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» LymeNet Flash » Questions and Discussion » Medical Questions » HELP!!!!! Insurance max is hit!!!

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Author Topic: HELP!!!!! Insurance max is hit!!!
knshore
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Member # 13451

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I haven't been on in a long time. A VERY short version of what is going on for those of you who remember me.

I tried going to school, couldn't--too much Lyme brain, fatigue, etc. My mom told me (I'm 19) that she couldn't pay for my Lyme treatment so I needed to work part time.

I started working part time, then realized I wasn't going to be able to keep up financially, so I got a full time job.

Went on a 6 week trip to France for work and got incredibly ill. Fell down stairs, fractured a vertebrae and my CD57 dropped from 45 to 11 in 6 weeks.

The day after I got home from the trip, my mom handed me ALL of the medical bills (more than $10,000) and told me she could only pay for the roof over my head, but I needed to support myself.

I freaked out of course and then found out my job probably wouldn't work out. I then woke up in early October and couldn't walk. Went to ER, had herniated disc in lower back. Was hospitalized for 6 days, given a nerve block (with steroids) and have not been the same since.

I am having severe multiple chemical sensitivity, etc. I also am in so much pain that my LLMD has suggested I see a neurosurgeon to have a disc replacement surgery because my MRI is that "of an 80 year olds" (his words exactly)

I should add that I've been hospitalized MANY times this year as well as to the ER too many times to count. Discovered a bleeding ulcer, gastritis (so bad my GI said he had never seen any so severe), acid reflux among many other things.

That brings me to where I am now. I juts found out that I have less than $1,000 left on my yearly max for insurance. My Dr's want to put me in the ICU to give me iron IV's (nearly died last year from them, but am critically anemic right now) in addition to possibly have me have surgery.

There's no MONEY!!!!!! I can't work, I'm trying to get on disability, but OMG!

What am I supposed to do? Does anyone have ANY ideas?

The ICU and surgery, in addition to figuring out why I'm hemorrhaging (my menstrual cycle is screwed up big time) all costs a LOT of money and I have no more insurance coverage!!!!

AHHHHHHH!!!!!!!!!!

Clearly, I'm slightly freaked out. If anyone has ANY suggestions, I am MORE than happy to try anything!

Thank you,
Kassandra

Posts: 215 | From Student | Registered: Oct 2007  |  IP: Logged | Report this post to a Moderator
sixgoofykids
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Wow, Kassandra, I'm so sorry to hear things are going so badly for you right now! I wish there were something I can do. Hopefully, someone will have some concrete suggestions.

I was hoping that since I hadn't heard from you in so long that you were all better and moving on with your life. [Frown]

Is your uncle or another relative willing to help you out some?

--------------------
sixgoofykids.blogspot.com

Posts: 13449 | From Ohio | Registered: Feb 2007  |  IP: Logged | Report this post to a Moderator
lymednva
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Kass, I don't have ideas, but wanted to let you know I'm thinking of you and hope you will get some good help soon. I'm so sorry to hear you have gone backward again.

--------------------
Lymednva

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sammy
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Kassandra, can I just send you a hug right now? It sounds like you could really use one and I know that I could too. I wish that I could help more...

About the old medical bills. Are they all from one hospital/medical facility? Have you tried talking with the billing dept? If you ask, they should be able to gather all your outstanding bills and put them in one account. Then you can work out a payment plan.

If you fall below the federal poverty guidelines you may also qualify for assistance with your hospital bills. Again, talk with the billing/financial office for help there.

Another thing to consider, are you doctor's aware of you financial/insurance situation? If not, you should talk with them. They might be able to offer alternatives to keep you stable through the end of the year?

Maybe try some outpatient IV therapy and pain management? I know that it would be like putting a band-aid on a big gashing wound, it wouldn't hold long but it might carry you into the new year. Then proceed with more aggressive inpatient treatments/surgery when your insurance kicks in.

Let me clarify, I am just brainstorming here. These are things that I would consider but I do not know your full medical picture. You need to take care of yourself, listen to your doctors, and be aware of your all options before you make any decisions.

Hang in there Kassandra, (you have such a pretty name:) ) Try not to let these worries weigh you down. I know, it is easier said than done.

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knshore
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I have a payment plan with one hospital. Most of the places I have outstanding bills with are not willing (at all!) to help. If you have insurance, you can't get charity for a lot of places. I have insurance, but my percentage is just too much for me.

My biggest concern right now is the fact that I have no medical coverage. It's rare these days that I make it past 30 days without going to the ER. It makes me incredibly nervous to not have coverage, and at the same time, if I had to, I'd go to the ER.

I appreciate everyone's suggestions. I am trying to explore as many options as I can. I'm going to see if I qualify for Medi-Cal or whatever the state program is. I can use that as my primary insurance and then have my current as secondary. The only issue is, I don't have any clue how long that takes to happen.

This all feels so overwhelming. I have an amazing team of Doctor's around me, but without the proper medical care, there isn't a whole lot that they can do.

I am planning to call my insurance company tomorrow to see if they have other ideas because I'm sure they have other patients who deal with this...it IS a high risk program after all!

I am trying my best to stay positive! In the middle of all of this, we are looking to move and we have no heat right now, so I'm cold. That's not helping my poor back.

Any suggestions are great, so please keep them coming! Even just a cyber hug means a lot!

Sincerely,
Kassandra

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Rumigirl
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Oh, Kassandra, this is more than anyone should have to bear!! Let alone anyone as young as you! I'm not sure what else to add at this moment (have to go to bed now). But I send you hugs and prayers. And more people will chime in, I'm sure. Keep us updated, and don't ever be afraid to ask for help---here or elsewhere. The squeaky wheel gets the grease!
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bettyg
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Kassandra [group hug] [group hug]

so sorry to read all about your health problems, your falling overseas, etc.

would your former employer pay for those bills? WORKER'S COMP??

go to top of support and read what to do when you run out of money; you may come across many helpful hints.

later towards the bottom is melanie reber's financial burden's link i added there ... a goldmine of info there too.

my best to you on this.

do you have an electric heating pad? would help your back; that's what i use but we do have heat also. [group hug] [group hug]

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Snailhead
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Betty is right as far as your fall and Workers Comp; please explore this.

I am not sure what state you are in, but if you go to your local Social Services office (I helped a friend once who had kidney cancer and no ins. coverage, they pushed her applications through and she was covered in a week) they will have a case worker assigned to you and should help you get every benefit (medical and otherwise) that is available.

God bless you Sweetie.

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Snailhead
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Oh, and P.S., I don't think you can have Medi-Cal as primary if there is any private insurance to be tapped into. I believe (I believe) you have to exaust all private ins. before any public plans will help you.

If you do go to Social Services, take info on your current outstanding medical debt with you. They may have some ideas/options.

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seibertneurolyme
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Found this info in the April 2009 issue of Health magazine. This may help with your existing bills.

"Consider a professional insurance negotiator for claims of more than $200.

http://www.MyINSNET.com

INSNET LLC, for example, has a 70% success rate in negotiating bills that average $1400 to $1500 down by around 20 percent. You pay 35 percent of your savings (28 percent if you identify yourself as a Health reader) as their fee. And if they can't save you money, there's no charge, company president Jack Gillis says."

Good luck.

Bea Seibert

Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004  |  IP: Logged | Report this post to a Moderator
knshore
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I am in CA.

I can't do worker's comp...it's a long story, but I was on a trial period and did not have insurance, etc. yet. Also, the fractured vertebrae is not the big issue right now. It didn't help with the fact that I herniated a disc, but it didn't cause it.

I have been VERY busy today trying to get some info and help. The challenge is that as many of you know, trying to do this all alone is really hard.

I am on the phone right now trying to get a patient advocate because I am still too sick to be able to do this stuff.

I spoke to a couple people today and one suggested trying to get medicare. All of that stuff is great, but won't help me right now. I am worried about making it through the rest of the year with coverage.

My back is getting worse and worse as time goes by and I'm worried about permanent damage. I'm WAYYYYY too young to have permanent spinal damage.

Anyway, I have to go, but the more ideas people have, the better!

I am totally willing to look into anything I can at this point!

thank you,
Kassandra

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knshore
LymeNet Contributor
Member # 13451

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I just wanted to give an update. I have discovered there are lots of resources here in LA. Luckily Lyme can fall under terminal illness (in my case without a doubt) so I qualify for lots of programs that usually help with HIV/Aids.

A lot of programs will help with terminal/severe chronic illness but mostly associate with HIV/Aids. I have found many resources that should be able to help even with simple things like bringing allergy free, healthy meals over so I don't have to cook.

Once I get a list together of all the resources, I will post them for people to use in the future.

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sammy
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Thank you for the update:) I'm so glad to hear that you will be able to get the help that you need.
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Rumigirl
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I know of a treatment that might really help your back a lot; it's called Prolotherapy. I know that right now you don't have the insurance or money for it, but starting next year, perhaps? If you are in LA or northern CA, I know doctors who are good with this.

I hope you can get some help soon---A LOT of help!

Posts: 3748 | From around | Registered: Mar 2008  |  IP: Logged | Report this post to a Moderator
   

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