Reflex Sympathetic Dystrophy (RSD and CRPS) Reflex Sympathetic Dystrophy (Complex Regional Pain Syndromes Type I) and Causalgia (Complex Regional Pain Syndromes Type II)(RSD and CRPS)


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Old 12-11-2006, 09:20 PM #1
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Default Health Insurance Problems

Well, i of course have had my fair share of health insurance nightmares, but i was just wondering about all of you guys.

And kinda not just out of the blue, but because im writing a research paper for my senior english class and my given topic is Health Insurance, and well, i feel that using real life examples makes my otherwise boring mundane topic just a little bit spicier. If anyone would be willing for me to interview them for a little snippet for my paper that would totally be awesome!

thanks!
anna
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Old 12-13-2006, 08:40 AM #2
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anna,

don't know if this is the kind of thing u have in mind, but my ins co decided this year that the treatments i've been having for 5 yrs (and doing extrememly well!) will no longer be covered because they r experimental/investigational......i have appealed and been turned down on appeal.....thye r willing to pay for SGB's even tho blocks don't help....they r willing to pay for phys therapy, drugs and all sorts of things that r useless to me, but they won't cover the one thing that has helped me.

if this is the kind of thing u want, or if u need more info, let me know.

liz
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Old 12-13-2006, 11:18 AM #3
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Hi Anna,
I haven't met you on here but I just wanted to say hi to you and I do want to respond to this.

I fight with my Insurance company every 6 months to pay for my Prevacid and every 12 months to pay for my Methadone. I have gotten help from our Govenor and this time Chaney helped me get it. The Governor's office called me yesterday and they are trying to help me from dealing with this every time I need a prior authorization which went into affect in our state in 2000.

Offices are changeing in January and the legislation meets here in Denver in January so I am going up to speak to get rid of the prior authorization law. We have fought it now for 3 years but we are hoping the new elected officials will do something about it this time. I'm also waiting for an email to see what else is being fought for this time.

I'm telling you this because we need people to fight back about these insurances and other issues against the elderly and disabled if only by phone and emai. The Colorado Cross Coalition for the Disabled have asked me to go up there for 3 years. This year I'm going if I have to crawl.

I do know what all of you are going through except WC people and when I hear their stories it reall Pi***s me off. I have a freind that had his arm ripped off and his insides ripped out about 3 years ago and his lawyer called him up and told him not to go hunting this year because they were taking pictures of him. How crazy are those people. I think people need to fight for different WC laws.

Sorry, when I get started on this subject it really gets my goat. 3 months before Bill died Medicare would not get him a scooter.

I see a lot of post on insurance problems here and I feel bad for all of the people here who go through this crap.

Get in touch with your Governors, President, Vice President, Senators, State Reps and anyone else who you can go at. They all have email addresses and you will get responses. I urge all of you to do this.

Ada
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Old 12-13-2006, 04:43 PM #4
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this is EXACTLY what is was looking for. My paper currently is just mostly boring statistics, and since i need to present this as my semester exam to the class in a big slideshow i wanted to add personal touches that would make them remember my presentation better, and things like that are perfect.

and liz, if you have anything else you wanna add or something just email me or message me or something, cuz every little bit counts!

and part of our assingment is to put our topic into action, and since i actually babysit for a local congressman i was planning on sending him a copy of the paper and my presentation, with a letter and then probably sending one to the governor's office as well
thanks!



anna
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Last edited by AnnaBananaBean; 12-13-2006 at 04:44 PM. Reason: well, you know how it goes, lol, i forgot parts haha
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Old 12-13-2006, 09:48 PM #5
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I really don't have any nightmare problems with my insurance denying me anything as of yet. I had doctors who knew how to get around alot of the issues that get denied & when they knew it would probably happen they knew what to write. I honestly have never had a thing denied. Well ok will take it back. Blue Shield of CA denied paying for my electric wheel chair. But by the time the stupid company actually put into it for payment it was almost 2 yrs after I had already had the chair. They denied due to not having been billed within the 12 months they were allowed. I have not been billed personally for it nor for a scooter that they never billed for. I got the scooter & chair from the same company about a year apart. So no nightmare for me.

Now my daughter works for Blue Shield, as I did at one time also, and she has nightmare stories galore, but can't talk about them to anyone.

You take care & good luck with your paper.

And Ada, YOU GO GIRL!!

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Old 12-14-2006, 08:13 AM #6
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Hi Debby,
Thanks for the support.

Bill couldn't get a scooter as I said just 3 months before he died.

It's good that you haven't had problems with your insurance. Have you noticed on here all of these people dealing with the WC and Insurance companies?

I got a call again from Ken Salazars office about my Prevacid and I just emailed him back about the conversation I had with one of his employees. She basicaly told me to keep my nose out of Meidicaid business. She said leave it to my Dr. and Nurse. I told her 3 times my nurse called me after the 3rd fax and 5th phone conversation with them that she could not get it ok'd for me so she was so frustrated she was giving up so I stepped in and I told her I will keep doing it. What an idiot. These people that work in the government either have book sense and no common sense or lacking on both.

I see people doing without meds because of their insurance finding excuses not to pay for them or scooters that they need and it just burns me up. I told Ken Salazar's office that I campaign on the internet, the phone and in the Drs. offices since that's my only life I have.

I guess it's keeping my mind off of Bill and another problem I have now. My house has been robbed by some low life teenage drug addicts so I have to deal with this now. I'm just sick over it. I have jewelry missing and CD's missing. Bill's wedding ring is the most important thing that is missing.

I have been crying so much here lately and I really am having a time getting through all of this. Hopelessness just makes my depressions so much worse.

Sorry I got off of Anna's subject. Anna, you write the best assay you can and send a copy to the President, Vice President and anyone that you can think of that might grasp a part of it and run with it.

Ada
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Old 12-14-2006, 11:45 PM #7
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Ada,
I learned a long time ago when they say no, it just gives me another chance to get them to say YES

But as far as the other goes with the robbery. THAT SUCKS!!! I have had my own home ransacked by teenaged idiots. They took our jewelry & my pain meds. Worst part was our grandsonw we raised was in on it. GRRRRRrrrrrr But how horrible for them to have taken Bill's wedding ring. These kids took a ring that had been my mothers. It had no monetary value at all, only sentimental. Luckily we got the jewelry back. And my doctor after seeing the police report replaced the paltry amount of Norco she allowed me at that time. I don't get meds from her for pain anymore. I hope they catch these idiots & you can atleast get most of the jewelry back especially the ring.

You hang in there ok???? Keep your family close at this time.

Love ya,
Debby
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Old 12-17-2006, 06:25 PM #8
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excuse me for asking this question. but what is "health insurance"? do you contribute to this health insurance?
i'm from south africa and we have what we call "medical aids". each month we contribute to it and we are allocated a certain amount for doctors, hospital, meds, dentists etc. well unless you're in hospital for 2 years, there's really no limit on hospitals. it's fully covered by the medical aid. as for meds, we have to pay a levy of 10% of the meds. so if the meds are R100, then we pay R10. doctor's are paid by the medical aids as well as other specialists etc. i've never once had a problem with getting any meds for myself. whatever is prescribed by the doctor or whoever is given to the patient.
was just wondering about it.
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Old 05-27-2007, 12:06 PM #9
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I have BCBS and had it when I had a Chiari Decompressio in 2004. Since then, my insurance has tripled in price. They have to keep me but at a price they chose. I cannot afford the insurance any longer and I don't know what to do. This year's premiums will be $20,000.00 per year and last year's premiums were $17,000 for the year. HELP!!


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Old 05-27-2007, 12:26 PM #10
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Quote:
Originally Posted by Duchess View Post
excuse me for asking this question. but what is "health insurance"? do you contribute to this health insurance?
i'm from south africa and we have what we call "medical aids". each month we contribute to it and we are allocated a certain amount for doctors, hospital, meds, dentists etc. well unless you're in hospital for 2 years, there's really no limit on hospitals. it's fully covered by the medical aid. as for meds, we have to pay a levy of 10% of the meds. so if the meds are R100, then we pay R10. doctor's are paid by the medical aids as well as other specialists etc. i've never once had a problem with getting any meds for myself. whatever is prescribed by the doctor or whoever is given to the patient.
was just wondering about it.

hi Duchess,
In the USA, and some other countries, there are Medical/Health Insurance companies. Many employers will pay for the ins fees as a employment benefit and we many also pay a portion of the fee also or if additional family coverage is wanted.
There is also many other types too - Medicare, Medicaid,
Workers Compensation{for work related injuries}, Disability Insurance
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