insurance papers

Under Medicare I get to (optionally) to pick an HMO. I had been with Kaiser
for about 7 years, and then switched to Secure Horizons for 2007. In 2008 I
am going back to Kaiser.

The paperwork arrived today. I mail it back tomorrow.

The trip through commercial HMOs was a mess. Kaiser is a non-profit.

In January of 2007 I had Humana. I couldn't even find a general
practitioner who would take the insurance. I was allowed an additional HMO
change, so I switched to Secure Horizons effective February 1st. Secure
Horizons had in-plan doctors and Secure Horizons charged the highest monthly
premium, so I expected they would have the best benefits. I picked an
in-plan primary care doctor. He was snotty. I said something like: "I
guess you'll get to be my primary care doctor." He growled: "You picked me,
so I don't have a choice." Finding a Urologist was easy. However, finding
a psychiatrist was a disaster. A dozen HMO contracted psychiatrists refused
to take me as a patient. After about 4 months the insurance company sent me
to a large Mental Health facility linked to a big hospital. It was July
before I saw a p-doc. Then the p-doc wanted to see me every month, but the
insurance company wanted fewer visits. It was a huge pain in the ass.

Kaiser is very organized. The doctors are all connected through the
computer and paperwork. With Secure Horizons none of my doctors ever talk
to each other.

For 2008 Kaiser has added an optional dental plan. The plan is not great,
but it is better than nothing, which is what I currently have for dental
coverage. I will miss my old dentist. He was a good guy.

In picking an in-plan Kaiser dentist, I had very little info about the
dentists. Some had Islamic names. They were out! I then noticed that the
listing showed alternate languages spoken at the dental office. I figured
that a dentist who speaks Russian, probably got his dental training in
Russia, so I looked for a nearby office that *only* spoke English.

For those of you trying to get SSDI and jeopardizing it by working.
Consider the cost of health care as you get older. In the time I was at
Kaiser I had three operations with general anesthesia, and the works. My
co-pay was $200, but I can only speculate at the tens of thousands I cost
Medicare. I may have had $100,000 in medical services.

I know you folks have to eat, but when I went to Social Security with a copy
of my hospitalization records showing "schizophrenia" I was immediately
given SSI. SSI was just $300 to $400 a month, but it got me by for the 7
months of unemployment that had to precede getting SSDI. There was also a
program called "General Assistance" run by the county. I qualified, but the
caseworker denied my claim on a bogus technicality. The only problem with
General Assistance was (would have been) that they want to get paid back, if
you are ever able to. The denial of General Assistance was because I owned
ONE share of a stock. It was worth about $35, but because I owned stock I
was considered ineligible. I had misplaced the certificate, so there was no
way to sell or get rid of the one share.

I had a dream the other night,

you still with me?

In this dream I was doing contracted work at a business site. They wanted
me to install some illegal equipment for their gambling business. Everyone
at the business was Chinese, except the guy I was talking to. He was a
black man. He offered me $2000 for something simple and easy, but not
allowed. I said OK. Immediately, two vans pulled up and I was arrested.
Except, instead of handcuffs, they attached a somewhat large satellite
tracking device to my left forearm. Then they drove away and left me there.

Maybe the black guy was a Mason.

I had a dream that I was driving to the East Coast. On the way I
stopped at a store in search of diet pepsi. I kept looking and looking,
they didn't have it so I settled for some diet rite and then I woke up.

In real life I am trying to give up diet pepsi because it is now 6.98
for a 12 pack here.

penguin

"Quiet Neighbor" <private@spamless.net> wrote in message
news:uF63j.71628$YL5.59877@newssvr29.news.prodigy. net...
> Under Medicare I get to (optionally) to pick an HMO. I had been with
> Kaiser for about 7 years, and then switched to Secure Horizons for 2007.
> In 2008 I am going back to Kaiser.
>
> The paperwork arrived today. I mail it back tomorrow.
>
> The trip through commercial HMOs was a mess. Kaiser is a non-profit.
>
> In January of 2007 I had Humana. I couldn't even find a general
> practitioner who would take the insurance. I was allowed an additional
> HMO change, so I switched to Secure Horizons effective February 1st.
> Secure Horizons had in-plan doctors and Secure Horizons charged the
> highest monthly premium, so I expected they would have the best benefits.
> I picked an in-plan primary care doctor. He was snotty. I said something
> like: "I guess you'll get to be my primary care doctor." He growled: "You
> picked me, so I don't have a choice." Finding a Urologist was easy.
> However, finding a psychiatrist was a disaster. A dozen HMO contracted
> psychiatrists refused to take me as a patient. After about 4 months the
> insurance company sent me to a large Mental Health facility linked to a
> big hospital. It was July before I saw a p-doc. Then the p-doc wanted to
> see me every month, but the insurance company wanted fewer visits. It was
> a huge pain in the ass.
>
> Kaiser is very organized. The doctors are all connected through the
> computer and paperwork. With Secure Horizons none of my doctors ever talk
> to each other.
>
> For 2008 Kaiser has added an optional dental plan. The plan is not great,
> but it is better than nothing, which is what I currently have for dental
> coverage. I will miss my old dentist. He was a good guy.
>
> In picking an in-plan Kaiser dentist, I had very little info about the
> dentists. Some had Islamic names. They were out! I then noticed that
> the listing showed alternate languages spoken at the dental office. I
> figured that a dentist who speaks Russian, probably got his dental
> training in Russia, so I looked for a nearby office that *only* spoke
> English.
>
> For those of you trying to get SSDI and jeopardizing it by working.
> Consider the cost of health care as you get older. In the time I was at
> Kaiser I had three operations with general anesthesia, and the works. My
> co-pay was $200, but I can only speculate at the tens of thousands I cost
> Medicare. I may have had $100,000 in medical services.
>
> I know you folks have to eat, but when I went to Social Security with a
> copy of my hospitalization records showing "schizophrenia" I was
> immediately given SSI. SSI was just $300 to $400 a month, but it got me
> by for the 7 months of unemployment that had to precede getting SSDI.
> There was also a program called "General Assistance" run by the county. I
> qualified, but the caseworker denied my claim on a bogus technicality.
> The only problem with General Assistance was (would have been) that they
> want to get paid back, if you are ever able to. The denial of General
> Assistance was because I owned ONE share of a stock. It was worth about
> $35, but because I owned stock I was considered ineligible. I had
> misplaced the certificate, so there was no way to sell or get rid of the
> one share.
>
> I had a dream the other night,
>
> you still with me?
>
> In this dream I was doing contracted work at a business site. They wanted
> me to install some illegal equipment for their gambling business.
> Everyone at the business was Chinese, except the guy I was talking to. He
> was a black man. He offered me $2000 for something simple and easy, but
> not allowed. I said OK. Immediately, two vans pulled up and I was
> arrested. Except, instead of handcuffs, they attached a somewhat large
> satellite tracking device to my left forearm. Then they drove away and
> left me there.

Give me a general idea of the benefits package you get, provided it's not
confidential. On Ontario Disability I get--and this is all public
information--not only shelter and basic needs to an amount, but free
prescription medication with a $2 copay per prescription, extremely basic
free dental with a cleaning every nine months plus fillings to the extent
they can't be avoided, glasses every three years, reimbursement for
transportation expenses to medical appointments, reimbursement for special
dietary needs, and possibly a few other things I haven't investigated.

The dream sounds freaky but far short of the horrible things most schizos
have pass through their heads while awake!

Miki

"Erik the Red" <spock_smokes@hotmail.com> wrote in message
news:822439b7-d3fe-4a14-bb81-994ffe2d3d09@w28g2000hsf.googlegroups.com...
> Maybe the black guy was a Mason.
>

First name Desmond? ... Uh, was he black? I forget.

Miki

"Penguin A" <kola5z@webtv.net> wrote in message
news:25447-474D1CD6-1@storefull-3176.bay.webtv.net...
>
> I had a dream that I was driving to the East Coast. On the way I
> stopped at a store in search of diet pepsi. I kept looking and looking,
> they didn't have it so I settled for some diet rite and then I woke up.
>
> In real life I am trying to give up diet pepsi because it is now 6.98
> for a 12 pack here.
>
> penguin

Yikes! That's twice as expensive as in Canada!

Do you guys have store brands like the PC Cola here? They tend to be fairly
inexpensive. Right now half-gallon bottles of PC Cola are on sale for 49
cents.

Miki

"Miki Kocic" <malefrancesfarmer@yahoo.ca> wrote in message
news:13kq7m8qml6ae83@corp.supernews.com...
>
> "Quiet Neighbor" <private@spamless.net> wrote in message
> news:uF63j.71628$YL5.59877@newssvr29.news.prodigy. net...
>> Under Medicare I get to (optionally) to pick an HMO. I had been with
>> Kaiser for about 7 years, and then switched to Secure Horizons for 2007.
>> In 2008 I am going back to Kaiser.
>>
>> The paperwork arrived today. I mail it back tomorrow.
>>
>> The trip through commercial HMOs was a mess. Kaiser is a non-profit.
>>
>> In January of 2007 I had Humana. I couldn't even find a general
>> practitioner who would take the insurance. I was allowed an additional
>> HMO change, so I switched to Secure Horizons effective February 1st.
>> Secure Horizons had in-plan doctors and Secure Horizons charged the
>> highest monthly premium, so I expected they would have the best benefits.
>> I picked an in-plan primary care doctor. He was snotty. I said
>> something like: "I guess you'll get to be my primary care doctor." He
>> growled: "You picked me, so I don't have a choice." Finding a Urologist
>> was easy. However, finding a psychiatrist was a disaster. A dozen HMO
>> contracted psychiatrists refused to take me as a patient. After about 4
>> months the insurance company sent me to a large Mental Health facility
>> linked to a big hospital. It was July before I saw a p-doc. Then the
>> p-doc wanted to see me every month, but the insurance company wanted
>> fewer visits. It was a huge pain in the ass.
>>
>> Kaiser is very organized. The doctors are all connected through the
>> computer and paperwork. With Secure Horizons none of my doctors ever
>> talk to each other.
>>
>> For 2008 Kaiser has added an optional dental plan. The plan is not
>> great, but it is better than nothing, which is what I currently have for
>> dental coverage. I will miss my old dentist. He was a good guy.
>>
>> In picking an in-plan Kaiser dentist, I had very little info about the
>> dentists. Some had Islamic names. They were out! I then noticed that
>> the listing showed alternate languages spoken at the dental office. I
>> figured that a dentist who speaks Russian, probably got his dental
>> training in Russia, so I looked for a nearby office that *only* spoke
>> English.
>>
>> For those of you trying to get SSDI and jeopardizing it by working.
>> Consider the cost of health care as you get older. In the time I was at
>> Kaiser I had three operations with general anesthesia, and the works. My
>> co-pay was $200, but I can only speculate at the tens of thousands I cost
>> Medicare. I may have had $100,000 in medical services.
>>
>> I know you folks have to eat, but when I went to Social Security with a
>> copy of my hospitalization records showing "schizophrenia" I was
>> immediately given SSI. SSI was just $300 to $400 a month, but it got me
>> by for the 7 months of unemployment that had to precede getting SSDI.
>> There was also a program called "General Assistance" run by the county.
>> I qualified, but the caseworker denied my claim on a bogus technicality.
>> The only problem with General Assistance was (would have been) that they
>> want to get paid back, if you are ever able to. The denial of General
>> Assistance was because I owned ONE share of a stock. It was worth about
>> $35, but because I owned stock I was considered ineligible. I had
>> misplaced the certificate, so there was no way to sell or get rid of the
>> one share.
>>
>> I had a dream the other night,
>>
>> you still with me?
>>
>> In this dream I was doing contracted work at a business site. They
>> wanted me to install some illegal equipment for their gambling business.
>> Everyone at the business was Chinese, except the guy I was talking to.
>> He was a black man. He offered me $2000 for something simple and easy,
>> but not allowed. I said OK. Immediately, two vans pulled up and I was
>> arrested. Except, instead of handcuffs, they attached a somewhat large
>> satellite tracking device to my left forearm. Then they drove away and
>> left me there.
>
> Give me a general idea of the benefits package you get, provided it's not
> confidential. On Ontario Disability I get--and this is all public
> information--not only shelter and basic needs to an amount, but free
> prescription medication with a $2 copay per prescription, extremely basic
> free dental with a cleaning every nine months plus fillings to the extent
> they can't be avoided, glasses every three years, reimbursement for
> transportation expenses to medical appointments, reimbursement for special
> dietary needs, and possibly a few other things I haven't investigated.
>
> The dream sounds freaky but far short of the horrible things most schizos
> have pass through their heads while awake!
>
> Miki
>

(Medicare without Medi-cal/Medicaid)

Shelter: In my county there is a list for getting publicly assisted housing.
However, they have one week "windows" every 5 years, or so, during which you
can sign up. They do not notify the people who have come in to apply, when
the list opens. They bury a notice of the list window opening in the
newspaper. (Who reads newspapers?) The effect is that while the waiting
list may be 5 years long, persons on disability cannot get on the list. I
tried to get on the list ten years ago. By rights, I should have assisted
housing by now, but I can't get on the list, so I am still at zero in the
process. In other parts of the US, I gather things are run differently.
Someone on here said that in New Hampshire there is no waiting period.

Medication co-pays vary with the HMO plan chosen, and the generic vs. name
brand status of the drug. Next year my co-pay will be from about $12 to
$90, depending. There is a $2500 limit on the HMO's drug cost. After that,
you pay 100% yourself, unless you get up to about $4000 or $5000, then they
start to cover the meds again. A typical atypical med costs more in a year
than $2500. Thus, I buy meds from Canada.

Transportation is not reimbursed. However, there is a service that I might
qualify for that provides the equivalent of cab rides for about $4. I have
a car, so I have not applied for it.

Dental had zero coverage until 2008. The 2008 program has a $20 per month
premium and limited benefits. A crown still costs $600+ under the insurance.

$125 free glasses every 2 years, but I buy my glasses on the internet
instead ($17.95) with a prescription I make up myself (based on optician
prescriptions from the past). To get the in-program glasses I would have to
see the in-program optician at about $30, and the last time I was there they
got my prescription wrong, and refused to fix it for a mental patient. I
had to go to a commercial optician who knew nothing of my mental history to
get a correct optical prescription.

Dietary needs: If my SSDI were very very low I might qualify for food
stamps, but I'm nowhere close.

Medicare costs $96.40 per month, and then having a Medicare HMO costs an
additional $94 on my 2008 HMO. I pay these out of my SSDI. A typical
doctor visit has a $30 co-pay. Special procedures can be $50, $100,
$200 -depending. Hospitalization is just under $300 a day. A blood test is
$20.

QN, that's horrible! But it's very similar to the individual private
coverage that insurance companies offer in Canada. The whole idea is to
collect premiums without paying out any benefits.

Miki

"Quiet Neighbor" <private@spamless.net> wrote in message
news:aNg3j.1302$Vq.792@nlpi061.nbdc.sbc.com...
>
> "Miki Kocic" <malefrancesfarmer@yahoo.ca> wrote in message
> news:13kq7m8qml6ae83@corp.supernews.com...
>>
>> "Quiet Neighbor" <private@spamless.net> wrote in message
>> news:uF63j.71628$YL5.59877@newssvr29.news.prodigy. net...
>>> Under Medicare I get to (optionally) to pick an HMO. I had been with
>>> Kaiser for about 7 years, and then switched to Secure Horizons for 2007.
>>> In 2008 I am going back to Kaiser.
>>>
>>> The paperwork arrived today. I mail it back tomorrow.
>>>
>>> The trip through commercial HMOs was a mess. Kaiser is a non-profit.
>>>
>>> In January of 2007 I had Humana. I couldn't even find a general
>>> practitioner who would take the insurance. I was allowed an additional
>>> HMO change, so I switched to Secure Horizons effective February 1st.
>>> Secure Horizons had in-plan doctors and Secure Horizons charged the
>>> highest monthly premium, so I expected they would have the best
>>> benefits. I picked an in-plan primary care doctor. He was snotty. I
>>> said something like: "I guess you'll get to be my primary care doctor."
>>> He growled: "You picked me, so I don't have a choice." Finding a
>>> Urologist was easy. However, finding a psychiatrist was a disaster. A
>>> dozen HMO contracted psychiatrists refused to take me as a patient.
>>> After about 4 months the insurance company sent me to a large Mental
>>> Health facility linked to a big hospital. It was July before I saw a
>>> p-doc. Then the p-doc wanted to see me every month, but the insurance
>>> company wanted fewer visits. It was a huge pain in the ass.
>>>
>>> Kaiser is very organized. The doctors are all connected through the
>>> computer and paperwork. With Secure Horizons none of my doctors ever
>>> talk to each other.
>>>
>>> For 2008 Kaiser has added an optional dental plan. The plan is not
>>> great, but it is better than nothing, which is what I currently have for
>>> dental coverage. I will miss my old dentist. He was a good guy.
>>>
>>> In picking an in-plan Kaiser dentist, I had very little info about the
>>> dentists. Some had Islamic names. They were out! I then noticed that
>>> the listing showed alternate languages spoken at the dental office. I
>>> figured that a dentist who speaks Russian, probably got his dental
>>> training in Russia, so I looked for a nearby office that *only* spoke
>>> English.
>>>
>>> For those of you trying to get SSDI and jeopardizing it by working.
>>> Consider the cost of health care as you get older. In the time I was at
>>> Kaiser I had three operations with general anesthesia, and the works.
>>> My co-pay was $200, but I can only speculate at the tens of thousands I
>>> cost Medicare. I may have had $100,000 in medical services.
>>>
>>> I know you folks have to eat, but when I went to Social Security with a
>>> copy of my hospitalization records showing "schizophrenia" I was
>>> immediately given SSI. SSI was just $300 to $400 a month, but it got me
>>> by for the 7 months of unemployment that had to precede getting SSDI.
>>> There was also a program called "General Assistance" run by the county.
>>> I qualified, but the caseworker denied my claim on a bogus technicality.
>>> The only problem with General Assistance was (would have been) that they
>>> want to get paid back, if you are ever able to. The denial of General
>>> Assistance was because I owned ONE share of a stock. It was worth about
>>> $35, but because I owned stock I was considered ineligible. I had
>>> misplaced the certificate, so there was no way to sell or get rid of the
>>> one share.
>>>
>>> I had a dream the other night,
>>>
>>> you still with me?
>>>
>>> In this dream I was doing contracted work at a business site. They
>>> wanted me to install some illegal equipment for their gambling business.
>>> Everyone at the business was Chinese, except the guy I was talking to.
>>> He was a black man. He offered me $2000 for something simple and easy,
>>> but not allowed. I said OK. Immediately, two vans pulled up and I was
>>> arrested. Except, instead of handcuffs, they attached a somewhat large
>>> satellite tracking device to my left forearm. Then they drove away and
>>> left me there.
>>
>> Give me a general idea of the benefits package you get, provided it's not
>> confidential. On Ontario Disability I get--and this is all public
>> information--not only shelter and basic needs to an amount, but free
>> prescription medication with a $2 copay per prescription, extremely basic
>> free dental with a cleaning every nine months plus fillings to the extent
>> they can't be avoided, glasses every three years, reimbursement for
>> transportation expenses to medical appointments, reimbursement for
>> special dietary needs, and possibly a few other things I haven't
>> investigated.
>>
>> The dream sounds freaky but far short of the horrible things most schizos
>> have pass through their heads while awake!
>>
>> Miki
>>
>
> (Medicare without Medi-cal/Medicaid)
>
> Shelter: In my county there is a list for getting publicly assisted
> housing. However, they have one week "windows" every 5 years, or so,
> during which you can sign up. They do not notify the people who have come
> in to apply, when the list opens. They bury a notice of the list window
> opening in the newspaper. (Who reads newspapers?) The effect is that
> while the waiting list may be 5 years long, persons on disability cannot
> get on the list. I tried to get on the list ten years ago. By rights, I
> should have assisted housing by now, but I can't get on the list, so I am
> still at zero in the process. In other parts of the US, I gather things
> are run differently. Someone on here said that in New Hampshire there is
> no waiting period.
>
> Medication co-pays vary with the HMO plan chosen, and the generic vs. name
> brand status of the drug. Next year my co-pay will be from about $12 to
> $90, depending. There is a $2500 limit on the HMO's drug cost. After
> that, you pay 100% yourself, unless you get up to about $4000 or $5000,
> then they start to cover the meds again. A typical atypical med costs
> more in a year than $2500. Thus, I buy meds from Canada.
>
> Transportation is not reimbursed. However, there is a service that I
> might qualify for that provides the equivalent of cab rides for about $4.
> I have a car, so I have not applied for it.
>
> Dental had zero coverage until 2008. The 2008 program has a $20 per month
> premium and limited benefits. A crown still costs $600+ under the
> insurance.
>
> $125 free glasses every 2 years, but I buy my glasses on the internet
> instead ($17.95) with a prescription I make up myself (based on optician
> prescriptions from the past). To get the in-program glasses I would have
> to see the in-program optician at about $30, and the last time I was there
> they got my prescription wrong, and refused to fix it for a mental
> patient. I had to go to a commercial optician who knew nothing of my
> mental history to get a correct optical prescription.
>
> Dietary needs: If my SSDI were very very low I might qualify for food
> stamps, but I'm nowhere close.
>
> Medicare costs $96.40 per month, and then having a Medicare HMO costs an
> additional $94 on my 2008 HMO. I pay these out of my SSDI. A typical
> doctor visit has a $30 co-pay. Special procedures can be $50, $100,
> $200 -depending. Hospitalization is just under $300 a day. A blood test
> is $20.
>
>
>

QN,

I did not read the entire message you wrote. I just wanted to jump in
and say that I misread where you wrote "in my county" as "in my
country" and read the rest of it and immediately had impressions of
Russian novels with the housing holdups.

I laugh at horror stories usually myself. I say, when I want to read
somehting really scary, I read Russian literature.

I couldn't even read the rest of the message. I am living the same
kind of nightmares with all kinds of getting assistance with living
issues stuff.