posted
Anywhere with a single payer health system.
Posts: 431 | From New England | Registered: Dec 2011
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kam
Honored Contributor (10K+ posts)
Member # 3410
posted
I tried to scan through this post to see woh actually did sign up adn the results.
I know our health care system is broke. I did not realize this until I came down sick myself in 2001.
I also know getting an insurance plan will not help wtih lyme and company.
But, our health care system still needs a lot of work.
I, too, considered moving to antoehr country at one time to get the help I needed. But, then I learned that those in other coutnries are also not getting the help they need with lyme disease.
I was disappointed in the review on the news for 2013 and the subject lines.
re: health care....all that was talked about was the snafu of the programing for the computer site.
No reports on how or what the US is doing to improve our health care system.
Posts: 15927 | From Became too sick to work or do household chores in 2001. | Registered: Dec 2002
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posted
Kam, in my opinion they will do little overall to improve healthcare until they fully integrate alternative medicine and the alternative paradigm of disease.
I am outraged that they want to force me to pay for a medical paradigm that I believe causes mayhem and death, and will not pay for what I believe heals. They are attempting to strip away my constitutional rights to life liberty and the pursuit of happiness by stealing what little money I have and economically disenfranchising me from medicine that works and heals and cures.
Posts: 803 | From USA | Registered: Oct 2013
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posted
Sickofthepain, if I were seeking another country and I had money I'd go to Germany. If I had little money I'd go to India. Both have excellent health care available.
Germany does integrate alternative and conventional medicine. I've read the lyme protocol for Germany. They have a solid game plan if you want to use drugs.. if you dont want to use drugs they are also masters at oxidative therapies and herbals.
In India there are master Homeopaths as well as conventional doctors who are very smart. Acutally some of the most brilliant doctors I have worked with were from India in the conventional realm. Medicine and medical care there is very inexpensive.
Posts: 803 | From USA | Registered: Oct 2013
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posted
I have UHC and my plan does pay for Lyme. I do have to pay out of pocket but then I get reimbursed at the out of network rate (70%). All of my abx have been covered just like other meds. I have not tried IV so it is possible that is where there would be a problem.
I don't see why it would be impossible to get similar coverage on the exchange.
My LLMD puts the code for Lyme, babesia, and bartonella on the insurance form. I have been treating for 6 years, one way or another, all covered, subject to the copay.
[ 01-01-2014, 09:20 PM: Message edited by: jkmom ]
Posts: 984 | From US | Registered: Dec 2007
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posted
lpkayak - NH does have Medicaid, they just chose not to participate in Medicaid "expansion" necessary for a state exchange. I had to put my kids on Medicaid last year, I lost my job shortly after I got my PICC and couldn't afford to put my kids on COBRA.
Medicaid "expansion" was rejected by 34 states because the fed gov will only fund that expansion for a certain number of years (I think three?) then dumps all the costs on the individual states, creating a huge financial burden (and god knows there's enough of that going around).
Not saying it's right or wrong, just clarifying NH's Medicaid situation.
Hope you're feeling better, you had some rough times last year.
Posts: 99 | From Cali | Registered: Dec 2011
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posted
Sadly there's just no way I could afford insurance under ACA.
For a family of four the cheapest Bronze plan offered in NH costs $760/month in premiums with $11,500 deductible, copays, 20% coinsurance, and $250/$500 fees for ER visits/hospital admission. That's roughly $22,000/year and I don't qualify for subsidies. The "no more than 9.5% of income" rule is a lie.
Fortunately I was rehired when my PICC came out. The sum total of my premiums and employer contribution (we each pay 50% of premium), and deductible ($3,000) is still cheaper than that Bronze plan (approx $15,000 total).
Even the rates I was given for full coverage of my family under COBRA were cheaper, approx the same $15,000 listed above.
To make matters worse: 1) There is only one exchange provider in NH - Anthem BC/BS
2) Anthem announced it is dropping 10 of NH's 23 hospitals from coverage for exchange customers. One of our counties won't have any available hospitals at all.
3) No out of state specialty hospitals will be allowed for exchange patients. This is important because NH hospitals rely heavily on Boston's specialty hospitals......so ACA patients won't be going to Children's Hospital, Dana Farber, Shriners, etc....
4) Another aspect of ACA that went into effect two years ago was a limitation on the amount of pre-tax $$ that could be contributed to an FSA (down to $2,500), and elimination of the ability to use FSA for OTC meds.
This bill was written with good intentions but was poorly designed and implemented.
I hope some folks can benefit from it, I just haven't met anybody yet who has.
Posts: 99 | From Cali | Registered: Dec 2011
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My LLMD doesn't take insurance so her visits are paid in cash, but UHC has never balked at paying for any of my meds or blood tests (get blood drawn every 6 weeks for the last two years). You might hit a snag if you need IV meds (i.e. PICC line), they'll most likely only pay for 28 days which is typical for insurance companies and IV meds for Lyme.
I think Lyme patients might run into trouble on the exchange for two reasons: 1) Payments to physicians will be much lower (similar to Medicaid/Medicare payments). The pool of physicians willing to take on these patients, who are willing to take insurance for Lyme, will be smaller, which will just add to the difficulty of finding a qualified LLMD who actually takes insurance.
2) Rx coverage isn't necessarily the same. Many of the exchange plans have restrictions on "authorized" meds, meaning if they determine a cheaper abx will do the job that's all they'll pay for. This is dangerous for us because LLMDs often need to try different combos of meds to find out what works best for each Lyme patient.
Posts: 99 | From Cali | Registered: Dec 2011
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lax mom
Frequent Contributor (1K+ posts)
Member # 38743
posted
Well my husband's first experience yesterday with insurance coverage from the exchange was a good one.
Copay for the same Dr he always had=$15.
Prescriptions for allergies, high blood pressure, Nystatin, and others covered with $100 deductible and reasonable copay.
I'm very happy with it. Plus we aren't paying $1040 Cobra. Before they raised it the cost was $740. That's devastating for middle class paycheck to paycheck folks which Obamacare clearly helps.
randibear
Honored Contributor (10K+ posts)
Member # 11290
posted
Hey at least its civil andpeople are not calling each other names.
Besides its good for us to know how it works.
-------------------- do not look back when the only course is forward Posts: 12262 | From texas | Registered: Mar 2007
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lax mom
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posted
Yeah randibear you're right. I got the last Aca thread closed down. I don't wantthat to happen. I just needed to express my dislike of the topic.
I like all of you I just don't want you all to start hating me because I am on the other side of the fence with my family's experience on this topic.
I know there are people who truly hate the ACA to the core, but it has been a blessing to my family.
posted
lax mom - I hope you don't think I was bashing ACA. I was In dire straights for health insurance last year so researched all my options. The numbers I gave for NH were actual quotes from healthcare.gov using my login.
I'm happy you were able to benefit from ACA. My intention wasn't to make any type of political or partisan statement, I was just sharing information.
Posts: 99 | From Cali | Registered: Dec 2011
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lax mom
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posted
No Southpaw, I don't think any one is bashing. I just wish the feelings were less love it or hate it like droid said and more middle of the road... but that's the nature of political policy.
map1131
Frequent Contributor (5K+ posts)
Member # 2022
posted
Lax, please don't take offense to the thread. As you can see it has been a blessing for many and a curse for many.
As long as we all treat each other with respect and just tell our story about what is known there is no reason to close it down.
The truth is the truth is the truth. I'm so glad for you and your family and you know that. I also feel for those that had their insurance canceled.
I see the writing on the wall. The company my husband works for is union. Indy union contract last year was changed and the company/union only pay for the employee only. Right now Humana is my primary and Medicare is secondary.
So when this happens in KY, which it will. I will be Medicare Primary and of course will need to have a supplemental policy with it.
Or however these new plans work. My mother has tried to explain to me how her and dad's BCBS policy works with Medicare. I just don't understand what she is trying to explain it to me.
But I better get an understanding of it all before the next union contract which is early 2015.
So please don't take down a very informative thread for all of us that are in different situations.
Pam
-------------------- "Never, never, never, never, never give up" Winston Churchill Posts: 6495 | From Louisville, Ky | Registered: Jan 2002
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lpkayak
Honored Contributor (10K+ posts)
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posted
you guys understand New Hampshire doesn't have Medicaid and that makes a big difference right I don't understand it but I know makes a big difference and its a real problem here at least a problem for people I know that I thought it would help it didn't occur to me someone could not make enough money to get on but im very lucky to have good insurance
There must be other states like nh-i wonder what kind of problems they are having
I do know people who can't afford good cars and now I have to go over an hour to a doctor for a hospital that's really hard here with the long winters
-------------------- Lyme? Its complicated. Educate yourself. Posts: 13712 | From new england | Registered: Feb 2004
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map1131
Frequent Contributor (5K+ posts)
Member # 2022
posted
If my insurance co told me I had to find another PCP.....I would absolutely fall apart at the seams.
My PCP has been with me and my nightmare since day 10. I can't even fantom looking for another.
lp, here comes the big winter monster. Our system starts tomorrow. Oh my, all weather systems come thru my body.
I better start praying now. Spend the day in a detox bath all day.
Pam
-------------------- "Never, never, never, never, never give up" Winston Churchill Posts: 6495 | From Louisville, Ky | Registered: Jan 2002
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Tincup
Honored Contributor (10K+ posts)
Member # 5829
posted
Randibear said.. "Hey at least its civil and people are not calling each other names."
Had to laugh out loud at that comment! HA! Thanks for the laugh!
If it helps, I was able to help 3 people get coverage that had none and they are very happy. Cost them so very little too. And it was done in the early days when supposedly the site wasn't working!
I put in my own info more recently just to see the costs, and I'd pay about $20.00- $30.00 a month for the second best plan in their program. (Can't now remember the exact amount.) Plus I'd get meds and little co-pay for them. Low deductible too.
For the direst in straights, many with long term chronic illness who had no help at all, I am so far pleased with what I've seen and experienced.
For those having troubles, please do see the codes I've listed. If they want it called ABL (Anything But Lyme) we can certainly cooperate with their way of doing it to get treatment.
map1131
Frequent Contributor (5K+ posts)
Member # 2022
posted
I too lead 2 lyme woman to kynet.gov, which our state was one of a dozen or more that took it on at the state level. On the last week(?), supposed week of signing up.
Both were lower income and will qualify with Medicaid or very low cost Medicare/insurance company coverage.
I was totally shocked when one asked me about pre-existing condition and not being qualified? I explained hey this is a huge part of ACA, pre-existing is no longer a reason for insurance company to use.
Explained that now you will be able to get care you need. Not that a LLMD is going to be covered, because I'm not sure of which LLMD is still taking Medicare/Medicaid?
Gave her all the doctors in surrounding states not to far away. But for those that are ill, getting a PCP is the first step if they don't have one today.
Immediate care and emergency rooms should become for the ones that have an ear ache=immediate care. For someone that just broke their leg on Saturday morning, you might need an emergency room.
A primary care doctor will become familiar with you. You can build trust and relationship, if you are lucky to find doc that you like and seems to be willing to help with your symptoms.
No, the odds of finding a PCP that is lyme literate isn't great, but you never know. You might get real lucky.
If you are having a symptom that is preventing your from functioning like some minor feelings of depression, they can take history and they very well could prescribe for you some mind anti-depressant that will make your world not so bad.
They can do thyroid tests. Remember lyme does attack many thyroids. So if your test results show low thyroid or even hyperthyroid they can do medication.
In the ideal world with this illness...you have a LLMD that you see every 3-4 mths accordingly and you have a PCP that sees you for any tests, blood work not related to lyme & co(unless they are lyme aware).
Your general healthcare needs with PCP and sometimes they even agree to do some tests that your LLMD says you need to have done. Ideally? That's the good combo. Which does happen.
Especially when you make history with one doc and not jumping all over here and there.
Like Tincup said, that list of codes is great. If your primary wants to dx you with fatigue and call it chronic fatigue. So be it. Don't fight their system, just use them to help you with non-specific lyme & company issues.
Some healthcare is better than no healthcare anyday. Some of our healthcare like supplements, vitamins, herbs, etc aren't covered by insurance. but some patients have severe Vit B12 defeicient and need high dosages of this, a doc can write you a script.
EX: Maybe get it filled at the pharmacy. If not that then use the cost of B12 as a tax deduction/write off. Doc rxed, so it's a tax deduction.
Pam
-------------------- "Never, never, never, never, never give up" Winston Churchill Posts: 6495 | From Louisville, Ky | Registered: Jan 2002
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lax mom
Frequent Contributor (1K+ posts)
Member # 38743
posted
quote:Originally posted by map1131: I'm so glad for you and your family and you know that. Pam
I know that Pam Thank you. That's why you founded a support group...because you're so...well...supportive and caring
Anyway, to reiterate, I never wanted this thread closed...I just wanted to express my dislike of the topic, that's all
randibear
Honored Contributor (10K+ posts)
Member # 11290
posted
Hey I got an idea....lol...
Lets call each other names....its more fun....
I'm hardheaded, stubborn, opinionated, and of course, modest..
-------------------- do not look back when the only course is forward Posts: 12262 | From texas | Registered: Mar 2007
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lax mom
Frequent Contributor (1K+ posts)
Member # 38743
posted
Hey randibear! I'M stubborn!
Why don't you go lie on a beach like a clam in the polluted ocean after an oil spill who had a lobster bite its shell and got an infection and needed healthcare but didn't have it cause they forgot to sign up for Obamacare...
...or something like that...oh forget it...I'm not good at those one liners like you!!!!
randibear
Honored Contributor (10K+ posts)
Member # 11290
posted
Well shoot....
Im off to jus sit and read today. Its football on sunday. Luckily I made roast and chili last week so im good there.
-------------------- do not look back when the only course is forward Posts: 12262 | From texas | Registered: Mar 2007
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lax mom
Frequent Contributor (1K+ posts)
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posted
Yeah, it's way too cold to be outside tonight. I'm in the SE and even here it's gonna be frigidly cold. Supposed to be a windchill of -23 tomorrow night...and that's not even up north!!!
I wonder if you're confusing it with NH's decision not to participate in Medicaid expansion, which would have been necessary to set up a state level exchange.
Posts: 99 | From Cali | Registered: Dec 2011
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kam
Honored Contributor (10K+ posts)
Member # 3410
posted
I had Blue Cross/Blue Shield when I was working and came down sick.
It took me 18 months to finally get a dx.
I was not able to afford Cobra.
Blue Cross/Blue Shield seemed to have their doctor's working out of a very small tool box.
I don't know if I had run into a lyme literate doctor while I still had insurance if it would have helped or not.
I do know that I was ony reimbursed $20 for the Igenex Test.
I was hoping to see more posts on people who had actually needed the ACA and how things went for them when they signed up.
I know many in the small town I lived in were small business owners and were not able to afford insurance for their families back in 2001 when I first started learning a bit more about health care due to my health going south big time.
Since I no longer live in that town, I don't know if they were helped or not by ACA.
I also knew others who were not able to get insurance due to a pr existing condition
A concern I had when my health went south. At that time, I thought it was tempary and I would be back to work.
Typing with eyes closed , laing in bed.
There is buzz here at the apartment complex I live in for senior citizens and the disabled about changes in insurance.
There was a meeting a while back on the subject and another on Thursday by someone else.
Best I can figure thees people are in business to help peole decide what insurance plans to get and what things they can get help with.
I have sent emails to both businesses.
They did help me to know that I should be covered with prescription needs at a time when I thought I wasn't covered and had paid out of pocket.
The pharmacy re imbursed me thankfully...pharmacy was also going thru new ownership with new help so things got a bit confusing for a while then pharmacy closed down.
I am still confused about it all. If health was doing well enough I would go to the meeting but health is not doing well enough.
I am concerned about coming up with the funds needed that medicare doesn't pay for and would like a second insruance.
But, since the people I contacted have not replied to my emails I assume it is because I don't have the insomce to pay out of pocket for a second insurance.
OK need to stop. This is making my brain worse.
Posts: 15927 | From Became too sick to work or do household chores in 2001. | Registered: Dec 2002
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kam
Honored Contributor (10K+ posts)
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posted
Another thing I learned when I moved from CA to AZ is that I was getting 40 hours a week with caregiver service whiel living in CA.
When I moved to AZ, I was given 4 hours a month caregiver service.
I thought they would be the same in both states. Wrong.
Income went down to $500 a month to when I moved across state lines.
I don't recall what it was in CA.
I know this topic is supposed to be on ACA but it has opened the window to health coverage in general.
Posts: 15927 | From Became too sick to work or do household chores in 2001. | Registered: Dec 2002
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kam
Honored Contributor (10K+ posts)
Member # 3410
posted
There is a post on another web site from a lady who wants to move from the San Diego area in CA as she is not getting the caregiver help needed.
She doesn't have lyme disease. I think she has a form of CP.
Another condition that varies a lot
She wanted to know which states were more helpful and provide more caregiver services.
Posts: 15927 | From Became too sick to work or do household chores in 2001. | Registered: Dec 2002
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lpkayak
Honored Contributor (10K+ posts)
Member # 5230
posted
Not nh
I m pretty sure the aca will help with basic health care but not lyme. Around here the new tx for a tickbite is one doxy one time. And if you dont have. A bullseye you have to fight for that
If you break an arm youre all set. And probably a minimal ckup once a year. They will probably happily give you statins and steroids and psyc meds.
There is value in getting the basics...but really. If we have to fight so hard for tx it will not become the norm soon
Again...there is value-if your gall bladder goes or your thyroid tests low youll probably get tx. Not armour-synthroid...
Kam i think you are smart to research what states give more basic help...but moving to an area where there is an llmd is risky. It would cost a lot of time an energy and you could not count on the llmd staying in business unless it is one that is really expensive cash only. Also the tx they prescribe are not covered
I do think you should look for a better place for general care...but lyme care is a wild card
I have no first hand experience with any of this but have seen things happen-both good and bad to ppl i know
-------------------- Lyme? Its complicated. Educate yourself. Posts: 13712 | From new england | Registered: Feb 2004
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nefferdun
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Member # 20157
posted
Stir things up randibear!
I got medicare a couple of years ago. It hasn't covered any lyme treatment yet except the tests the infectious disease doctor did, which were pretty useless.
What it DOES cover though is a therapist! I mean the mental emotional kind. This can drive you nuts and when you add in the trauma of life itself, it helps to have someone else on your side.
SO maybe if you all get Obamacare and go to therapists, it will be so expensive they will see that just paying our doctors bills is a cheaper alternative.
-------------------- old joke: idiopathic means the patient is pathological and the the doctor is an idiot Posts: 4676 | From western Montana | Registered: Apr 2009
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SO maybe if you all get Obamacare and go to therapists, it will be so expensive they will see that just paying our doctors bills is a cheaper alternative.
- Good point!
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96239 | From Texas | Registered: Feb 2001
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