Health Insurance/Medicaid

[dahliablue]

I was approved for Supplemental Security Income and Medicaid in October. I am having massive troubles with my local branch of Medicaid. I can't find many doctors who accept it and the customer service is awful. They take forever to approve things and my health is getting worse because I have to wait to receive help from them and the public health

Comments

[couilly_poof]

Thanks for posting this! I am applying for SSI soon and I've been feeling pretty hopeless about it because I've been told over and over again that people with Fibro don't get it.
So yay! There is hope! :)

[ginalin]

I know a few people who have gotten it. It's a "real" condition now, so that helps. *G*
Most people I know who got it years ago for fibro just took it for the more or less chronic depression that often accompanies fibromyalgia, because it's much easier to get SSI for a chronic mental disorder. It's a VERY depressing condition, obviously.

[dahliablue]

Yes, there is hope. Fortunately (or unfortunately for me), my pain and disabilities are visible. The doctor I had an exam with started out with the usual "it's all in your head" stuff, but I stood my ground and she finally listened to me. I think she was the deciding factor with the letter she wrote.

I cannot stress enough how firm you need to be. List everything you can't do. List everything you wish you could do but can't, all the ways your life is limited. It's horribly depressing, but you have to show your worst case scenario. Then during the exam, stress how certain you are that your disabilities are real and not psychological. I have a therapist who wrote a review for my case detailing how I'm not disabled by depression but a physical illness, so that might have helped too. Even though I get depressed because of limitations, it's not why I can't work. Stress that.

Sorry for the unsolicited advice! Good luck.

[couilly_poof]

Yes! Thank you for the advice! I've been in need of advice and encouragement. Once in a while I go through a 'I'm not disabled enough!' thing because I'm like 'I can answer phones most days for probably enough time to hopefully make enough for my living as long as I still have foodstamps and get on Medicaid.' etc. But yeah. I really really really need to get on it. I've left bed once today to go to the bathroom, for example. This due to building a snowman yesterday. Oi. :p
I'm going to actually be taking a two-pronged approach because I've heard that works best for most people (mental and physical) because I have depression, anxiety and PTSD as well as FMS.

[ginalin]

Well, most people get on SSI and they can't afford any other kind of health insurance anyway. The rates are pretty high, even if you get accepted, and no one covers pre-existing conditions

[dahliablue]

My SSI is nowhere near enough to pay for insurance, but my family said they would help me if I could find something. I had a feeling the rates would be a nightmare.

I hope the new administration helps things. I can't imagine how to fix such a broken system, but I hope they do.

[ginalin]

Health insurance rates depend somewhat on which state you live in, even with the same company.

We lived in Wyoming, one of the lowest population states, and therefore, the rates are higher. Higher population states can offer the same insurance at somewhat lower rates, but it will still cost you quite a bit and I doubt they'd cover a pre-existing condition unless the laws on that change. Obama has talked about getting rid of the pre-existing condition rules regarding health insurance. We'll see. :)

[n2sing]

Here is what I have learned about medicaid.... I can see any doctor that will take the insurance wanna know how?... It is so easy I kicked myself... Do you have a local hospital?? I assume you do... GO TO THE ER... when they treat you for whatever current problem you are suffering from they will give you a referal if they don't give you one ask for one... Then when you call that doctor's office for an appointment tell them you were in the Er and you were referred to them they should take you...

Option 2

My not so local hospital group it's about a 45 minute drive has a network of doctor's employeed by the hospital they usually have a central scheduling department find the hospital in the area usually a teaching hospital get the website or central scheduling number and make an appointment they should also take you...
If you need me to help you I will be more then happy to... Just send me a private message and I can help

[ginalin]

Yeah, I was going to say that too. Go to the ER if you don't have any other options. They HAVE to take you if you have Medicaid, no option of turning you down, and they HAVE to refer you to a doctor for follow up, who HAS to take your insurance.
There's a way around this bureaucratic crap. My kids were eligible for state health insurance which functions a lot like Medicaid for years...because we couldn't get any or afford it when we were self employed.

I did that a few times when I couldn't get a doctor to see them. *G*

I did find a doctor eventually who just took walk ins, and any sort of insurance, and he was a good doctor too. It's hard, but you can usually find one if you keep looking. He refused to work for an HMO...they can be really sucky about taking Medicaid or State insurance.

Another thing that needs to change....grumble.

[dahliablue]

My main problem is knee and hip pain possibly from the way I walk. I need to see a sports medicine doctor. I go to a public health network, but they're so swamped with people that the wait is 3 months to be seen by specialists. I'm trying to go anywhere else, but they won't refer me and Medicaid won't pay for it unless the referral is from my PCP.
I don't know if an ER could help with all this since I need ongoing help with specialists. Or could they?

Thank you for your help!

[n2sing]

If you go to the Er for the pain and they give you referal it will work... I have medicaid and I do not need a referal to see anyone.. I have a rheumy an allergist, Gi and soon a neuro...

Once they refer you the doctor they give you should be able to give you continous care they won't see you once and drop you.

[n2sing]

There is usually a one year wait from approval on ssi to get medicare.. so you are stuck on medicaid until the year is up

[dahliablue]

Oh, really? That's good to know. Thanks!

[cluelessinchi]

Really? I thought that only was true if the person had SSDI. I also thought that it was a two year wait.

[balamuthia]

I'm sorry I don't have advice for you, this post is just another reason the state of our health care system makes me so angry!

*hugs*

[dahliablue]

It's overwhelming how broken everything is.

Thank you.