Insurance

Posts from Jan. 1, 2018 to the present. Plus important announcements. (ICD warning sounds)

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InSync
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Joined: July 21st, 2012, 10:26 pm
Location: The Edge of America, SC

Re: Insurance

Post by InSync » June 1st, 2018, 8:38 pm

So true, Robo. It would seem that Medicare should be the easiest to understand, but it is not only the most complex, but there aren't a lot of people knowledgeable to actually advise people. I can't even get my head around the fact that medication coverage is separate from the Medical. I keep hearing something about medication administered in the hospital not being paid. I don't even know what that's about. It really is too much. I don't think I look forward to it.

Physician access has become my biggest problem. When hospital corporations bought nearly all of the medical practices in my state, they centralized billing, scheduling, etc. Now, the only direct number I have is for my cardiologist. I was unhappy with my EP's handling of the St. Jude recall, so I transferred my care to the EP I saw in the transplant program, where my cardio doc is. I had an in office visit with the new guy in February and his staff was supposed to take care of transferring my remote transmissions to my new doc and call me back with the schedule. No one did. I've called 18 times since February and keep getting the central call center, who say I can't call directly, but they will send a message to the office to call me. Thus far, nothing. When I get back to Charleston this week, I'm going to just walk into the office and ask for an interrogation. If they won't do it, I'm going to the ER with chest pain and I'm not walking out until I have a replacement. Lack of follow through seems to be a systemic problem in healthcare.

I hope you get your CPAP soon and that you get some relief!
Dilated Cardiomyopathy, LBBB, CHF
St. Jude CRT-D 5/12
The beat goes on.....

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Ozchrissy
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Joined: September 27th, 2008, 9:28 am
Location: Australian

Re: Insurance

Post by Ozchrissy » June 2nd, 2018, 7:18 pm

One thing that has become apparent with all this is that we must have a pretty middle class group. I am amazed constantly about how you all afford your cover and also the out of pocket expenses with your medications. I can't help but wonder what happens to people who are on minimum wages, unemployed or on a low paying job. Do they just go without medical assistance or do they get some help. Personally, with my income over here, I am not destitute, but there is no way I could pay the cost that you all seem to have to pay out. I would be dead, and believe me it is not an over exaggeration.
“I am not what happened to me, I am what I choose to become.” Carl Jung

Diagnosed with cardiomyopathy in 10/99
LBBB & VT diagnosed Feb 06
Guidant Biventricular Pacer ICD inserted Feb 06: Boston Scientific Incepta CRT-D inserted May, 2012
Oesophageal Cancer, 2012, Gall Bladder & Septicemia 2014 resulting in VFib and severe heart damage
Bare Metal Stent May, 2012 Mitral Valve replaced 2015
Meds: Entresto, Bicard, Coralan, Eurtorxsiq, Frusehexl, Spiractin, Sigmaxin, Creon, Warfarin,
Appropriate Shocks for Ventricular VFib.

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TruckerRon
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Joined: February 22nd, 2010, 8:52 pm
Location: Provo, UT

Re: Insurance

Post by TruckerRon » June 3rd, 2018, 10:26 pm

Ozchrissy wrote:
June 2nd, 2018, 7:18 pm
One thing that has become apparent with all this is that we must have a pretty middle class group. I am amazed constantly about how you all afford your cover and also the out of pocket expenses with your medications. I can't help but wonder what happens to people who are on minimum wages, unemployed or on a low paying job. Do they just go without medical assistance or do they get some help. Personally, with my income over here, I am not destitute, but there is no way I could pay the cost that you all seem to have to pay out. I would be dead, and believe me it is not an over exaggeration.
In my limited experience, we do have a real "safety net" through the combination of government agencies and private charities, both traditional organizations and local ad hoc fundraising. The people who suffer the most seem to be those who are self-destructive and consistently making horrendous choices in their lives.

As for me, I was unemployed and looking for work when my SCA struck. With no insurance, our savings vanished... but then the nonprofit organizations stepped in, we found a job-training program that paid me to change my career plans since trucking was forever taken away (can't get a DOT medical card anymore). My wife joined me in the job training program. Add in disability insurance and we've managed to hold on to our home and keep everyone fed. Finally we each found the right job for our temperaments and training, so we're actually pulling slightly ahead.
TruckerRon -- Received Minion I on 17 Sep 2009, Minion II on 26 Jan 2015

Non-ischemic cardiomyopathy
Medtronic Viva XT CRT-D
No shocks yet...
My intro is at: http://www.icdsupportgroup.org/board/vi ... 099#p57099

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mykidsmom
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Joined: February 9th, 2012, 5:09 pm

Re: Insurance

Post by mykidsmom » June 5th, 2018, 8:18 am

oh gosh.....i dont know what to say....

did you hear anything re the cpap yet? like that its been fricking approved and your getting it soon?? like everyone here is saying robo...rattle the can....Set mrs robo after them....

hugs
I think.....Therefore I am.!!!!!

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ROBO Pop
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Joined: September 14th, 2009, 2:36 pm
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Re: Insurance

Post by ROBO Pop » June 5th, 2018, 9:47 am

Thanks for your concern, it has been rough. I think we're at 6.5 or 7 weeks since diagnosis. I'm at the edge of insanity not having slept more than 3 or 4 hours a night for so long, and even that was not restful.

My Cardiologist's office notified me Friday afternoon that they submitted everything to a new supplier. Uh, oh here we go again, another long protracted wait ... but to my surprise the new supplier called yesterday to tell me I'd been approved and schedule training, which we all know could be a problem since I'm not trainable. They told me my insurance always approved CPAPs and she wasn't sure what the other suppliers issue was.

Anyway so the soonest they can get me in is Thursday, so two more nights of exhaustion, then hopefully safe and restful sleep sleep sleep. I gotta get a life, I'm starting to sound like frickin commercials.

On a side note that doesn't pertain to anything in particular, Mrs Robo took yesterday off and we went out for the day. Went to the San Xavier (San Ah veer) mission on the Tohono O'Odham (Toe Hoe No O O dum) reservation and I took some photos for a future painting. It's one of those things that are nearby and you just take for granted and forget is there, but what an aw inspiring place. We have a number of old missions in Arizona but this one is still in use by the Franciscans (Catholic) and serving the local native Americans. The church is Known as the white dove of the desert, it's a Spanish mission built in the 1700's and completed in 1797 back when this was Mexican territory. Just a few miles out of town but you can see it from 25 miles away because of the whitewash coating. Anyway this church is highly photographed and many paintings have been done, but I'm hoping I can come up with a new approach to give it a fresh feel (and maybe sell for big $$$). Sorry I'm rambling, guess it's exhaustion.
Broken Heart
Nobody has ever survived life, but I'm trying...
My story and sticking to it
http://www.icdsupportgroup.org/board/vi ... 97&p=91375

DebW
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Joined: July 23rd, 2016, 6:23 pm

Re: Insurance

Post by DebW » June 5th, 2018, 11:14 am

ROBO! Sounds like there is a light at the end of the tunnel!!! Thank goodness they are coming and I hope it helps. It sure helps me at night.
And this place sound intriguing, I think I should visit it when I go for my next check up at Mayo. Thanks for that info, not rambling at all
:) :) :)

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mykidsmom
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Joined: February 9th, 2012, 5:09 pm

Re: Insurance

Post by mykidsmom » June 5th, 2018, 1:27 pm

So happy to hear this Robo so seems like this Thursday you'll be in business and hopefully getting the much needed sleep....Its all thanks to my friend joan you know...she has a direct line to god..he listens to her so i asked her the other day to add you to her prayer chain.....god never listens to me so i dont bother....but joan adds me to her list and i just know then everything will be ok...gotta phone her and tell her another success story...x

We live in Peterbourough and theres a Hiawatha reservation just about 10 mins from our house....its amazing and the most beautiful place on earth....Id love to live there..but unfortunately cant trace any bloodlines to them darn it...but we do attend some of the functions they put on...recently they had a pow wow...willie goes to take photos...hope you got some great photos..
I think.....Therefore I am.!!!!!

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Ozchrissy
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Location: Australian

Re: Insurance

Post by Ozchrissy » June 5th, 2018, 7:54 pm

Oh Robbo, relief at last. How brilliant you were able to get the photos for your paintings. I love doing that, and have quite a collection of them from everywhere I have been. I love the challenge of not doing the stock standard painting, and when you let your "soul" take over, then marvelous things happen. I am now the same with a new exhibition coming up, I have been told by the organizer of the last exhibition that I could have sold 10 or more of my Emu's so doing another one and two others, but in a similar style.
“I am not what happened to me, I am what I choose to become.” Carl Jung

Diagnosed with cardiomyopathy in 10/99
LBBB & VT diagnosed Feb 06
Guidant Biventricular Pacer ICD inserted Feb 06: Boston Scientific Incepta CRT-D inserted May, 2012
Oesophageal Cancer, 2012, Gall Bladder & Septicemia 2014 resulting in VFib and severe heart damage
Bare Metal Stent May, 2012 Mitral Valve replaced 2015
Meds: Entresto, Bicard, Coralan, Eurtorxsiq, Frusehexl, Spiractin, Sigmaxin, Creon, Warfarin,
Appropriate Shocks for Ventricular VFib.

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ROBO Pop
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Joined: September 14th, 2009, 2:36 pm
Location: the Oval Office

Re: Insurance

Post by ROBO Pop » June 7th, 2018, 2:13 pm

So I had a stress test this morning and went to pick up the CPAP equipment. The stress test was my wife's driving, I'm still shaking. Why does the woman believe you accelerate as you close on the vehicle ahead and only depress the brakes when it's too late. That dump truck loomed large in my windshield and I depressed my imaginary brake so hard my foot went through the floor board. And someone please explain to me what the logic is behind driving in the lane furthest from where you need to be and only changing lanes at the very last instant in heavy traffic while going like a bat.

Anyway I finally made it, and alive I might add, to be trained and pick up the CPAP equipment. Yes, in spite of my wife's assertions to the contrary I am trainable...old dog and all. It's a bit complex but the first supplier knew up front they weren't approved provider and took over 5 weeks to inform me because they were just in no hurry. Approved providers like the one I dealt with this morning don't need to get insurance approval.

I must admit I thought it was really going well until I asked my trainer how long before I see some improvement and hair growth. His response was really quite hurtful - "You wish". Now what kind of response is that to give a sick and dying man, shouldn't he at least give a hint of hope?

Well I gotta hit the medicinal wine, for my nerves
Broken Heart
Nobody has ever survived life, but I'm trying...
My story and sticking to it
http://www.icdsupportgroup.org/board/vi ... 97&p=91375

DebW
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Joined: July 23rd, 2016, 6:23 pm

Re: Insurance

Post by DebW » June 7th, 2018, 3:41 pm

Yayyyyy for getting the CPAP equipment!!!! I really hope it helps you. Just so you know, I don't like to drive when my hubby is with me, he just tells me how to do it. ha

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mykidsmom
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Joined: February 9th, 2012, 5:09 pm

Re: Insurance

Post by mykidsmom » June 7th, 2018, 4:21 pm

yahoo...so happy to hear this...hope you see some improvement really soon..

My husband thinks hes mario andretti...did i mention once i jumped out of his moving car on a major Hiway..i figured my chances of being run over and surviving was better than disappearing into the brain of the driver in front of us..

now when he was ill and i had to drive him everywhere....we had standard cars and he made me rent an automatic....a couple of days in that he just walked out and got a taxi......we didnt talk for a long time..

conclusion men and women shouldnt be in the same cars together ...ever..
I think.....Therefore I am.!!!!!

DebW
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Posts: 543
Joined: July 23rd, 2016, 6:23 pm

Re: Insurance

Post by DebW » June 8th, 2018, 8:11 am

How was the first night with your CPAP ROBO?

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ROBO Pop
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Re: Insurance

Post by ROBO Pop » June 8th, 2018, 1:29 pm

I got the face, actually nose, mask Trucker recommended and made it through the night. They forewarned the first few nights are often rough. But I'm going to substitute distilled liquor in the humidifier tonight and that should help. Probably coincidence. But I don't feel so hot today.
Broken Heart
Nobody has ever survived life, but I'm trying...
My story and sticking to it
http://www.icdsupportgroup.org/board/vi ... 97&p=91375

DebW
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Joined: July 23rd, 2016, 6:23 pm

Re: Insurance

Post by DebW » June 8th, 2018, 1:39 pm

Liquor in the humidifier sounds like a good idea to me!! I might try that. Yes, I would give it a few days. When I first got my cpap, I got the nose mask. Well, it didn't work for me, cuz, when I sleep I open my mouth and all the air comes out. ha. So, had to go back and get the full one. At first it was hard to get used to. They told me I had to make sure I was getting at least 4 hours a night with it or insurance wouldn't pay. And when that 4 hours would come, I ripped that thing off. At least for a couple weeks and now it is on all night. I hope this really helps how you feel. =)

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Suzanne
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Joined: October 1st, 2009, 8:42 pm
Location: Toronto, Ontario, Canada

Re: Insurance

Post by Suzanne » June 8th, 2018, 2:11 pm

ROBO, I hope you get a good nights sleep tonight and feel better tomorrow...I hope each night gets better. :big-hug:
~ Suzanne ~

St Jude ICD and Lead Implanted Feb.20/09
8 Shock Storm March 21/09
Lead Dislodged, so Replaced with Medtronic Lead June 16/09
ICD and Lead Explanted Nov.23/09
Medtronic Reveal XT (Cardiac Monitor) Implanted Jan.25/10...explanted and new one reinserted on July 21/11

Cardiac Monitor explanted Sept.9/14

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