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» LymeNet Flash » Questions and Discussion » Medical Questions » Question about Health care in Texas ( Please Help )

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Author Topic: Question about Health care in Texas ( Please Help )
Annxyz
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Does Texas have any kind of healthcare program for people who can not get health insurance due to illness ?

I have health insurance but the premiums have gone really high ( unaffordable ) . Also , the insurance has a high deductible, and covers NOTHING preexisting . That means I am paying : high premiums, all of my drugs costs , a high deductible . The insurance company is getting a hefty amount of money from me , and in return I get literally nothing in return .

They do not know I have lyme DX because I paid for the Igenex test .

I have a small income but am not indigent . However , I can not continue paying the insurance costs and everything else , since it covers so little.

The frustrating part of this is that even though the insurance company is out ZERO ( NOTHING ) for me , my premiums go UP every six months !!!!

I am feeling desperate and the stress from this situation is wearing on me 24/7 .

I would GREATLY (!!) appreciate any insight from any kind person who has a suggestion.

I do not think I qualify for disability (SSI)
because I was a fulltime Mom ( only worked part time ) until I became ill in 96 , so according to Soc Sec , I did not work enough quarters in the past ten years to qualify .

My primary concern is insurance coverage. I am not well enough to do a regular job ( which I would love to be able to do ) yet , I can not
continue paying for insurance that is robbing me and covering NOTHING .

I thank you in advance for any suggestions or insight .
Ann

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ANNXYZ

Posts: 744 | From Mineola | Registered: Apr 2006  |  IP: Logged | Report this post to a Moderator
James H
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Texas has become a black hole for Lymies.

You might look at a Health Savings Account if your carrier offers a compatible plan.

It is still a high deductible plan where you pay for nearly everything out of pocket, but with tax free money. The money in the account can also be used on expenses such as vision and dental that would be outside of your major medical.

One needs to weigh just what could happen to you that the policy WOULD cover, and how much financial protection it would really be.
Also what assets you are trying to protect with it.

If you don't have alot, it may be just 'financially wiped out' versus 'financially really, really wiped out'. Sometimes in this perverse world there is more help in the latter situation.

Its all kind of a moot point though. In Texas anymore if you have Lyme you are lined up at the barn with the chickens to get some tetracycline powder from a big plastic bucket. The doctors have all been given the memo about what happens if they treat somebody's Lyme Disease.

Sorry to be so grim.

Posts: 714 | From San Antonio TX | Registered: Oct 2004  |  IP: Logged | Report this post to a Moderator
MariaA
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Sorry, what happened in Texas- another medical board license-yanking?

--------------------
Symptom Free!!! Thank you all!!!!

Find me at Lymefriends, I post under the same name.
diet: http://lymefriends.ning.com/group/healthylowcarbrecipes
Homemade Probiotics thread
Herbal Links Thread

Posts: 2552 | From San Francisco | Registered: Apr 2006  |  IP: Logged | Report this post to a Moderator
Annxyz
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Thank you James . I went to talk to a lady in town who SELLS insurance ( yse!) . She sells primarily supplements for the medicare age folks. this woman is 45 and I asked her about
finding affordable insurance - major medical.

This business woman HAD NONE HERSELF ! She said
" I can not afford major medical, so I just have catastrophic coverage ".

I am finding many middle class folks without major med coverage because of spiralling costs . I am afraid I may have to join them and simply have a catastrophic policy .

Frankly, I feel totally RIPPED OFF each month when I see what I am paying , and yet receiving no practical benefit .

If I apply for a policy and reveal I have lyme , I will be refused. My question is , does the state have any help for those who are uninsurable because they have a disease ?

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ANNXYZ

Posts: 744 | From Mineola | Registered: Apr 2006  |  IP: Logged | Report this post to a Moderator
James H
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quote:
Originally posted by MariaA:
Sorry, what happened in Texas- another medical board license-yanking?

Not recently. Last year we had board actions and threats of license yankings sending one of our finest fleeing to the relative safety of California. Your gain, our loss.

That sent a chill to any doctors who might have been been inclined to be helpful previously.

I'm sure somebody is really proud of their accomplishment, and probably was given a big bonus.

Lyme Disease has now been permanently eradicated in Texas... By decree.

Posts: 714 | From San Antonio TX | Registered: Oct 2004  |  IP: Logged | Report this post to a Moderator
James H
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...But, if the disease has been declared nonexistant in Texas by order of the Governor, do you really have a Lyme diagnosis on your medical records?
Posts: 714 | From San Antonio TX | Registered: Oct 2004  |  IP: Logged | Report this post to a Moderator
James H
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I'm not aware of such a program for adults, but here is where you would look:
http://www.tdi.state.tx.us/

...And this seems to be their list of available health coverage options:
http://www.texashealthoptions.com/

Posts: 714 | From San Antonio TX | Registered: Oct 2004  |  IP: Logged | Report this post to a Moderator
Annxyz
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James , I sincerely thank you for taking the time to find this. I appreciate your helpful attitude .

Unfortunately , this says very little . There is NO ANSWER for " What if my premiums keep going up? " . I do not know why they bothered to create this " info site " except perhaps to make Texas not look too backwards .
They pose the question, but it is NOT answered .

The overall situation is bleak EVERYWHERE
unless a person has good enough health to hold down a full time job and works for a company that provides it .

I have talked to two local busness owners here in town . They have NO major medical coverage , because it is unaffordable.

The government seems to have no serious concern for this disastrous situation, and I predict it will get worse . How in the world will the gov't be able to provide years & years
of care for the soldiers , men AND WOMEN,
coming home in droves with blown off limbs, burned faces , missing ears , etc.. ?

The frustrating thing is that the legislators , who do not care about the average folks , have excellent coverage .

I had a docxtor visit with a dermatologist recently . Dr "H" spent about fifteen minutes doing some routine things ( which cost $200)
like looking at myskin .
I had scheduled the appptmt because I had a suspicious area on my face . She said " you will need a biopsy " but you will need to come back for ANOTHER VISIT to get that done.

I have had biopsies before . She could have done it lickety split , and I KNOW IT . It only takes a quich slight scrape and about a minute !

The real issue at hand was getting me back in her office and securing another office visit fee ( $ 200 ) . This is the state of health "care" .
What a misnomer .

Sorry for the rant !

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ANNXYZ

Posts: 744 | From Mineola | Registered: Apr 2006  |  IP: Logged | Report this post to a Moderator
jazzygal
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I would LOVE for your to write a "letter to the editor" in my newspaper, the PUBLIC HEALTH ALERT...your story needs to be heard.

I am also a board member of the TX Lyme Disease Association and the situation in TX is GRIM...but we are fighting back!

Go to http://www.publichealthalert.org/text1.htm
and scroll down to pages 6 and 7.

Notice the article "Sick as a Dog" in from TEXAS A&M University...they are doing studies and even have a research lab on TICKS--yes, IN TEXAS!

It is my personal opinion they may be a HUGE part of the success of the battle we are waging to be recognized in TX.

On pg 7 there is a story titled TEXAS WARNING IGNORED, FALLOUT DEVASTATING.

You might find both helpful.

My family also has insurance troubles...our monthly deductibles top $500 just for the lovely priviledge of being covered.

Then we have a $3,000 deductible for out family, or $1500 per person (which ever comes first.)

Last year we did not meet our deductible until the second week of NOV and then it all started over again in JAN.

We have separate deductibles for medical visits, hospital & ER visits, and prescriptions....

So if we have an ER visit, that money is not even applied to our $3K deductible for regular medical care, it goes to the "hospital deductible".

We have a $250 per person deductible on meds.

We are looking at giving up our home just so we can continue medical treatment.

The only GOOD thing about our insurance is that it covers blood lab work 100%...and last year they paid over $70K in lab fees for my family...so for that we are grateful!

But the whole experience has been financially devastating!

Dawn

Posts: 222 | From USA | Registered: Apr 2006  |  IP: Logged | Report this post to a Moderator
Annxyz
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Dawn,
Thank you for sharing . I am sick to death of what health care has become. I do NOT believe it exists to make people healthy ; it exists
to make those " providers " wealthy . Not just the doctors , but the labs , drug companies etc..

Yesterday I read on the front page of the paper
that studies are showing that stents are not really saving anyone's life . So , why have they been the accepted treatment for heart blockage ? Now, we also find that breast cancer rates have been dramatically lowered
since doctors began to be cautious about prescribing them . Why were they accepted as a rite of passage with menopause to begin with?

Statins are passed out like candy pills , yet they have serious side effects . There are simple things and CHEAP , that can lower cholesterol like policosanol , beta sitosterol .

I have a friend with liver disease . Her doctor NEVER ONCE has mentioned N acetyl cysteine or milk thistle . YET HE DRIVES AN OUTRAGEOUSLY EXPENSIVE HUMVEE , and brags at the gym about his new $ 2 million dollar home ( this is a region with low cost of living ) .

I may be crazy , but after spending lots of money and getting nowhere , I am about to conclude I will only get well if I find a way to heal myself . I am also coming to the belief that " health care " can bankrupt me , and provide no improvement to my health .

--------------------
ANNXYZ

Posts: 744 | From Mineola | Registered: Apr 2006  |  IP: Logged | Report this post to a Moderator
James H
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Ann,

Your rant is justified and you are percieving the situation correctly. It is amazing that so few people seem to be able to grasp this, as blatant and in our faces as it is.

This is what happens when diseases are no longer enemies to be conquered, but are 'profit centers'.

Billion dollar industries are built around 'treating them' by some profitable means. Large 'charities' named after a disease spring up, and collect more billions from a naive public.

Now, with all this in place and all this money being spent, won't somebody surely find a cure?

Yes they may, but it will be over their dead body.

The really perverse thing that happens is that these huge 'disease industries' actually begin protecting their namesake disease.

The public is strung along with little bits of hope and bled financially.

Researchers that find an underlying cause are often persecuted, and stuff like the IDSA nonsense is used to bully Doctors who would like to try different approaches.

The US medical industry has always operated like this to some extent. It seems like there was still a sense of morality and responsibility for public health keeping it in line in the past. That seems to be gone now.

It doesn't appear The System is willing to open a Lyme Disease profit center. Probably because it would take too much business away from the very profitable Alzheimers, MS, ALS, Fibromyalgia, Rheumatisim, Joint Replacement, Antidepressant drug, Statins, and other profit centers.

It doesn't make good business sense to possibly treat an underlying cause of these huge profit centers.

That's the bottom line, and the bottom line is what it is all about.

Understanding the world we live in and adjusting our expectations is a helpful step, as it keeps us from going down many fruitless wrong roads.

You are correct again, that as individuals we need to take control of our own health and do what ever we can with what resources we have.

Lyme is a serious medical problem, and we really need competent and non-conflicted professional help if we can find some. Most are ill prepared to tackle this on their own, yet that is what they must do.

Quite a few here have managed to get well enough to be functional and able to earn a living again. Usually with a combination of what ever medical help they could find, coupled with knowledge backed individual effort.

My wife and myself are both in that category. Well? Not totally, but pretty good most of the time! [Wink]

James

Posts: 714 | From San Antonio TX | Registered: Oct 2004  |  IP: Logged | Report this post to a Moderator
Lymetoo
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[QUOTE]Originally posted by James H:

This is what happens when diseases are no longer enemies to be conquered, but are 'profit centers'.

Billion dollar industries are built around 'treating them' by some profitable means. Large 'charities' named after a disease spring up, and collect more billions from a naive public.

Now, with all this in place and all this money being spent, won't somebody surely find a cure?

Yes they may, but it will be over their dead body. The huge business structure that has sprung up actually protects it's profit center, because if a cure were found, it would be put out of existance!


Instead, the public is strung along with little bits of hope and bled financially.

The really perverse thing that happens is that these huge 'disease industries' actually begin protecting their namesake disease.

Researchers that find an underlying cause are often persecuted, and stuff like the IDSA nonsense is used to bully Doctors who would like to try different approaches.

The US medical industry has always operated like this to some extent. It seems like there was still a sense of morality and responsibility for public health keeping it in line in the past. That seems to be gone now.

It doesn't appear The System is willing to open a Lyme Disease profit center. Probably because it would take too much business away from the very profitable Alzheimers, MS, ALS, Fibromyalgia, Rheumatisim, Joint Replacement, Antidepressant drug, Statins, and other profit centers.

It doesn't make good business sense to possibly treat an underlying cause of these huge profit centers.

That's the bottom line, and the bottom line is what it is all about.

==========================


[bow] Well said, James!!!!!!

--------------------
--Lymetutu--
Opinions, not medical advice!

Posts: 95340 | From Texas | Registered: Feb 2001  |  IP: Logged | Report this post to a Moderator
Annxyz
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I moved back home to TX after 10 years in Atlanta. I was diagnosed in Atl , and told I would need long term ABX . I get to TX , and find I am supposed to be cured in 28 days ! I had already had lots of ABX , and still not cured after one year , but I expected such .
Now I am left to take the desperadoe's path to fixing myself . And That is exactly what I am doing . Do I really KNOW how to eradicate this by myself ? NOOOO,,,

But my friends who have travelled out of staet to " expert LLMD's " are not cured either and they $$$$$pent money I do not have to waste . As the old saying goes " It's root hog or die " .

I saw an ear specialist last spring ( 350 bucks one hour to tell me what I knew and I gained NOTHING!!!) He asked " Are you receiving adequate treatment for lyme? " You know you will need massive amounts of ABX because it is a spirochete like syphilis " . There is only one REASON we are denied care , and that is because the insurance companies have pressured the medical licensing boards . It all boils down to protecting the profit center as Jas mentioned .


I just left a nice little coffee shop in town here . The owner has NO HEALTH INSURANCE . Same
for most of the business owners ! It is simply unaffordable. I am paying stiff premiums monthly , plus ALL OF my MEDS because of preexistng issues , and a high deductible. The insurance company is fleecing me and is OUT NOTHING for me , yet they raise my premiums even though I cost them ZERO .

To be honest , I worry about this 24/7 . I can not continue , yet I tremble to be uninsured and get in a desperate situation .

I will state something , and please know I do not intend to offend anyone , just state my feelings . I am sick to death of what I have witnessed of compassionate conservatism ( this is spoken by a woman who campaigned for Reagan )
and its fruit .

Compassion for WHOM? The CEO's who get rich while the average Joe works harder for stagnant wages and less benefits ? For the oil companies that raise the price of oil so no average Joe can afford a vacation or has to worry about heating his home ? Compassion for
the DRUG companies , who pressured Bush to PREVENT people from buying drugs in Canada , yey ALLOWS the drug companies to TEST the drugs in INDIA ( !!! )

I have always been a " conservative " and believed that our system is the best and brightest . But the truth is , we are governed by lobbyists who put money into the " legislator's " pockets , then the Legislator
leaves office and he BECOMES a lobbyist !

I am not advocating anything other than democracy , but I can certainly see how socialism gained appeal , when people feel forgotten or powerless .

Incidentally , the coffee shop owner said that she would take her chances and save her money , and if she got cancer she would demand treatment and sue if she was refused , because
the hospitals " do not refuse treatment to illegal aliens " who live openly EVERYWHERE around us .

I have had four doc visits this past year. The cost : ear doc $350 , chest cold and routine lab , $500 , dermatology $200 , and was asked to schedule another apptmt for waht she could have done in ONE!!

Who can survive this madness without questioning whether it is all worth it ?

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ANNXYZ

Posts: 744 | From Mineola | Registered: Apr 2006  |  IP: Logged | Report this post to a Moderator
James H
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Welcome to our growing club... "Los desperados mdicos de Tejas". [Cool]
Posts: 714 | From San Antonio TX | Registered: Oct 2004  |  IP: Logged | Report this post to a Moderator
   

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