Planning The Unpredictable » Insurance

MS ShmMS – I am going to climb Everest

nina — Mon, 01 Jun 2009 21:58:34 +0000

Just climbing Everest is insane but add in MS? Crazy!!!!

http://www.jsonline.com/features/health/45924582.html

Ten years after doctors presented Lori Schneider with a hellish warning to prepare for life in a wheelchair, she ascended to the place on Earth closest to heaven.

Schneider stepped to the summit of Mount Everest, in sunshine and bitter cold, on Saturday morning, and became the first woman with multiple sclerosis to reach the roof of the world. Standing at 29,035 feet, the 52-year-old adventurer unfurled a banner for World MS Day, and then called her father, in Janesville.

“She said, ‘I’m here Dad, I’m on the summit, I made it,’ ” Neal Schneider recounted. “She was very, very happy, as you can imagine.”

Hihi, I’m still around.

nina — Sat, 31 Jan 2009 20:16:17 +0000

First things first, I am on this weeks Carnival of MS Bloggers so head over and check it out!

And for a regular update…. work has been very busy. We are *so* close to shipping which means I am busy busy! We had layoffs last week which were pretty hard for me. It was a reduction of about 90 people worldwide, two from my cube row of 6 people. I am safe for the time being but round 2-3 are scary. I would have to purchase COBRA if I was laid off which I imagine is around 500/mo. We get 2K/mo in Washington state for unemployment. It would be tough to pay mortgage + insurance.

The house passed a bill this week to provide ‘discounts’ on COBRA for all laid off workers:

The stimulus package would provide newly unemployed workers a 65 percent subsidy to help pay their COBRA coverage for up to a year.

“Certainly, that would make it more affordable,” says Karen Davis, president of the Commonwealth Fund, though she points out employers now pick up 75 to 85 percent.

The House bill would also make COBRA benefits available to people over the age of 55 for up to 10 years, until they become eligible for Medicare.

6th month checkup

nina — Mon, 20 Oct 2008 02:51:40 +0000

I noticed someone found my blog by googling the cost of MS. I think we all know the cost of MS is huge. The question is were they asking about the cost in financial, emotional or physical terms. I decided I would show the cost of MS for the 6 months in a financial sense.

Here is the current toll for my prescriptions:

Date of Service	Drug Name	Prescription Cost	You Pay Out of Pocket
10/17/08	COPAXONE	2177.36	20
9/24/08	COPAXONE	2177.36	20
9/14/08	VITAMIND 50000	7.78	7.78
8/28/08	COPAXONE	2177.36	20
8/1/08	COPAXONE	1981.22	20
7/31/08	BACLOFENTAB10MG	25.38	10
7/10/08	COPAXONE	1981.22	20
6/16/08	COPAXONE	1981.22	20
Totals		12508.9	137.78

And my medical costs:

Date of Service	Total Charges Submitted	Service	Total Paid by Plan	You Pay Out of Pocket
09/04/08	72	Eye Doc	15.13	15
07/21/08	145.35	Neruo	69.08	15
06/26/08	4902	Spinal MRI	3803.64	0
06/23/08	173.3	Neuro	97.73	0
06/23/08	533.8	Neuro	337.29	15
06/06/08	557	Neuro-Ophth	384.24	15
05/23/08	70	Home Nurse	63	7
05/25/08	263.89	Home Nurse	237.5	26.39
05/21/08	138	Neuro-Ophth	81.44	15
05/20/08	2479	Brain MRI	2188.69	0
05/20/08	805	Neuro-Ophth	552.83	15
05/15/08	72	Eye Doc	15.13	15
05/15/08	139	Eye Doc	63.22	0
05/14/08	118	Eye Doc	28	15
Totals	10468.34		7936.92	153.39

So that is a total of $22,977.24 billed to my insurance and my insurance has paid $20,445.82 since May when I went blind in one eye. I have paid $291.17 out of pocket.

Quite a deal really (for me at least)….

Maybe this week I’ll write about the cost of MS in the other ways. Until then, I hope everyone has a good week.

The Bailout

nina — Sat, 11 Oct 2008 05:17:52 +0000

Part of the bailout plan was the Mental Health Parity Act. It basically says that mental health illnesses should be treated as a medical problem and have equal coverage under your health insurance. A lot of insurance companies either don’t cover mental health at all or have a limit of what is covered. At first, this seems like a great thing. Finally, mental health illnesses are recognized as a real health condition.

The problem comes again with the wording:

‘(4) AVAILABILITY OF PLAN INFORMATION- The criteria for medical necessity determinations made under the plan with respect to mental health or substance use disorder benefits (or the health insurance coverage offered in connection with the plan with respect to such benefits) shall be made available by the plan administrator (or the health insurance issuer offering such coverage) in accordance with regulations to any current or potential participant, beneficiary, or contracting provider upon request. The reason for any denial under the plan (or coverage) of reimbursement or payment for services with respect to mental health or substance use disorder benefits in the case of any participant or beneficiary shall, on request or as otherwise required, be made available by the plan administrator (or the health insurance issuer offering such coverage) to the participant or beneficiary in accordance with regulations.

So, the insurance companies get to make the determination if mental illness is serious enough that treatment is a medical necessity. I was speaking with a mental health professional regarding this new act and she said insurance companies are already qualifying the mental illness as “serious” or not. If they consider it “serious”, the patient will get more care. She asked the insurance company what was consider “serious” and they told her that they were unable to provide that information. They told her to bill them and they would decided if it was serious. She had very little hope for this bill to make a positive impact on the lives of American’s.

If someone suffing from a mental illness goes into remission, will the insurance companies decided it’s no longer “serious” until the next time they aren’t in remission? It is an interesting question.

Never a dull moment…

McCain’s health care plan is NOT free

nina — Fri, 03 Oct 2008 04:12:11 +0000

In tonights debate, Palin said this:

IFILL: Governor, are you interested in defending Sen. McCain’s health care plan?

PALIN: I am because he’s got a good health care plan that is detailed. And I want to give you a couple details on that. He’s proposing a $5,000 tax credit for families so that they can get out there and they can purchase their own health care coverage. That’s a smart thing to do. That’s budget neutral. That doesn’t cost the government anything as opposed to Barack Obama’s plan to mandate health care coverage and have universal government run program and unless you’re pleased with the way the federal government has been running anything lately, I don’t think that it’s going to be real pleasing for Americans to consider health care being taken over by the feds. But a $5,000 health care credit through our income tax that’s budget neutral. That’s going to help. And he also wants to erase those artificial lines between states so that through competition, we can cross state lines and if there’s a better plan offered somewhere else, we would be able to purchase that. So affordability and accessibility will be the keys there with that $5,000 tax credit also being offered.

Dear Governor Palin,

Your plan is not free. It seems you left out a big part of your plan. Your plan requires us (you know, America’s) to pay income tax on the amount our employer spend to get us a health care plan. This is around 1K/mo or 12K/yr in additional income which you would have to pay taxes on. For that, you would then get 2,500 or 5,000 in a tax credit to help pay for health care insurance.

Your plan actually costs about the same but does significantly less for American’s. If I am still confusing you, here is a graph that was published in one of those national media outlets called The Wall Street Journal: