This is topic Losing insurance in forum General Support at LymeNet Flash.


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Posted by JBS (Member # 37360) on :
 
My son is 35, just recently diagnosed with Lyme. He has all kinds of health problems, and I think he is having problems with stress, HBP, high heart rate and just not handling problems very well.

He has insurance through the High Risk Pool as he can't get insurance anywhere else. My mother has been paying for it. Well, she has Alzheimer's and has now said she doesn't want to pay for it.

He hasn't been able to hold a job very long as he ends up in hospital with GI related problems with vomiting and nausea, pancreatitis, pain, seizure, etc.

I'm very concerned about his health insurance (I also have Lyme and can't work) and can't imagine him not being able to go to at least his regular internist. He has been adding on medications by the boatload in the last few months - HBP med, high heart rate, meds, high cholesterol (305) meds, high triglyceride (778), rising glucose (101), not to mention pain meds for GI and arthritis, meds for acid reflux, antibiotics - it goes on and on.

If he loses this insurance, he won't be able to get anything for another year. Considering he has been in the hospital about 6 times in the last year, it's just crazy.

He doesn't want to try to keep insurance as he is so worried about his bills. (His wife recently lost her job). But I think he is not mentally processing things well.

I know there's not much anyone can do. But I thought maybe someone might have input on his psychological well being and what I might can do to help.
 
Posted by cozynana (Member # 34270) on :
 
One thing you might do is call the LDUC and see if they have some options for him. I know they have helped some people obtain meds. etc. I don't know what to tell you about not processing things right. That could have been me you were describing!
 
Posted by JBS (Member # 37360) on :
 
I think he can get some medication help - but it's the lab work and tests and hospitalization that are so expensive. He has $60,000 worth of hospital bills already he's trying to pay off from before he had insurance.
 
Posted by poppy (Member # 5355) on :
 
Medicaid?
 
Posted by JBS (Member # 37360) on :
 
Can't get Medicaid unless he gets disability. That would be a year away, and I don't think disability for Lyme is very easy. Especially in Texas!
 
Posted by WheelWatcher (Member # 34223) on :
 
Ive heard that it is easier to get disability for all the disabling symptoms that lyme causes, without having to call it "ly,me" like severe GI issues, or the joint pain causing difficulty with movement... Ex my husband has orthostatic intolerance and awful vertigo meaning he cant drice, and sometime cant stand or walk which is disabling and due to the lyme, but is also a separate diagnosis on its own. Also sometimes lyme & coinfextions (especially bart) cause serious mental health difficulties that can be disabling as well. Does he have a disability counselor or lawyer to help with the application?
 
Posted by JBS (Member # 37360) on :
 
I guess I'm rather pessimistic as I have been dx'd with Fibro/CFIDS for 20 years and recently Lyme. I was turned down and now can only get Medicaid if I could get disability. Medicaid at least in Texas is rarely taken by any doctor and they aren't passing out lab work or testings very easy.

But I would think the most hope he would have for disability would be the GI/pancreatitis problems as they are the ones that seem to put in the hospital so much. Perhaps the joint pain/trigger finger might be a symptom they may look at. But it doesn't seem to disable him so much as hinder him.

Not sure about the anxiety.

In Texas the only way I know to talk to anyone is that you fill out your form, send it in and when you are denied, you then go to see a disability lawyer. Didn't know people would help fill out forms.
 
Posted by poppy (Member # 5355) on :
 
Will any of the Affordable Healthcare Act provisions apply to your son's situation? He is the kind of person it is meant to help. But then TX may be one of those states that will not be doing anything for its uninsured.

You might want to look at this site for info:

http://www.healthcare.gov/law/index.html
 
Posted by JBS (Member # 37360) on :
 
Thanks for everyone's support! Found out that his insurance will only be half of what it was, so I will figure out a way to get it paid.

Unfortunately, he will really need it. He went into the hospital Saturday with Acute Pancreatitis.
 
Posted by Rivendell (Member # 19922) on :
 
I'm glad he will be able to continue his insurance coverage.

But, he should seriously try to get disability.

It is the symptoms that count. There needs to be a diagnose to back up the symptoms, but it doesn't have to be Lyme.

Everytime he sees his doctors, he needs to mention how his symptoms are keeping him from working.

Periodically, get a copy of his doctor's records to make sure the doctor are mentioning all this in their office notes.

Visit the website "Disability Secrets" for lots of advice on winning his case.

Good luck!
 
Posted by Keebler (Member # 12673) on :
 
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