Insurance nightmare

amother

↑ Moccasin

Wed, Oct 20 2021, 8:28 am

amother [ Lime ] wrote:

So basically, anyone who lost their job would be out of luck.

Before Obamacare, we moved out of state. We couldn't get insurance at all to cover me. The only way I could get insurance would be to sign off on an awful plan and I wouldn't be allowed to get pregnant for five years, otherwise they wouldn't insure me or the baby. Luckily, my husband took a job he hated just for the company insurance. He suffered for that job, and I refused to let him quit for a decade. A DECADE.

.

So in its stead, we've made tons of others sign off on awful plans. Makes sense, right?

mig100

Wed, Oct 20 2021, 1:01 pm

amother [ Moccasin ] wrote:

So in its stead, we've made tons of others sign off on awful plans. Makes sense, right?

yep exactly.

thats what happened. now even if you have a job that gives insurance, its usually awful and expensive. the days of getting a job you dont like for easy coverage are over. its no longer a given that large employers give decent health insurance.

In case I was not clear, I am NOT a fan of obamacare. at all

amother

↑ OP ↓

Wed, Oct 27 2021, 3:06 pm

mig100 wrote:

I really should just move on but I came back to report that my deductible resets in JANUARY! (My husband started working in September) so for 3 months we are paying premiums (1,000 a month) + 6,000 deductible +copays. Literally 10,000 for medical care over 3 months. And then start from scratch again in January.

I cannnnot with this craziness, I feel like I’m hallucinating or just living on a different planet that no one else realizes how insane this is.

amother

Outerspace

Wed, Oct 27 2021, 3:17 pm

Quote:

You do realize that NY is almost unique in having Medicaid that actually provides excellent coverage. In most areas, if it is even available, almost no medical providers actually accept it. So those of you who hate the "progressives" are reaping the benefits of living in a progressive state. Medicaid in most of the red states is a joke and wasn't expanded so almost no one qualifies.

Wow, what misinformation.
I live in a red state, where yes, it is very hard to get on medicaid - if you are an adult.
But for kids medicaid and child health plus have much higher income brackets. My kids were on medicaid for close to 8 years while DH was in school and they were treated by top doctors in some of the best hospitals in the world.

amother

Latte ↓

Wed, Oct 27 2021, 6:45 pm

I’m on Fidelis Medicaid and I think it’s a nightmare.

The doctors are terrible, so many who didn’t go to med school in America because they weren’t smart enough to get in.

Finding a private practice psychiatrist has been impossible: there is ONE is all of Brooklyn. He went to medical school in Egypt.

I had excellent doctors on my marketplace plan: top med schools, top residencies. Sure, I had to do a lot of research to find them but they were there. I can’t tell you how much trouble I’ve had finding qualified physicians on Medicaid.

↑ thunderstorm

Wed, Oct 27 2021, 6:48 pm

amother [ Latte ] wrote:

In Rockland County Fidelis is the most accepted insurance.
The City is different.

amother

↑ OP ↓

Wed, Oct 27 2021, 7:49 pm

amother [ Latte ] wrote:

If you’re open to telehealth- Acheive behavioral health has an amazing psychiatry department. They are in monsey but can service Telehealth anyone in NY.

Also- for the amount of money it costs to have insurance sometimes you can get a sliding scale price in places that don’t accept fidelis.

amother

Mulberry

Wed, Oct 27 2021, 7:51 pm

amother [ OP ] wrote:

I pay $2200 a month with a $1500 deductible. You should’ve chosen a higher priced plan and lower deductible if it was for only a couple of months.

amother

↑ OP ↓

Wed, Oct 27 2021, 7:54 pm

amother [ Mulberry ] wrote:

I pay $2200 a month with a $1500 deductible. You should’ve chosen a higher priced plan and lower deductible if it was for only a couple of months.

We are thankfully able to still change to that. I didn’t realize we would be having big ticket items still this year and thought it was a waste. Oh well. It’s still a fortune!

amother

↑ Latte

Wed, Oct 27 2021, 8:06 pm

amother [ OP ] wrote:

I really want a private practice psychiatrist, not someone who works through a clinic or an NP. This is a non negotiable for me.

miami85

Wed, Oct 27 2021, 8:13 pm

We were in this exact situation several years ago. I finally got a "decent paying job" after graduation but we were over the medicaid cutoff by $3K, and my employer's health insurance was very expensive--and this was during the height of Obamacare when no one took the plan my employer took which cost a LOT to cover my husband who finally was at a point where he was ready to leave kollel, so that's what he did, got a job, but getting a job was not the panacea we thought it would be--required 2nd car, more insurance, tolls, more childcare, my husband wasn't home during the day to do shopping, cooking, washing dishes etc.

amother

↑ Carnation

Wed, Oct 27 2021, 8:36 pm

amother [ Latte ] wrote:

I have a suggestion as far as doctors and specialists are concerned, but don't know if it would work for a psychiatrist. I have a child with a chronic medical condition who I put on Medicaid when he became an adult. It is important for him to see the best specialist in the field and have state of the art testing. His medication costs $40000 a month. I have found that specialists in major teaching hospitals usually have "clinic hours". During clinic hours the specialists see patients on medicaid and other inferior plans. Yes, you have to be seen only during those days and hours but it is very doable. And you can have follow ups and tests done at your convenience by the Fellow or Attending who usually all take Medicaid. The specialist reviews, recommends and amends the follow up care. Alternatively, you can send cds of scans, test results etc to a specialist who does not accept your insurance for advice on medical protocol for a "consultation fee" which is relatively affordable. Managing my son's care this way has worked very well and we don't have to meet any enormous deductibles, we have no co-pays and every single test and medication ever ordered was covered 100% bH.

amother

↑ Azalea ↓

Wed, Oct 27 2021, 9:07 pm

amother [ OP ] wrote:

I’m not sure where this is coming from? Maybe deal with your anger, the same way I’m dealing with mine (get your own thread maybe lol).

I guess we all see what we want or I wasn’t clear- I work full time as well... just don’t make enough to have bumped us off medicaid.

My husband was a student till recently (was doing TA work part time as well).

We definitely aren’t moochers. I’d be fine paying for healthcare but I need to atleast get quality care! Equivalent to welfare.

Trust me, I am not angry and have no anger issues. But I get frustrated when people want to go on welfare to be able to fund extravagances. Vacations, new sheitel, buying a home... all should not be done on welfare. Medicaid is part of welfare- government funded programs for the poor.

amother

↑ Azalea

Wed, Oct 27 2021, 9:20 pm

amother [ Hyacinth ] wrote:

This is a really rude and aggressive post. We all know that’s not what OP meant. And no, you wouldn’t pay for her Medicaid that’s not how it works. Op was just venting about the insane prices and terrible coverage options there are.

A girls allowed to want things and none of what she wants is unreasonable.

A girl can dream but not if someone else has to foot the bill. And whose taxes are funding her welfare and Medicaid?

amother

↑ OP ↓

Wed, Oct 27 2021, 9:39 pm

amother [ Azalea ] wrote:

A girl can dream but not if someone else has to foot the bill. And whose taxes are funding her welfare and Medicaid?

I’m just not following your train of thought- We are paying an insane amount of taxes and I’m just resentful that while we as a country pay for the poor (and those that choose to stay poor) to have decent medical care- which I fully believe in! We can’t come up with a way for me to also get quality care that doesn’t eat up any breathing room in my paycheck. To the extent that I can’t afford luxuries, which no one owes me, but as an economy it’s not sustainable and it disincentivizes people from working.

At no point did I say that I stay at home or want to, nor that I got any luxuries on Medicaid so I’m again confused what you’re saying and how it relates to what I said.

amother

↑ OP

Wed, Oct 27 2021, 9:42 pm

amother [ Latte ] wrote:

I really want a private practice psychiatrist, not someone who works through a clinic or an NP. This is a non negotiable for me.

I hear. I wish you Hatzlacha. It is important that you trust your provider.

I recently encouraged my sister to transfer after 2 years + of working with a highly recommended private psychiatrist and she is blown away. It may be worth looking at some point. Otherwise focusing on someone with a sliding scale.