So happy I could cry: I finally have great-seeming health insurance

November 9, 2012

I’ve long since given up on going out on a Friday night.  If there’s a special event, like a friend’s birthday, then I’ll make the effort when I can, but otherwise, I just stay in.  I hope that changes one day, but for now, paying bills is the same to me on  Friday as on a Wednesday.

So I was going through my bills and other paperwork tonight, and I came across my new health insurance handbook.  It arrived in the mail earlier this week and I hadn’t gotten to it.  Unlike most people, I actually read these things.  Plus, I went to my PCP’s office today to show them my new insurance card and arrange a referral for my rheumatologist and they said I didn’t need a referral, so I wanted to make sure for myself.

I started flipping through the handbook, figuring I’d do a thorough reading later, but then it really caught my attention.  You see, I’ve always had employer-provided HMO plans.  With these plans, PCPs (primary care physicians) must give referrals for all specialists, and I pay premiums and co-pays for everything.  I’ve been lucky to have plans that didn’t have deductibles or co-insurance.  It was a very restrictive system, but it was the only one I knew.

That’s why I was shocked to find out about my new plan!  Now, I haven’t used any of these services yet, so I can’t be sure if they’ll work out the way they’re supposed to.  And I don’t know how long I’ll have this plan.  For one thing, I appealed my denial of medicaid, so I could end up with that instead of this.  And of course that doesn’t compare to the uncertainty of the long term disability insurance mess.  If I get the insurance coverage when we appeal, then I’ll get my old health insurance back.  I’d rather keep this new insurance, I think, but I definitely need to win that appeal so that I have an income.

I was accepted for this new plan despite my pre-existing health problems because Massachusetts rocks, and it was given to me without having to pay premiums because I have no income and Massachusetts rocks some more.  Believe me, I know how lucky I am!  But I was still shocked to read the details of this plan.  I can see specialists WITHOUT A REFERRAL!!!!  I feel like I’m dreaming.  This means that I don’t have to worry about whether or not my PCP agrees with my decision to see a certain doctor!  My big issue now is that I need to find a new endocrinologist, since my last one dumped me for being the cause of too much paperwork and too many expensive tests.  I’ve been worried about finding someone who practices what I think is best approach based on the research I’ve done.  Then, once I find them, my PCP would have to approve…. but not anymore!  I figure if I can see someone soon, then even when/if I get my old insurance back, my PCP would be more likely to go along with it because I’d already have seen the new doc (or she’d be pissed, in which case I’d find a new PCP.)

Even more amazing, there are no co-pays for visits, and the co-pays for meds are incredibly low.  Now again, this is a plan for people who have no income, so I know this isn’t what everyone gets.  Still, it’s amazing to me that they did it right!  They are offering free coverage to people who can’t afford to pay, so that we don’t get really sick and end up costing even more money to them later.

It’s amazing, almost unheard of, but I think I’ve finally encountered a health-related, government-related system that isn’t broken!  I sure hope it turns out to be as good as it seems, because right now, it seems too good to be true.

I’m sure all of you readers in other countries are wondering what all the fuss is about.  I just can’t even tell you.  Click on the “Healthcare” category in the sidebar on the right (you might have to scroll up or down) and you’ll start to understand just a little bit.  It’s really lousy here in the U.S when it comes to health insurance.  Most of it is linked to employers, and many people choose jobs based less on their passions, the work, or the job potential than on the health insurance that’s provided.  I really hope this ray of sunshine lasts for me, and that the new Affordable Care Act helps things!

6 Comments | Educating, Expectations, Healthcare, Medication, Politics, Raves, Support, Unpredictable | Permalink
Posted by chronicrants

Breathing a sigh of relief: we had the sense to re-elect Obama

November 7, 2012

I was worried last night that Mitt Romney could be elected president.  Actually, it was more like scared.  Well, to be honest, I was absolutely fucking terrified!

A few days ago I wrote about Romney’s lack of compassion when it comes to providing healthcare for the non-millionaire sick people in this country.  You see, unlike every other industrialized country, the United States does not have universal health insurance.  Incredible, right?  I had planned to write about some of his other stances that could affect us, but I didn’t feel well for several days and wasn’t able to write.  I didn’t feel better until this evening, and by then I had already reveled in the wonderful news: President Barak Obama was re-elected!

My joy at this news might offend some people and that’s fine.  You have your opinions and I have mine.  But since this is my blog, I’m expressing mine.  😉

There are so many ways that last night’s election was a good thing, but let me list just a few here, in no particular order, including some great health-related results:

  1. While there is still racism in this country, it isn’t enough to stop Obama’s election or his re-election.
  2. There are now a record number of women in Congress.  We are still incredibly under-represented, but we’re moving in the right direction.
  3. There is still misogyny and and sexism in this country, but the worst offenders, those who suggested that there is such a thing as “rape that is not forcible” and that “rape is a form of conception,” were voted out of office.
  4. The Affordable Care Act will not be repealed.  I didn’t think it would be anyway, but at least now we don’t have to watch our government waste time and money with the attempt.
  5. Three states voted to legalize marriage equality and one state voted against a ban of marriage equality.  This is the first time that marriage equality has won at the polls and it happened in FOUR states!
  6. My own state elected a smart, sensible, honest woman to the senate.
  7. With the ACA safe, women with health insurance will still be able to get free birth control.  Now we need to make this happen for the women without health insurance!
  8. With Obama in the oval office, I feel much better about who will next be appointed to the Supreme Court.
  9. It is less likely now that Roe v. Wade will be over-turned.
  10. My state and others passed medical marijuana laws.  Finally, there will be a treatment without the horrible side effects of so many (all?) of the others!
  11. My faith in the American people has been generally reaffirmed.  Yes, there was the riot on a college campus last night.  Yes, there were racist comments being made.  But overall, the American people showed themselves to have, in my opinion, good judgement.  Overall they were not racist or sexist or homophobic.  Overall they voted for the good of the nation, not only for the good of themselves.  And now I can breathe a bit easier because of it.

I could go on and on.  There was the first Hindu woman elected to Congress.  And the first openly bisexual woman.  And so many others.  But in the end, the important thing is that I feel our country is moving in a great direction.  I can hardly wait to see what happens next.

3 Comments | Decisions, Expectations, Healthcare, Medication, Politics, Raves, Relationships: Family & Friends & Dating & Sex | Permalink
Posted by chronicrants

Good news: I was denied SSDI

November 1, 2012

You’re probably wondering about that title.  Shouldn’t I be upset that I was denied SSDI?  I should be, but I’m not.

I’ll admit, I teeny tiny part of me was hoping that I’d be approved for SSDI on the first application, and that teeny tiny part of me is a little bit disappointed.  It would have made things immeasurably easier, no doubt about it.  But I also know that a ton of people get denied the first time around.  I read the denial rate was 80%.  I don’t know if that’s accurate, but more than 80% of the people I know have been denied the first time they applied, so I was assuming I would be too.  What I didn’t expect at all was that it would happen so quickly!  I applied for SSDI less than 2 months ago.  At the time, the web confirmation told me to expect a response within 4 months, but I assumed that was wrong.  I figured I wouldn’t hear anything for at least 6 months, maybe even a year.  And I heard today!

So I’m saying this is good news, because now I get to appeal the decision this month, instead of having to wait until next spring.  As soon as I speak with my lawyer I can start the next stage of this annoying, irritating, frustrating, exasperating process.  The sooner I get approved, the easier my life will be.  I am fortunate to be in a position where I can manage not having any income in the short term, but I’m not exactly wealthy, and not having an income in the long term could be a real problem.  I don’t want to cringe tomorrow when I buy the large 24-pack of toilet paper, but I know I will.  I don’t want to wear pants that are 2 sizes too big because I can’t justify even thrift store spending, but I do.  I don’t want to depend on others to support me, but without SSDI I will have to.  SSDI may not pay much (actually, it would be $3 more than my current rent each month!) but it’s still far better than nothing!

So starting tomorrow (or whenever my lawyer gets back to me) I can be proactive and work on appealing this damn thing!  I’ll let you know what happens….

4 Comments | Expectations, Healthcare, Politics, Rants, Raves, Unpredictable | Permalink
Posted by chronicrants

Why using assets to determine benefits eligibility sucks

October 28, 2012

Let’s take two identical people, Jane and Mary.  Jane and Mary each graduate from college and get good jobs in the same city.  Each earns $45,000 per year.

Jane goes on some trips, but tries not to spend too much.  She uses frequent flier miles to go to Europe.  She brings her lunch to work every day.  She lives in a nice apartment, but it’s nothing fancy, and it’s definitely not her ideal.  She buys decent clothes, but tries not to spend too much.  She manages to save $10,000 each year.  She puts most of her savings into a retirement account, and keeps some handy in a savings account, just in case she needs it.

Mary goes on a fancy vacation every year, spending as she pleases.  She eats out all the time and goes to fancy clubs with high cover charges.  She lived in a luxury apartment for a bit, but now owns a condo in a trendy neighborhood.  She goes to the expensive department stores to buy high-end clothes and shoes.  She keeps around $200 in her checking account.  She doesn’t have any savings, but she doesn’t mind.

Now, Jane and Mary each get sick and have to stop working.  They both apply for SSDI.  Then they need to apply for other services too, like SSI and food stamps.  Mary is able to apply for all of these but Jane is not eligible to even apply for SSI or food stamps.  Why?  Because Jane has savings!

You see, someone decided that to get a lot of federal and state services and aide, what matters is not only income, but also assets, but for some reason they do not count houses toward the asset limits.  So Mary can get extra services that she can use to pay her mortgage, but Jane does not get these services to help pay her rent.  Mary gets help buying food, but Jane does not get help buying food.  Jane did what she was “supposed” to do – she saved for the future.  Now, the government is telling her to spend down all of her hard-earned savings before she can get their help.  And if she needs the money later?  Too bad.  To get help now, Jane needs to spend the money that she could otherwise use in a few years for extra medical bills, food, or clothes.

Now, suppose Mary and Jane both get these extra benefits, after Jane spends all of her savings.  After a few years, Jane and Mary are ready to go back to work!  Yay!  Mary is back where she started (minus a few years of work experience.)  On the other hand, Jane is now behind.  In addition to the same lack of work experience, Jane has also spent her retirement and other savings, and now has to start over.

Guess who I am?  Yup, that’s right.  I keep discovering that there are all sorts of services I can’t get, or even apply for, because I have savings.  Since they don’t look at real estate in calculating assets, I could take all of my savings and buy a house and then I’d get those services…. but I don’t want a house!  Why should I have to spend down my hard-earned savings?  I have spent my entire life (well, almost – I started saving when I was 10) building this up, and I resent being told that I’d get more help now if I’d wasted that money on martinis, fancy cars, designer purses, and the newest electronic gadgets.  I understand that help should be reserved for only those who need it, but if a house isn’t counted towards assets, then I don’t think my retirement fund should be either.  If they want me to spend down the money in my checking account, that’s annoying but fair.  But my retirement account should be off limits!

Our system is broken in many ways, and I believe this is one of them.  After all, if I need to spend more than SSDI provides for new sneakers, an umbrella, unexpected medications, or some other “luxury,” then wouldn’t it be better if I could spend my own money on it?  It would sure be a better use of the cash than buying Hermes bags…. which I don’t even want.

5 Comments | Expectations, Frustration, Politics, Rants | Permalink
Posted by chronicrants

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