Author Topic: Mad a heck, irritated , frustrated depressed  (Read 17164 times)

ANGuy

  • Sr. Member
  • ****
  • Posts: 438
Re: Mad a heck, irritated , frustrated depressed
« Reply #15 on: October 29, 2014, 01:19:26 pm »
The point is that some people need help (state-sponsored care) who are not illegal aliens and drug addicts. I for one. My surgeries cost more than $100,000. I was on "watch and wait" status for close to five years. I had to wait until the thing grew to the size of a golf ball and I was at death's door before being diagnosed and treated. It was Medicaid that saved my ass. If I had known I could have qualified for Medicaid early on and obtained a timely diagnosis, chances are my treatment would have been much easier, less expensive and without the complications I suffered.

Soundy is in a jam. She's had her surgery and from what she has described, may be experiencing symptoms of regrowth. In my case, I've had MRIs every year since my surgeries in '05. Last year one on my doctors recommended that I start having MRIs every two years. I was fine with that until I began feeling like I did before my initial treatment with headaches, horrible double vision and deathly fatigue. So I told my doctor how I was feeling and an MRI was scheduled right away. It should be the same way for Soundy but she needs the extra help from either Medicaid or SSDI. Insurance companies will leave you for dead if they could have it their way.

From what I gather reading your posts, you seem to be in relatively good shape: your AN is still on the small side, you're on watch and wait status, you probably have a good job and most important, you've yet to be walloped with surgery and a gargantuan hospital bill.

No, the point is that somebody cheap-shotted the United States of America and it's medical system.  The medical system that paid for $100,000.00 of your medical care.  The system that some seem all too quick to criticize, meanwhile others pay for it.  That $100,000.00 of "free" medical care you got came out of SOMEBODY ELSE'S pocket, like my kids, who will sped a large portion of their lives paying for it.

The point is, all of this is political and doesn't belong here.  But, that's no matter to the passive/aggressive types who are so eager to complain about the United States of America.

I am very political.  But, I have the class and good taste to leave politics where they belong.  When I go to my kids' sporting events, I don't wear my political T-shirts because that is not the place for it.  But, of course, there was one parent who just had to wear a Barrak Obama T-shirt to every practice and game one season.

I am a Jew.  When I am fortunate enough to be invited to a Church service, I don't start discussions about whether the Messiah has been here yet or not, I graciously accept the welcoming hearts of the people in the Church.

This is a bulletin board used to discuss issues regarding AN's.  It does not need to be infected with discussions regarding socialism vs free markets, or any other "-ism".

That was my point.  Instead of continuing to try and make excuses for why you and others have gone out-of-bounds on this stuff, maybe you should just keep your posts on topic.

It's no big deal I guess.  I can easily just skim this board from time to time and see if there are any developments in the medical field that could be of assistance to me and ignore all the drivel.  I can make it a point not to post at all while I am at it and let this place devolve into whatever it will become.  Of course, I could also do what some here have chosen to do.  I could bad-mouth other countries and mock their medical systems.  I could mock other aspects of their society as well while I am at it because apparently that is acceptable, at least to you and a few others.
Diagnosed June 2014 1cm AN at 47 years of age.  Had fluctuating symptoms since 2006.    6 mos MRI (Dec 2014) showed no growth, MRI  in July 2015 showed no growth.  MRI Jan 2016 showed no growth.  MRI Aug 2016 showed no growth.  I'm gonna ride the WW train as long as I can.

ANGuy

  • Sr. Member
  • ****
  • Posts: 438
Re: Mad a heck, irritated , frustrated depressed
« Reply #16 on: October 29, 2014, 01:28:01 pm »
Soundy: Back to your issue, and please understand I am Canadian and don't know your medical system well. Let me ask, if you say took out a loan for the MRI and it came back that the tumor had regrown would the insurance company pay you back? You could get the MRI...if it turned out you couldn't get the money back from the insurance company is that something you can afford to do?
Another thing comes to mind, here we often have "studies" going on, some of course are like take this pill and we'll pay you etc., however sometimes there's others like for new medication etc and if you have the illness they will get you tests quicker, for example when the doctor's finally listened to me and wanted to get me in for testing quickly they put me in an MS study, I got my tests much quicker that way, is there such a thing where you are?

Some good advice there.  What typically happens is there is an appeal process.  Claims or pre-approval can get re-submitted under different terms and coding to see if they will be cleared.  Most medical providers have staff on hand to do this type of thing and importantly, it usually works.  I don't know the statistics, but from an anecdotal point of view, lots of denied services are ultimately approved.

Also, the state's attorney general's office typically has and insurance branch that will help to hold insurance companies to there commitment.  That would not be my first step, but I would call the AG's office before I jsut gave up and  took the ins co's position as the last word on the matter.

There is a sub-forum on here for insurance issues and that would be a good place to look for info, as well as working with the medical provider to get more info.

And I agree wit your point that things shouldn't be this complicated, but insurance companies have always been like this to some extent and it is just a fact of life.
Diagnosed June 2014 1cm AN at 47 years of age.  Had fluctuating symptoms since 2006.    6 mos MRI (Dec 2014) showed no growth, MRI  in July 2015 showed no growth.  MRI Jan 2016 showed no growth.  MRI Aug 2016 showed no growth.  I'm gonna ride the WW train as long as I can.

ppearl214

  • Administrator
  • Hero Member
  • *****
  • Posts: 7447
  • ANA Forum Policewoman - PBW Cursed Cruise Director
Re: Mad a heck, irritated , frustrated depressed
« Reply #17 on: October 29, 2014, 02:19:57 pm »
Hi all,

I know that this is a heated debate and very touchy for some.  I would like to remind everyone to respectfully "agree to disagree."

I am monitoring and hope that this lively discussion stays on even keel.

thanks.
Phyl
"Gentlemen, I wash my hands of this weirdness", Capt Jack Sparrow - Davy Jones Locker, "Pirates of the Carribbean - At World's End"

Crazycat

  • Hero Member
  • *****
  • Posts: 795
  • Self-Portrait/ "Friends, Romans, countrymen...."
Re: Mad a heck, irritated , frustrated depressed
« Reply #18 on: October 29, 2014, 09:34:18 pm »
That's already out the window Phyl.

First of all, you said, "This is a bulletin board used to discuss issues regarding AN's."  I've got news for you: it's all part of the the where, how and why of obtaining treatment, whether you want to admit it or not.

Second,  in-effect, threw the gauntlet down when you pronounced how proud you were that you got the coverage you needed with a $10.00 co-pay (see how far gets you when the hammer falls).

Also, what do you kids have to do with a person receiving state-sponsored care? Shouldn't they be covered under your insurance? Or is it that it's okay for them to receive the state-sponsored care and not some stranger like myself?

It makes my blood boil to hear talk like that when I think of what I went through with this thing and how it completely screwed my life up.

Okay Phyl, I'm done. I'll hold my piece now.
« Last Edit: October 30, 2014, 09:30:21 am by ppearl214 »
5cm x 5cm left-side A.N. partially removed via Middle Fossa 9/21/2005 @ Mass General. 
Compounded by hydrocephalus. Shunt installed 8/10/2005.
Dr. Fred Barker - Neurosurgeon and Dr. Michael McKenna - Neurotologist.

ppearl214

  • Administrator
  • Hero Member
  • *****
  • Posts: 7447
  • ANA Forum Policewoman - PBW Cursed Cruise Director
Re: Mad a heck, irritated , frustrated depressed
« Reply #19 on: October 30, 2014, 09:28:30 am »
Hi all,

I am requesting you all take this discussion offline in PM/emails.

Paul, I've had to remove a couple of references in your post as they are not appropriate.  I know you understand.

Please keep in mind the audience (other than a couple of people) that are reading this.

Please note that one more time this is reported to me, this thread will be locked.

"Gentlemen, I wash my hands of this weirdness", Capt Jack Sparrow - Davy Jones Locker, "Pirates of the Carribbean - At World's End"

Soundy

  • Hero Member
  • *****
  • Posts: 1329
  • prophetic picture done by my 5 year old, June'04
Re: Mad a heck, irritated , frustrated depressed
« Reply #20 on: October 30, 2014, 08:15:30 pm »
Wow ...

I live in Tennessee ... when I had surgery we had Cigna and were switch ( not by choice ) to BCBS of Tennessee ... I used to have a $20 co-payand could see who I wanted ... now no co-pay and I am suppose to pay for visits before leaving office ... my regular doctor works with me and I pay 50% if I don't have the rest and bill remainder ... I have to pay out $2500 on myself before they start paying anything ... this is with changes made about 6 months ago ... we pay $480 a month for family coverage ... I have my own additional out of pocket and higher amount than hubby and kids to pay on deductible because I am a high risk patient ... can't find anyone that will take me on for less ... I think at times the insurance company is trying to weed me off

I am going in again next week and doctor is going to write up MRI order with suspicion of bells palsy .... we will see what happens
3mm AN discovered Aug 2004
Translab July 2 ,2007
3.2cm x 2.75cm x 3.3cm @ time of surgery

Mimispree

  • Full Member
  • ***
  • Posts: 138
  • HUG A NURSE TODAY!
Re: Mad a heck, irritated , frustrated depressed
« Reply #21 on: November 20, 2014, 09:03:11 pm »
Dear Soundy:

I seem to be someone who is grateful to the Affordable Healthcare Act, or ObamaCare.  I found them to be very helpful.  I had to call them instead of doing my application online, because their website couldn't deal with the apostrophe in my last name...  It's better now.  Anyway, it took 15 minutes on the phone to get me the coverage I needed for the surgery.  I found out what insurance provider my surgeon and hospital accepted, then the insurance provider did a three-way call with the ObamaCare site, and I got the coverage I needed at a reasonable price.  The whole thing is to look at the Out-of-Pocket expense.  I found one with a total of $2,000 out-of-pocket per year.  I can't even afford that because the effects of the tumor (before I knew I had one) forced me to close my bakery and I had to pay for emergency room stuff that turned out to be caused by the undiagnosed tumor.  Anyway, after my surgery I applied for financial aid with my $2,000 out-of-pocket expense, and they set-up an affordable monthly payment plan.

So remember, there are options for you out there.  It may be frustrating and maddening, but you can find assistance.  Call the Affordable Health Care and just talk to someone.  They are very helpful and efficient. 

I wish you the best and I thank you for sharing.  I guess we can all come to this site to vent, cry, cheer each other on, and simply care about one another.

Be well,
Michelle
2.8cm Trigeminal Neuralgia tumor removed Translabyrinthine approach on July 31, 2014 at the University of Utah Health Center.
Dr. Clough Shelton and Dr. William Couldwell.
SSD; Right side facial paralysis; Poor right eye sight; Dizzy 24/7; Eyelid implant 02/215; Sense of humor intact.

Soundy

  • Hero Member
  • *****
  • Posts: 1329
  • prophetic picture done by my 5 year old, June'04
Re: Mad a heck, irritated , frustrated depressed
« Reply #22 on: November 22, 2014, 04:37:17 pm »
I have talked to them and since my husband has insurance through work that I am on as a part of the family plan I would have to pay more for insurance going through Affordable Care provider than we are already paying... I was deemed not eligible ... if we could just take me off his insurance I might be eligible ... that is a big might ... but he can have full family or single coverage meaning he would have to take the girls off his policy too and then hope we could get them covered some other way...

believe me ... I have been around and around without getting any real workable options...if he did go to the single plan and we tried to get insurance on me and the girls and failed to get it at an affordable price we would have to wait a full calendar year to add us back ... we would get coverage but if it costs us more than we are already paying for same coverage it defeats the point ... so if I were to try , me and the girls could be out of coverage for a year ... due to income amount being too high we can't get on Tenn Care ... there is a program for kids up to 18 called tender care  but the girls are not eligible due to income  ...

that is probably a bit garbled as I was condensing it and retyping it in some sort of order... everything I have checked would take a book to write
 
The MRI I had showed something that they are saying does not appear to be tumor regrowth , possibly just scar tissue with some adhesions developing that could be causing the new symptoms ... or rather the worsening of symptoms I have had since surgery since metal mouth and the twitches have been there since AN was removed in 2007... recheck again in 6 month sooner if any remarkable changes occur ... I hate when they use that word ... REMARKABLE

So for now on a watch and wait sort of schedule and hope it isn't Bennies little brother we are looking at... the department that does speech and occupational therapy saw me unofficially (unbilled) and gave me some face exercises to do and said to take a non smiling picture of my face every few days and watch for changes... things they do with stroke patients
3mm AN discovered Aug 2004
Translab July 2 ,2007
3.2cm x 2.75cm x 3.3cm @ time of surgery

 


anything