimbursed for it. I told her it doesn't work that way, they don't reimburse, it's a negotiated cost with the doctor's office, that's all. She informed me they only do electronic billing and do not mail out bills to insurance companies and will not do so. I call the insurance people to find out how they would submit the bill electronically (as that is what most doctor offices do now) and they inform me they don't have it set up that way. They said if the doctor's office is in the multiplan (they are according to the multiplan website) that the doctor's office has agreed to mail them the bill. Interestingly enough, cardiology, my general doctor, none of them know about this.

I filed a complaint with the Insurance Commissioner in my state. I called them and told them they would reimburse me the money I have spent on this insurance, that if they didn't, I would be contacting the Attorney General in my state, and would be hiring a lawyer. He put his supervisor on, the supervisor told me I could cancel the policy but that I am beyond the 30 days and they would not reimburse me. I told them they would be reimbursing me. Went back and forth like that for 15 minutes, I finally hung up. I get an email from them telling me that my policy is being canclled but that it will be good until 10/20/18. I called them back, got a different representative this time, told him I had never used the policy, felt like it was sold to me under false pretenses, and that I did not want it to remain in effect until 10/20/18. That I had wanted to be reimbursed for what I had paid. He informed me that I am within my 30 day period, and that he would start the reimbursement procedure. I told him I wanted that in writing. He sent me a notice that my policy was cancelled as of 8/21/18 and that they are working on my reimbursement.

Thing is they tell you that there is a 30 day wait for going to the doctor. You don't know until you get to the doctor's office that benefits is going to say you aren't covered and that the insurance is worthless, and by that time, your 30 day period is passed and you can't get reimbursed. The insurance commissioner's office called after I filed the complaint, and I explained all of that, and she said, "Yes, that's how they get you with that 30 day wait, it's usually then that you find out you aren't covered and they take your money."


[Edited 9/21/18 23:04pm]

Gotcha...

I've org you some info, that may assist. But since you know the" game", you probably looked at these options.


Keep the faith benni. hug

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Reply #53 posted 09/25/18 5:54pm

XxAxX

avatar

dang Benni that just sounds so hard. i hope you are hanging in and enjoying life.

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