I may have cancer, and my insurance is killing me...

reply to post by canadiansenior70

I cannot enlighten you, because, all I can say is that the ACA is nothing but a bailout for the Health Insurance industry, disguised as something Obama did 'for the people'. Every bit of it was a lie.

It unfuriates me the more I discover about it, and I know quite a lot about it. There are two things, and only two things I find admirable about the law.

1. You cannot be cancelled due to serious illness which brings high overhead to the insurance company
2. You cannot be denied insurance due to a pre-existing condition.

That's all.

Before, I used to have an HMO, I paid 118.00 every two weeks. I had a co-pay of 35.00 for a doctor visit, 200.00 for the ER, and 400.00 for a hospitalization. Most prescriptions were 10.00 copay, and specialist was 45.00.

Last year, it went up some, 158.00 every two weeks, 45.00 dr visit, 250.00 ER, 450.00 hospitalization, and prescriptions were still 10.00. Specialists went to 65.00.

Oh, and my epidural steroid injections were treated as outpatient surgery. 1800.00, of which I had a copay two years ago of 200.00 each, last year it went up to 235.00. I could have up to 6 injections a year, but rarely had more than 3, sometimes 4. It seemed I never reached a cap, if there was one. Any time I ever got any statements, it always said my portion that I paid was 00.00, obviously not true.

What else can I say? The previous posts outline my new payments, however, I was even misled on them. In fact, lied to.

My current premium is 335.00 every two weeks. A major medical deductible of 2700.00, and a pharmacy deductible of 2700.00. I still do not know my cap. I think it is 10k, and that's PER PERSON. So, if my husband needs to go to the doctor, we start alllll over for him, too.

My employer kicked in 1500.00 on January 1, on the medical debit card I use, which I also have a pre-tax deposit made from my paycheck, seperate from my premiums, of 67.00 and some change. Those deposits are every two weeks, and, like I said, pre-tax, so I am certain at the end of the year when I file taxes, I will get spanked for using that money anyway.

Also, any unused monies on the debit card will roll over to the next year. Last year, people that had this plan, any money that wasn't spent was lost by December 31. That is why I chose to stay with my HMO until it went away. I had no choice but to take this plan this year.

I could never comprehend how they could take money out of your paycheck all the way to the last pay period of the year, and if you didn't spend it, you simply forfeited it. So that meant you had to make an appointment, or buy medications the last week of the year, and likely frivolously spend the money to just keep from losing it.

This was likely why it was so hard to get any appointments when I got sick in October, and ended up not really being taken care of until February. It took 31 days just to get an appointment.

Okay, so, into every life, a little rain must fall.

I was doing great post op. It was almost too good to be true. Sigh. I guess I should have paid more attention to thag back pain I had when I woke up.

Seems while positioning me on the table for surgery, they blew out a disc in my back. My pain doctor now thinks I likely have a severe herniation in my lumbar spine which is compressing the horsetail.

I have severe numbness in the lower outside of the right leg, numbness and tingling in my foot and toes, my heel is numb. I have severe pain in the hamstring in the right leg, pain across the front of the right thigh. My leg, where it is numb, is literally dead, I can feel nothing.

On the left leg, my great toe and inside of the lower leg is numb and tingling.

I cannot go up stairs without help, and can no longer lay down more than an hour to sleep. When I lay down in any position, my entire right leg is numb from the buttocks to the toes.

I bought a cane yesterday. Best 25.00 I have spent in a LONG time.

Got my FMLA paperwork filled out today, and got a referral to a neurosurgeon and a referral for an MRI.

Been waiting almost a week now, for my insurance company to approve an epidural steroid injection. The pain doctor said it is urgent, wanted me in ASAP last Wednesday, because the sooner he gets the steroid meds on the nerve, the more chance of saving it.

Right now, my entire sciatic nerve is compromised. I am terribly concerned about permanent damage, and my insurance company drags their feet. Again. My right leg has grown noticeably weaker in just the past week, where when I stand, it trembles, and going up steps without the cane, I have to use both hands on the railing and literally pull myself up the stairs. If there is no railing, I almost can't make the stairs at all. It's very drastic.

The doctor also said I will likely have to have a fusion, as that will be the only way to repair the damage and stabalize the spine now.

reply to post by Libertygal


Hiya LG,
First I am appalled at the prices you quote for health care.

I lived in Ontario when in my first Accident in 1969, and didn't have any out of pocket expenses, for hospital and Rehab Unit. This not a boast, just a fact.

Then with the car hitting me 5 years ago, there were still no charges to me for ambulance, surgery, whatever, then the broken leg of Dec 18, put me in a position of no longer requiring hospital care and was put into Recuperative Care (Rehab). This is where I paid $720 ($180 per day, (where the cost is $2000.00 month to keep it running.)

I really sense something wrong with your system!!

Now to your "crushed" spine that might require fusion....this is so hard to believe that such negligence happened for you, right on top of mine, and all your other problems. I hope they take responsibility and do not charge you for fixing the problem they caused.

Interior Health, here, is taking responsibility for my 4 pressure sores, due to their negligence with the knee brace, and I am receiving the best of care right now, with a Wound Care nurse coming to dress my wounds, first 3 x wkly, now 2 x wkly, and the whole case has been reported to the 'top dog'. I don't pay a thing. Your description of getting around is horrendous.

Nevertheless, I have broken out in a weird rash and we are all investigating what it could be. So far not the Tubagrip stocking for damaged leg, nor food or drink, nor laundry detergent, la-la-la, and one left to check is on the drink area, the "BOOST" protein drink.

Chin up, and Good Luck with surgery, AGAIN!!!!!

@ ¿ @ Best Wishes

CS&70

reply to post by Libertygal


Like you havn't already been through enough, good grief! You poor sweet thing! Still here and thinking of you Honey. Hang in there as best you can and keep us updated. HUGS!!!!

reply to post by canadiansenior70

Yeah, the peices apall me too! Lol, and I just read an article, health insurance rates "will necessarilly skyrocket" this year, accordingly, for next January. Simply because not enough people have signed up for Obamacare. A bailout was prewritten into the bill, but Obama was trying to hide it.

The AP ran a story on in Tuesday, and apparently were madw by the government, to pull the story, but not before other press got a hold of it. I woukd link it, but they pulled it, and I don't want to search atm for other articles.

They are speculating rates to tripple, or quadrouple, for January! They let the cat out of the bag too soon, I suppose, prior to the elections.

I am supposing the hardest hit will be Republican, or Red states, and not just insurance companies in the exchanges, but private companies, as well.

As for them paying for what happened to my back? Are you kidding?! Hahah. No.

It has already been stated in no uncertain terms, it was bound to happen sooner or later, and it was just something that "happened, no ones' fault, your back was already bad. It just happened when they put your legs up in the stirrups". Nope, this is all my bill, my problem, and possibly, my paralysis, if the insurance doesn't move with the damned injection approval.

Been waiting now, 9 days. For an emergent injection. Pardon me while I laugh. I know they are going to deny it. Watch.

I am also now pending approval for the MRI. Scheduled for next Tuesday, which I know they will also not approve in time, as well.

They are trying to force me to go to the Emergency Room so they can deny coverage.

I woke up Wednesday and my lower leg was so severely swollen, I had to call out of work. I took two water pills, amd had to put my leg up to reduce the swelling. I could not even put on my shoes and socks, the swelling was so bad. So, one more day out of work, so thank God I applied for FMLA, when I did.

The swelling is down by about half, and I have to work tonight. Laying down with my foot up makes both legs go totally dead. It is terriblg uncomfortable.

reply to post by canadiansenior70


It may be the Boost, I have heard of people being sensitive to that. I am interested to find out what it was, let me know!

I have compression stockings from my surgery, I think I am going to start wearing those, now. They call them TED hose. They are knee high, just the exact height as the numbness, so hoping they help with swelling now.

reply to post by Night Star


Thank you, you are so sweet to offer support!

(hug hug)

You deserve it Hun!

I just came out of hospital from being treated for pneumonia!

I must say that it was a 'boring' stay, 2 nights, 3 days..... and of all my hospital stays, it gave a reason to search you out and ask how YOU are doing!!!! especially Libertygal and NightStar.

How are your afflictions treating you?

My (new number) SIX pressure sores are coming along with 2 trips per week to the Clinic.

Best Wishes and Good Health to everyone!~

CS-70

So far so good for me. Wondering how Libertygal is doing.

Glad you are out of the hospital. Thanks for asking about us and stay well!!!