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Old 01-07-2010, 03:05 PM
 
Location: Raleigh, NC
3,423 posts, read 9,228,911 times
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Quote:
Originally Posted by sanrene View Post
If this person is disabled and unable to work or care for his/herself, they should have some kind of public assistance, including medical care, right?
Yes, that's my point. They should. They (the government and the local agencies) won't but yes, they should.

Quote:
Originally Posted by sanrene View Post
If she went to a hospital in need of medical care, they would treat her.
Iffy. You forget the fact that she needs to somehow get there, since she has no way on her own. And there's a charge for that. Which insurance doesn't cover. Which I can't pay. So no, they are now refusing to transport her. I have to do that. As far as once she's ther, for now, yes. However, they send me the bill, which of course I also can't pay, and again the insurance won't cover, so I don't know if there will become a point where they refuse to admit her. They already refuse to honor the basic stuff, like NOT sending her out with no shoes on in sub-freezing weather, and not honoring her medically necessary eating schedule. And the scary part is that her physician is as powerless to do anything about any of this as I am.
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Old 01-07-2010, 03:28 PM
 
Location: Moon Over Palmettos
5,975 posts, read 17,557,678 times
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Quote:
Originally Posted by superk View Post
I can't because I don't need it, as I have a job and Health Insurance and a pension and a 401K. She can't because she gets disability from Social Security, and because both of our incomes always count as one. But even if they count her seperately, the amount of the disability still places her well above the limit. And before you ask the law here doesn't allow for a divorce under these circumstances.
I'm missing something here so forgive me if I ask questions. You have insurance, a pension and a 401K. Is your wife not covered under your insurance? Or is she in a facility and your insurance does not cover that part? Even if she is covered under your policy, they would only cover certain durable medical equipment (looks like the power chair was covered). They won't always cover transportation, and even the cost of an ambulance transport is subject to limits. Transportation may be covered under certain policies if you have coverage for organ transplants, for example. This is exactly what I mean by cadillac plans, those that cover every conceivable thing. Those things cost quite a handsome buck which is to be expected. But there is just no way you can cover her clothes or her shoes under a medical plan so as sad as it might seem for her not to have this means. You may just have to dig into your 401K on a hardship basis to pay for all the non-covered stuff.
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Old 01-07-2010, 04:41 PM
 
13,072 posts, read 11,399,782 times
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Quote:
Originally Posted by superk View Post
Ok, that's probably a better way of stating it. If a person has a serious medical condition and wants and needs care in order to live, and without it will certainly suffer horribly and untimately die, and that medical care is refused due to their and their family's inability to meet that cost not covered by their insurance, or are denied insurance coverage (i.e. the old "pre-existing condition" clause), then haven't we as humanity failed?
There are other means to get help for such. In fact, many organizations and charities donate for this specific reason. Humanity hasn't failed, it just has a process with some things. A church in my home town sent many people to special surgeries to which they could not afford (and no, you didn't have to be a member)

What happens if a business constantly overextends itself trying to "help" others and by doing so it places itself in extreme hardship?

I had a friend who constantly "helped" people in his work. He was very generous and people kept asking without concern for him, they always had some emergency that required my friend to give up for them. He helped many people. It cost him his business, he went under, lost his home, his cars and essentially put his family in the street.

Do you want to know how many of those people aided him when he asked or when they heard about his issues? None (and many were in positions to help)

Helping is a great thing, but doing so at the cost of ones self essentially eliminates a helping person. Eliminate enough and there is nobody to help at all because everyone is looking for help.
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Old 01-07-2010, 05:00 PM
 
Location: SC
9,038 posts, read 14,285,241 times
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Quote:
Originally Posted by superk View Post
When did a patient's basic rights to receive and appropriate level of healthcare become solely based on money? When did all of the ethical and moral obligations, the whole Hippocratic Oath, become obsolete? When someone who has become, through no fault of their own, disabled and unable to work or care for themselves, why are they denied any compassion within the healthcare system?
Since day 1.

I think you'll also find that VERY FEW people fall into the category you describe. All people except those born with a disability have a LOT of influence over their health or ill health. Medical care has NEVER been free except that which nature provides - which also happens to be highly effective and mostly ignored and maligned in this country.

If people wanted to get healthy there is nothing stopping anyone from doing it on their own. Study Natural Medcine! Find and use the althernatives instead of conventional medicine-- that will NEVER make you will (if you have a chronic disease) but will only help you live with your disease. What good is that? Why should taxpayers pay for that?

The health food stores, libaries, bookstores and the internet are chock full of info that can help you get well very inexpensively without a medical doctor or prescription drugs. You don't need a health insurance policy to do it. All you need is a little INITIATIVE.
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Old 01-07-2010, 05:13 PM
 
Location: Raleigh, NC
3,423 posts, read 9,228,911 times
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Quote:
Originally Posted by bibit612 View Post
I'm missing something here so forgive me if I ask questions. You have insurance, a pension and a 401K. Is your wife not covered under your insurance?
Yes. It's your normal policy that covers normal prescriptions, doctor's visits, dental, vision, that sort of stuff, with the associated deductables and limits. I pay for the prescriptions they don't cover (that's $850-$1000 a month alone). They don't cover any of the durable goods stuff (like the chair). Yours truly paid for that out-of-pocket. And as long as I carry her on my policy she can't get Medicare.

Quote:
Originally Posted by bibit612 View Post
Or is she in a facility and your insurance does not cover that part?
Also yes on both.

Quote:
Originally Posted by bibit612 View Post
You may just have to dig into your 401K on a hardship basis to pay for all the non-covered stuff.
The IRS doesn't allow that.
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Old 01-07-2010, 06:08 PM
 
Location: Raleigh, NC
3,423 posts, read 9,228,911 times
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Here are some facts that I have learned:

1. Contrary to what you may have been told, you will be required to perform medical procedures on your spouse even though you have no training, or even if you don't want to. I had signed an order with both my doctor and hers that, on her request, I would not have to perform any of these tasks. The insurance was supposed to take over at that point, but they refused. So, if you don't, or can't, you have to pay someone else to.

2. Contrary to common sense, the preference seems to be for the patient to stay at home alone and stagnating, rather than being allowed to go live somewhere where they can be around other people and have opportunities to participate in activities to stay busy and to keep the tedium down. The spouse is also supposed to stay home and be the primary caregiver. Any assistance you may ask for you will have to pay for. Respite is a fallicy and doesn't really exist in any meaningful manner. No one seems to know how you're supposed to not work, not collect a salary, not carry an employer-provided healthcare plan, and still pay for a mortgage/rent, utilities, transportation, fuel, insurance, food, clothing, and both of your healthcare needs.

3. If your home has not been adapted for accessibility, you again will have to cover the cost of any work you may need to have done. Other equipment you may need, like ramps and grab bars and hospital beds and hoyer lifts are NOT covered under your insurance.

4. Contrary to what those TV commercials say, your insurance most likely does NOT cover the cost of a power wheelchair or scooter. If they do, you will have to cover the cost of any maintenance.

5. Transportation is nearly impossible if you can't easily get the person in and out of your car. You have to pay (for both of you) for specialized tranportation services, and they are rarely available during the daytime hours of 10AM to about 3PM.

6. Extreme medical expenses do NOT qualify you for bankrupcy, or prevent a foreclosure or a reposession.

7. Assisted Living is always paid out-of-pocket. Nursing homes may receive Medicare or Medicaid payments, but only if the resident qualifies. Any of these places can reject an application for admission for any reason they want to. You have no say as to WHICH nursing home someone is placed in, so it could be located anywhere in the state. An apartment community, if they don't receieve any federal money, can prohibit anyone from being a tenant for any reason they want to. There are no apartments that are specifically designed for the disabled or handicapped. There are some that MAY allow you to have some conversions done, and safety equipment added, as long as you pay for it (and for the removal on the back-end).

8. Your 401K cannot be used to pay for medical expenses or to prevent a foreclosure/reposession or a bankrupcy.
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Old 01-07-2010, 07:37 PM
 
Location: Moon Over Palmettos
5,975 posts, read 17,557,678 times
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I understand all your points. Your health insurance policy probably does not cover home health care, services of a visiting nurse to render services like infusion, insulin administration or such. If your policy does not cover it, yes you would have to pay for this. I think that Medicare covers many of these services, but you would have to find a way around things to get Medicare. My father got a scooter through Medicare and he did not pay a red cent. You might be able to get some relief on the Rx through Medicare so try investigating this aspect. You may want to get private Rx insurance. Walgreen's offers one so you may be able to cover the meds not covered by your insurance. Ask if there are generic substitutes for her meds. CVS offers a Health Savings Pass program that allows you to pay only $9.99 for a 90-day Rx on 400 generic meds at a cost of $10 annually to enroll.

Retrofitting the house would have been covered I believe if she had a disability insurance policy...not sure about that, but because she's currently disabled, it's too late to get one at this time even if I could do research for you.

Respite care is covered by another policy called Long Term Care. It is separate from the medical insurance policy and is extremely expensive. As a former employee of one insurance company, none of the employees could afford it and they basically stopped offering it on open enrollment.

I'm not sure about the 401K part of your statement. I know you could distribute anything you want provided you pay the penalty and tax on the distribution. Let me ask my husband who's a tax accountant about this and will get back to you. Any distribution is at least taxable, even without the penalty.
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Old 01-07-2010, 07:39 PM
 
6,745 posts, read 8,276,290 times
Reputation: 1846
Quote:
Originally Posted by superk View Post
When did a patient's basic rights to receive and appropriate level of healthcare become solely based on money? When did all of the ethical and moral obligations, the whole Hippocratic Oath, become obsolete? When someone who has become, through no fault of their own, disabled and unable to work or care for themselves, why are they denied any compassion within the healthcare system?
i remember the citizens of walnut grove paying doc baker with pies and chickens.
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Old 01-07-2010, 07:40 PM
 
Location: Foot of the Rockies
86,887 posts, read 102,301,239 times
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Quote:
Originally Posted by sanrene View Post
If this person is disabled and unable to work or care for his/herself, they should have some kind of public assistance, including medical care, right?

If he/she went to a hospital in need of medical care, they would treat her/him.
Only in a life threatening situation. What so many people do not understand is you cannot just show up at a hospital and get your blood pressure checked, a pap smear, or most of the types of care you get at a dr's office.
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Old 01-07-2010, 07:44 PM
 
820 posts, read 749,848 times
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Quote:
Originally Posted by superk View Post
When did a patient's basic rights to receive and appropriate level of healthcare become solely based on money? When did all of the ethical and moral obligations, the whole Hippocratic Oath, become obsolete? When someone who has become, through no fault of their own, disabled and unable to work or care for themselves, why are they denied any compassion within the healthcare system?
It's not based solely on money.
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