Health · Medical · Multiple Sclerosis · Primary Progressive MS · Ramblings · Strength

Be the squeaky wheel!

This is true on all kinds of levels. But, when it comes to your healthcare, it should NOT be this way!

An update to my healthcare insurance fiasco: it’s all been approved for my ER visit. Now I know this should make me really happy, and it does. The only problem I have with all of this, is that it took so much of my spirit and caused so much stress for something that was, an ‘error’. my question, is what if I hadn’t appealed or been so loud about it? That ‘error’ would’ve cost me over $20,000. Unfortunately I know there are people out there that don’t know their rights. There are people out there that don’t know how to appeal. There are people out there that don’t have an army of amazing friends that will retweet and help. We need healthcare reform on different levels. We need better advocacy for people to be able to fight. We need better healthcare insurance so that companies don’t have these, ‘errors’!

So yes, I’m very happy this all got taken care of, but it should not have happened in the first place. I am very thankful for the representative I spoke with that helped me, but it should not have happened in the first place.My advice to people who get these outrageous medical bills where your insurance company is denying you. Don’t stop fighting! Scream About it to everyone as loud as you can! Look for the right type of attorneys if you need to. And in all my fun dealings with this I gained a little knowledge. An Erisa Attorney is where you want to start your search. Take it to the Internet, take it to the newspapers, the news stations, anywhere you feel you could be heard!  

We need to be heard when we are denied healthcare. We need to stop letting the health insurance companies run our medical care and act like they are our doctors. They are NOT!! I am not going to give up or stop being heard. We are all human beings and we all deserve healthcare regardless of our income, our gender, our race. 

Be loud, be heard. Have courage and be kind.

Health · Medical · Multiple Sclerosis · PAIN · Ramblings · RANDOM · sadness · Strength

DeNiEd AgAiN

Some of the not so great things that happened to me in the past six months or so is that I was denied acute physical therapy rehab. I went through every one of their appeals and was denied every time. They say for me it’s not medically necessary and basically that’s the only reason given. Let me think, I have severe hip contractures due to being bedridden, yet acute physical therapy isn’t medically necessary for me. 🤔 The story goes a little something like this…

On August 18, 2019 my husband was trying to get me into the sling for my Hoyer lift so I could get out of bed. As he started lifting me and the sling pulled up around my body, the pain was so excruciating I really believed my hips were going to break. Needless to say I never made it all the way up or out of my bed. We called 911 and I was taken to Palmdale regional medical Center. At that time we weren’t really sure what my hip pain was. We knew that my knees and ankles had contracture issues, but my pain management doctor was saying it might be arthritis, osteoporosis etc.. The ER doctor explained that my hips had contractures just like the rest of my legs. It was as if a💡went off in my head. Like, no shit… oh my god how could my other doctor(s) not figure this the fuck out. The rehab institute at Palmdale regional medical Center was where I had been for one month in February 2018, so I asked if they could contact my doctors and try to get me back in. It took the next two nights and three days before Independence Blue Cross came back with, DENIED. After exhausting all four of my appeals, (4months) I was DENIED Rehab. Not medically necessary. I completely understand that the doctors that work at these insurance companies are basically rent-a-docs that probably can’t get a job at a legitimate place, but come on, I’m the poster child for rehab.  In fact, for how severe my contractures are, the only options are surgery or acute physical therapy. So that in a nutshell is my denial for, realistically, life-saving therapy for me…Now on to my new dilemma where I’m being denied. They are now saying that they will not pay for my ER visit because it was not an emergency. 🤬 When a representative from Independence Blue Cross called me to ask about this appeal for this charge, I told her what the emergency was. I explained the same thing that is stated above; how I was trying to get out of bed with the use of my Hoyer lift and the pain was so excruciating from the muscle contracture’s that I could not do it. I could not move!! Now in my book that’s a fucking emergency. obviously it was an emergency enough that they paid for the ambulance. I mean really for fucks sake.

(Attached) is what the incompetent person, I’m trying to be nice about this, said in the DENIAL letter. “You stated that you were experiencing difficulty and could not stand so you went to the emergency room for services” is she fucking kidding me?!! First off I would never have said that because I haven’t been able to stand for 6 years 2 months!!! For fucks sake I’ve barely been able to get out of my bed. I’m not sure what part of, I’m bedridden and I was having pain in my hips trying to be lifted in my Hoyer lift, that she didn’t understand. So she either lied on that form or she just didn’t give a shit to listen to what I had to say.I bet it’s a little bit of both… Lied so that the insurance company wouldn’t have to pay which falls right in line with doesn’t really give a shit. I have a call in to her, so we will see if she calls back. They are on EST and right now it’s 4:56 PM PST, so I bet she’s just not gonna call back. I really believe that these people and these money corporations do this often so people like me are not given the care that is needed. They think they can be our doctors and that they know better than our doctors.🖕

So now I get to deal with all of this. Sorry the little attachment above is a little wrinkled. When I read that line for the first time, I lost it. Everything and anything in my reach was thrown. When I realized I was trying to pull my hair out and the scratching on my face started hurting I just broke down into a big heap of tears.

At this point my body has deteriorated more and more and my muscle contractures have gotten worse and worse. I have so many calls in to so many people and they either don’t call back, or they’re rude. If anyone reads this and you know of anyone that could help me, attorney, disability advocate, hell a juggler, 😜 please send them my way. I really don’t know how much longer I can go on. Have courage and be kind.



Politics

Conflict of Interest?

Is it or isn’t it?

One of Obama’s economic advisors is the CEO of GE. So, obviously he deals with financial issues etc. Well, what about healthcare? GE is partners with United Healthcare and who knows how many other health care biggies.

Right now we use United Healthcare. It is terrible. They constantly deny me treatment and/or medications. After stressful fighting with them and getting appeals going I finally get the things i need.

I guess I should explain that my husband works for a company owned by GE. As of next year, the health insurance is changing, again. In the past 5 years it has changed 3 times, this will make 4. Now, isn’t a big part of Obama’s presidency to ‘reform’ healthcare? Does President Obama know what his ‘friend’ Jeff Immelt is doing to his employees in 2010? Is the ‘reform’ going to STOP big CEO’s and big insurance companies from killing us with their healthcare policies?

In 2010, our insurance is almost going to be like car insurance. The more you pay, the less your deductible. The lowest deductible is 2000.00 per family member. This is to be paid first, then they will pay 80% up to 3500.00, then you get full coverage. And then add what we have to pay for the insurance [4000.00]. WTF!! And, we have no idea about medications. Will the employees be getting raises to help with the high cost of their health [insurance]?? OMFG, roflmao! Hell no!

Now, there is a meeting for the employees to ask questions and voice their concerns. No one wants this, but they do not give a shit. The plan now, does not give GE enough money, so they have found a way to shove the knife in deeper. The meeting is just to appease the masses! HA!

I really want to believe in Obama and his promises. Anyone was better than McCain/Palin…but now I’m not so sure. My faith in my country started going during our last presidency, now I’m not sure what I have to hold on to anymore! Come on Obama, tell this money grubbing POS to STOP! Tell the insurance companies to STOP raising their prices. Stop all the frivolous lawsuits!

I may now have to go on MediCare. I do not want to, but my doctors told me they prefer it. They do not have to answer to the ins. companies for authorizations, they are not second guessed, and their patients get their care in a timely manner. So, maybe I should go on MediCare. I am so completely at a loss right now.

Why is it that members of congress, the senators, etc. get healthcare for life whether they are in office or not? Yet, we as Americans get shit on at every turn. We pay our taxes, we are good citizens, but since we do not have the ability to ‘grease’ the hands of politicians we get shit on.

We live paycheck to paycheck as many do. We own a home, we have two vehicles, and we have gr8 credit. We pay our bills on time…I am just so flustered over all of the BS going on.

So, I ask you President Obama, how can you allow people who work for you to do this to their employees? I want to believe you will bring about the change this Country has needed for the last 20 years. Well, will you?

Blessings and Peace!

Ramblings

A great article from Truthout!

Truthout.org

Being a person who lives with a disabilty, healthcare is a very serious area for me. I have private insurance and still have to jump through hoops for care with my insurance company. Meanwhile the rates are raised consistently. It took 8 months to be paid for my power wheel-chariot. 8 MONTHS!!

Then, constantly denied medications and/or tests until my doctor calls their rent-a-doc to get permission! WTF is that about? I think my doctor knows a hell of a lot more than their over the phone, who the hells knows who they are, what are their credentials, rent-a-doc! This is ridiculous to me.

The article, IMHO, shows what all the problems are about. The big M word; Money!!

Blessings and Peace to all!