Author Topic: insurance  (Read 9845 times)

Offline herb

  • Hero Member
  • *****
  • Posts: 456
  • left above knee amputee New Hampshire USA
    • View Profile
insurance
« on: June 10, 2008, 07:15:57 AM »
Hi All - here is a MSNBC article about insurance and amputation  Herb

http://www.msnbc.msn.com/id/25062948/
« Last Edit: June 10, 2008, 07:19:03 AM by herb »

Offline pegleg jack

  • pegleg jack
  • Global Moderator
  • Hero Member
  • *****
  • Posts: 811
    • View Profile
Re: insurance
« Reply #1 on: June 10, 2008, 08:38:20 AM »
Herb, it is just another company that us amputee's must fight tooth and nail to get them to reallize that we are just as good as any AB is, but no they want to put us back in to the backroom agian, like we were 15 years ago. back they we were freaks and about the only place we could get a job was the circus side shows.

Thats why i am working with the ACA  and another group down here in TEXAS to get the parity bills passed.

These insurance company dont want to spend any money that they can give to their CEO'S in bonuses and servance pay, let a lone thier base pay, most of the are being over payed any how as far as i am concerned.
you-all have a great day.

snowbear

  • Guest
Re: insurance
« Reply #2 on: June 22, 2008, 11:50:45 AM »
Something desperately needs to be done! this a a absolute shame for all us amputees. >:(

Offline ann

  • Hero Member
  • *****
  • Posts: 708
    • View Profile
Re: insurance
« Reply #3 on: July 19, 2008, 08:33:20 AM »

Do most of you that's on medicare here in the US also carry a supplemental policy plus a prescription policy?Thanks, ann

Offline pegleg jack

  • pegleg jack
  • Global Moderator
  • Hero Member
  • *****
  • Posts: 811
    • View Profile
Re: insurance
« Reply #4 on: July 19, 2008, 09:43:39 AM »
no ann i dont i just carry the supplemental policy and the prescriptions are included in it, right now i only by 3.00 for generic brand 30 day supply and one of my other i pay 30.00 for a 30 day supply. From what i understand it is if you are on MEDICARE and dont have the supplemental is that you need the part D. prescribtions policy. Check with your local social security office and they can tell everything that you need. I am happy with what i have now
you-all have a great day.

Offline ann

  • Hero Member
  • *****
  • Posts: 708
    • View Profile
Re: insurance
« Reply #5 on: July 19, 2008, 08:42:29 PM »
'PegLeg',  I will have to check on that.  At the present time I have Medicare and a prescription policy...I pay $5 for generic for a month.  But I didn't know that a supplemental policy covered prescriptions...I have to have drug coverage..as I take several and it adds up quickly.  I always am in the donut hole for at least four months.   :) ann

Offline Mitchee

  • Hero Member
  • *****
  • Posts: 180
  • Oshkosh, WI
    • View Profile
Re: insurance
« Reply #6 on: July 19, 2008, 09:56:43 PM »
Hi PLJ and Ann,

I used to be on Medicare.  (I just returned to having group health insurance.)  While I was on Medicare, I had a supplemental policy AND Medicare part D for Rx coverage.  If you did not enroll in the initial enrollment period for Medicare Part D coverage, most likely you do NOT have Rx coverage.  Also, if you have supplemental coverage, that does NOT guarantee that you have Rx coverage.  Most supplemental policies that covered Rx's PRIOR to medicare part D, DROPPED their Rx coverage because they required that a person enroll in Medicare Part D coverage.  This info may not be accurate if you have Medicare HMO coverage.

Does this make sense??  Any questions, please do not hesitate to ask me or send me a PM. 

Thanks.

Michelle
Initial injury:  July 1985
Amputation:  December 2006 - Ertl LBKA

"The journey of a thousand miles must begin with a single step."
 -Lao Tzu

Offline pegleg jack

  • pegleg jack
  • Global Moderator
  • Hero Member
  • *****
  • Posts: 811
    • View Profile
Re: insurance
« Reply #7 on: July 20, 2008, 01:21:12 AM »
Mitchee, you are right i just check my card and i have both and have two differant address to send claims to: one for medical and the other for drug claims, i used to have Humana and it was costing us 140.00 month plus the medicare deduction out of our checks, know i have no premiums just what they (gov) takes out of our checks, which i believe is over 90.00 a month now.

Thanks for the update and information on this.
you-all have a great day.

Offline ann

  • Hero Member
  • *****
  • Posts: 708
    • View Profile
Re: insurance
« Reply #8 on: July 20, 2008, 09:37:22 AM »
Thanks guys...I am looking for a supplemental @ the present time to go with my prescription & medicare policies.  I just received a bill from the hospital for  over {$30 thou }that was over three years old. GRRRRRRRRRRRRR  I can't for the life of me, understand why they are just now sending it.  AND   they had the gall to ask if I  could send them the complete payment or put it on a credit card?

Offline herb

  • Hero Member
  • *****
  • Posts: 456
  • left above knee amputee New Hampshire USA
    • View Profile
Re: insurance
« Reply #9 on: July 20, 2008, 08:08:36 PM »
Hi Ann - I had a similar experience a few years ago on a bill for my youngest son. The insurance company payed the bill but then on review decided that the hospital did not handle the invoicing properly so they withdrew the payment and the hospital, then sent me a bill for $26 thousand dollars. I had to fight with collection agencies, the hospital and the insurance for more than a year to resolve that.Another time the insurance company withdrew a payment that was made because they decided it was an accident and they thought somebody else might be responsible for the bill. My son had fallen off one of my horses. They eventually repayed the bill but it took hours on the phone and several letters. It seems as though the insurance put too much effort in finding ways to avoid paying legitimate bills. My little brother died a few years ago because his insurance denied coverage for a treatment he needed. He appealed the denial twice before they agreed that they would pay for the treatment.By that time they had delayed their approval for a year and he was too weak to get the treatment and he died shortly after he got the approval. I have had bills pre-authorized and then not paid. I think that many people in the insurance business are no better than criminals. Herb

Offline pegleg jack

  • pegleg jack
  • Global Moderator
  • Hero Member
  • *****
  • Posts: 811
    • View Profile
Re: insurance
« Reply #10 on: July 21, 2008, 09:55:43 AM »
Ann and Herb, our family had that same thing happen to them, what happen my sister had a stroke and then after about two years one of the hospitals that she was in came up and said that she owed them if i remember something around 12000.00, and demanded full payment right now, what she did was told them that they would get x amount every month until payed off, oh they screamed and threatened her about it but after  about 3 or 4 payment they stoped.

I am right now doing the same thing on a bill that MEDICARE didnt pay on my wife ROTO CUFF surgeray, and they keep saying that  it is past due and are going to give it to a collection agency, but it hasnt happened yet because they are getting their money, not as fast as they would like to but still the same it is getting payed off,

And i know that it is going to happen agian on my operation, that there is going to be a big bunch that MEDICARE will refuse to pay and it will have to come out of my own pocket.

Dont qoute me on this but have been told as long as you are pa;ying something each month that they are limited on just what they can do to you.

I remember a nother story that happened that is similiar to this a guy owed the hospital in the town i was raised in somewhere about 12000.00, they kept bugging them and this is what he did to them and they couldnt do a darn thing about it, the first of each month he would go into the hospital and lay two quarters on the counter and ask for a reciept and that was his payment on the bill, and they the hospital tried everything in the book to get him to pay it off, (he had the money in the bank), but the hospital found out lthere was nothing that they could do at that time, now i know that you have to make a lot bigger payment to keep them a bay, but it can be done
you-all have a great day.

Offline ann

  • Hero Member
  • *****
  • Posts: 708
    • View Profile
Re: insurance
« Reply #11 on: July 21, 2008, 11:00:39 AM »

PLJ,  I feel like taking the whole three years to pay off what I owe them.  It would serve them right if I did.  I did tell them I thought their accounting system  needed a work~over.  She tried to blame it on the insurance co., but it was their mistake!!  It will be paid, but in my own time; in payments. ;D

Offline stinker373

  • Full Member
  • ***
  • Posts: 66
    • View Profile
Re: insurance
« Reply #12 on: August 06, 2008, 12:22:56 PM »
Almost every amputee that is covered for 80% has to think twice before buying a limb.  the 20% is way over our heads and can be as much and $13000.00 and more.  Where ae we spose to get that money? From a hat?  I know most of us dont have that kind of  money in our bank accounts.  There has to be a way of changing the system to help us out with this expense.  If we are spose to pay for it that means that our jobs will eat up our limb expensises very fast and what to do we have left to live off of.  Maybe stay home and not work?? In that case government considers a basic limb which is literally made of wood.  Walk on that if you dare.  That is what the government pays for. If you are working guess you might be walking to work.  You wont be able to afford a car. Ok I see, take out a loan which turns into much more money after its payed back.  Then you are back to square one becsuse by the time you manage to pay it back your leg is now broke and so are you.  Insurance will not pay for repairs to limbs and we all know how expensive that an be.  Oh. lets not forget that limbs are only warenteed for 2 years.  Insurance only pays for a limb every five years.  Waht do you do inbetween this time frame?  WALK IN AGONY as you manage to go to work and your back gets really bad. 

Now how much of this realates to you as an amputee?

Offline pegleg jack

  • pegleg jack
  • Global Moderator
  • Hero Member
  • *****
  • Posts: 811
    • View Profile
Re: insurance
« Reply #13 on: August 06, 2008, 01:48:13 PM »
About all you can do it start riding your wheels like i am right now cause i cannot afford to have a new pair of sockets made right now to i am stuck in my wheel chiar for awhile, dont know how long this is going to be.

There is a lot of people in this same boat, and i dont know of much we can do, for those clowns in DC dont give a hoot about our needs as long as they get thiers first, have ask both of our SENATORS down here in TEXAS about changing this and they start running the other way, they dont want to mess with medicare except when they can take or cause use to have pay out more for our needs.

Being in my chiar is because of an operation on both legs i just had but i am going to have to have both sockets replaced.
you-all have a great day.

snowbear

  • Guest
Re: insurance
« Reply #14 on: October 10, 2008, 03:27:01 PM »
I just ordered 2 new liners mine are shot and about 10 months old. I need more socks to make up for it, as its worn out. I have to pay $202. 63 cents for them we have 80% coverage. It nuts the liners are about  $600.00 a piece and only last 6 months or so. ::)