Can we make the medical system more complicated?

[MorkandMindy]

I retired was refused for Medicaid this time on grounds of age. There is according to most sources no upper age limit for Medicaid, but the official said it is used to supplement Medicare and as I don't have Medicare I can't get Medicaid, so I get zero coverage. I explained I have cancer and untreated will die in about two years, but she said that when I had the full 40 credits I could apply for cover and if that is a year and a half from now then that's when I can get cover.

It seemed illogical to me since both Medicaid and Medicare are government funded, but rules is rules and I is dying.

I've had problems getting accurate information over the phone, so I persevered and found the Health Marketplace will give coverage and owing to my income it will be very low cost and the joining period is Nov 1 to Dec 15 (why?).

There is an exception to this rule, that if you lost your medical coverage, then you qualify for a special enrollment period.

 

[MorkandMindy]

But there is an exception to the exception, that if you lost coverage more than 60 days ago you are not entitled to the special enrollment period and I'm just barely outside that limit, having planned to get Medicaid which has no such limit, and a totally different set of requirements.

So I persevered again and found the Summary of Statutory Requirements SSA 1902(a)(10)(A)(i)(II)(aa) which referenced another part of the document, and - this document is big - and I was under a lot of stress...

I finally tracked down the bits I needed there and in 42CFR435.116 etc and it came down to that maybe if I moved in with my children who have medicaid then I will also be covered, maybe.

 

[MorkandMindy]

And there are a lot of documents covering eligibility though many are not specific as these vary from state to state and time to time.

SOOO, what are these administrators authorized to do? Allocate health care to the needy. And what are they actually doing? Deciding who is not eligible on grounds not of income or savings but on various complex rules and enrollment periods and between a whole bunch of different types of eligibility, different plans: PPO, HMO, POS, EPOS, Indemnity, HSA, which under stress along with the other government documents 42CFR435.116 etc it is enough to give anyone a mental health problem.

 

[cow451]

And there are a lot of documents covering eligibility though many are not specific as these vary from state to state and time to time.

SOOO, what are these administrators authorized to do? Allocate health care to the needy. And what are they actually doing? Deciding who is not eligible on grounds not of income or savings but on various complex rules and enrollment periods and between a whole bunch of different types of eligibility, different plans: PPO, HMO, POS, EPOS, Indemnity, HSA, which under stress along with the other government documents 42CFR435.116 etc it is enough to give anyone a mental health problem.

Remember these things when you vote. I am not being flippant. You have done an amazing job of making an argument for universal coverage.

 

[MorkandMindy]

In the second book of the Hitchhiker's Guide to the Galaxy Douglas Adams explains that the planet of Golgafrinchan had solved it's biggest problem by inventing a story that the planet would soon be destroyed and the population would be sent to the distant largely unoccupied planet Earth in three arks.

Ark A would contain the inventors, creators of art, writers, all the great thinkers. Ark C would have the doers, and Ark B would contain all the middle people, the insurance salesmen and all those administrators that made our lives complicated.

Ark B would be sent first to make sure everything was in place for when Arks A and C arrived, which they never did because they were never built. The whole scheme was to get rid of all the people who were non productive and just got in the way.

After that Golgafrinchan entered a new era of creativity and productivity. But Ark B landed on Earth.

 

[Tanj]

Wow. How horrible. My condolences on your illness, and hope you get the treatment you need....somehow.

 

[MorkandMindy]

Wow. How horrible. My condolences on your illness, and hope you get the treatment you need....somehow.

Thank you.

 

[Greengardener]

I too offer condolences on what you are going through. Would you feel comfortable saying which state you are in?

 

[MorkandMindy]

Sure, I'm in New Mexico

 

[MorkandMindy]

I too offer condolences on what you are going through. Would you feel comfortable saying which state you are in?

Thank you for asking, I'm now feeling really foolish because I started thinking there was just Medicaid and Medicare, and that if I met the requirements I would get one or both, and not expecting anything complicated and my main energy went on getting a better job, yes after retirement. Retraining now that I had the time and doing something really interesting and profitable.

I'm also rather fearful, anxious, and with fear and trepidation finally filled in my Medicaid form once I had met the requirements and saw the word 'declined'.

I'm going to try to get SSI as that might work, or I might have to move, or there appear to be other loopholes. I've noticed four for women including two for cervical and breast cancer, but none for prostate cancer which is mine, but there may be updates I haven't seen either.

It was only yesterday I got rejection from the Health Marketplace by missing the 60 day limit after losing my health insurance, but any ideas at all would be very helpful.

 

[SkyWriting]

I retired was refused for Medicaid this time on grounds of age. There is according to most sources no upper age limit for Medicaid, but the official said it is used to supplement Medicare and as I don't have Medicare I can't get Medicaid, so I get zero coverage. I explained I have cancer and untreated will die in about two years, but she said that when I had the full 40 credits I could apply for cover and if that is a year and a half from now then that's when I can get cover.

It seemed illogical to me since both Medicaid and Medicare are government funded, but rules is rules and I is dying.

I've had problems getting accurate information over the phone, so I persevered and found the Health Marketplace will give coverage and owing to my income it will be very low cost and the joining period is Nov 1 to Dec 15 (why?).

There is an exception to this rule, that if you lost your medical coverage, then you qualify for a special enrollment period.

I am sorry about your situation. Only by God's grace does every reader not go before you. Or we might all go at the same time.

NASA, ESA Team Up To Deflect Killer Double Asteroid

 

[Tanj]

I am sorry about your situation. Only by God's grace does every reader not go before you.

That's not true.

My elevated PSA levels were found during my routine check up I have every 6 months with my doctor that, because I live in a single payer country, costs me $0 out of pocket. I then went on to an MRI and then a full prostate biopsy. Both of which cost me $0 out of pocket. Luckily the biospy came back negative, but had it been positive I would have received immediate treatmen which also would have cost me $0 out of pocket.

It's by the "grace" of your system that MandM is in this situation. God is not involved.

 

[Nithavela]

In the second book of the Hitchhiker's Guide to the Galaxy Douglas Adams explains that the planet of Golgafrinchan had solved it's biggest problem by inventing a story that the planet would soon be destroyed and the population would be sent to the distant largely unoccupied planet Earth in three arks.

Ark A would contain the inventors, creators of art, writers, all the great thinkers. Ark C would have the doers, and Ark B would contain all the middle people, the insurance salesmen and all those administrators that made our lives complicated.

Ark B would be sent first to make sure everything was in place for when Arks A and C arrived, which they never did because they were never built. The whole scheme was to get rid of all the people who were non productive and just got in the way.

After that Golgafrinchan entered a new era of creativity and productivity. But Ark B landed on Earth.

You forgot the part where the Golgafrinchans were wiped out because of a lack of one of the occupations from Ark B.

 

[grasping the after wind]

Remember these things when you vote. I am not being flippant. You have done an amazing job of making an argument for universal coverage.

Really that seems d sot me to be an extremely illogical thing to say ? I don't see how that argument makes any sense at all. You propose we give control over the whole system to the same bunch that caused the problems described by the poster as a remedy to the problems the poster has encountered.

 

[grasping the after wind]

Remember these things when you vote. I am not being flippant. You have done an amazing job of making an argument for universal coverage.

Really that seems to me to be an extremely illogical thing to say ? I don't see how that argument makes any sense at all. You propose we give control over the whole system to the same bunch that caused the problems described by the poster as a remedy to the problems the poster has encountered.

 

[Speedwell]

Really that seems to me to be an extremely illogical thing to say ? I don't see how that argument makes any sense at all. You propose we give control over the whole system to the same bunch that caused the problems described by the poster as a remedy to the problems the poster has encountered.

Nope.

 

[cow451]

Really that seems d sot me to be an extremely illogical thing to say ? I don't see how that argument makes any sense at all. You propose we give control over the whole system to the same bunch that caused the problems described by the poster as a remedy to the problems the poster has encountered.

The “bunch” worked to make changes. The GOP has done nothing, even when they had total control. Doing nothing isn’t going to do anything to help anybody.

 

[cow451]

Every first world country has some form of universal healthcare. Except one. Guess which one. Come on, GOP, you can do better than nothing.

 

[RDKirk]

That's not true.

My elevated PSA levels were found during my routine check up I have every 6 months with my doctor that, because I live in a single payer country, costs me $0 out of pocket. I then went on to an MRI and then a full prostate biopsy. Both of which cost me $0 out of pocket. Luckily the biospy came back negative, but had it been positive I would have received immediate treatmen which also would have cost me $0 out of pocket.

It's by the "grace" of your system that MandM is in this situation. God is not involved.

Was your biopsy done with the inter-rectum electric staple gun?

Pak! Oww! Pak! Oww! Pak! Oww! Pak! Oww! Pak! Oww!
"Doctor, how many of those do you have to do?"
"Oh, about nine."
"That was seven."
"Oh, about twelve."

Mine came back negative as well, thank God, although the urologist said he was surprised at that.

 

[Speedwell]

Was your biopsy done with the inter-rectum electric staple gun?

Pak! Oww! Pak! Oww! Pak! Oww! Pak! Oww! Pak! Oww!
"Doctor, how many of those do you have to do?"
"Oh, about nine."
"That was seven."
"Oh, about twelve."

Mine came back negative as well, thank God, although the urologist said he was surprised at that.

Mine was positive but radiation treatments seem to have had good results so far. Thank God I was on medicare already!!!