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Insurance interlude

So my father has private insurance. He gets it through my mother’s job. It’s good insurance they pay for the top tier. And yet we’re in trouble.


This is what the insurance allows for

Acute rehab : 60 days per year

Subacute rehab: 30 days per year

In house therapy sessions: 40 per year

Out patient physical therapy: 60 per year


So my father will run out of subacute rehab time June 27th and it costs $750 a day to keep him there, not including therapy. It’s $33 per 15 minutes and he needs OT, PT, and Speech and he should have minimum 45 minutes of each of them. He’s not ready to come home. He’s made great progress but they told us he needs to be monitored 24/7. He needs help transferring from wheel chair to anywhere. He can’t get in and out of anywhere or move is wheel chair and there are ten steps to get in and out of the house. But the rehab just sort of shrugged and told us oh well your problem now.


Solution #1 trying to get dad Medicaid.

He doesn’t qualify right now. He owns two properties. It doesn’t matter that he doesnt have much money in his bank account nor that will not be working for a long time. He doesn’t qualify. So now I have to meet with a lawyer to get everything transferred out of his name. But the earliest this will happen is August 1st.


Solution #2 get him transferred back to acute rehab (I have 37 days left there) but that involves getting the doctor therapists and acute rehab to all agree that that is warranted. That’s currently in the works.


He’s already been denied disability because apparently you can’t get disability if you work for yourself. Doesn’t matter that her brought ten years of taxes from him and his business. Just flat out denied.


So long story short: private insurance is a sess pit of suck, the government sucks, and the American health care system is severely lacking.

anonymous asked:

my new psych said (i quote) ‘i don’t like to officially diagnose, so i’m just letting you know you have schizophrenia but i won’t put it in your file’. can she do that??? without the dx i can’t get meds to treat my hallucinations. she also told me that instead of focusing on treating psychosis i should work towards accepting it + my hallucinations/delusions...

Hi anon

I don’t know where you’re from, but sometimes doctors don’t put information on your file to avoid discrimination in the future for jobs or applying to schools, however, that information is also private, and if that’s interfering with you getting medication and proper treatment then she’s doing it wrong. It is true that you should accept your hallucinations/delusions, but it’s also true that they many times don’t let you lead a normal life and you need medication to get rid of them or at least tame them.

My advice is that you find out how can affect you having the schizophrenia diagnosis in your file, and if that’s not gonna prevent you from getting a job or an education, see a second doctor who will prescribe you medication. Like I said, it changes in different places, in my case, where I’m from (Chile) this information is private but it can stop you from having private medical insurance and you’re stuck in the public health system, but if you chose not to disclose this information to your employers they don’t have to know, unless you get sick and then I say it’s depression never schizoaffective though you can still get fired.(it’s illegal but they do it anyway)

How about the followers, what policies do you have in your countries regarding this issue?

npr.org
Why Air Ambulance Bills Are Still Sky-High
The median air ambulance bill is more than $36,000 and is seldom covered by health plans. So far, legislative hurdles and industry pressure have kept Congress from stepping in. ... Since nearly three-quarters of flights are for patients insured by low-paying Medicare, Tricare and Medicaid, he says, "providers must shift costs to insured patients." ... States are hampered in their efforts to ease the strain for residents. The Airline Deregulation Act of 1978, which was intended to encourage more competition, prohibits states from regulating prices for any air carrier, including air ambulances. What's more, many large employers' health insurance is not governed by states but regulated by the federal labor law known as ERISA. So a remedy likely has to come from Congress. And it has proved to be a heavy lift. For example, the committees that deal with regulation of the air industry — the Commerce Committee in the Senate and the Transportation Committee in the House — don't make health policy or regulate health insurance. Last year, some lawmakers sought to let states regulate air ambulances with a provision in the bill reauthorizing the Federal Aviation Administration. But that measure was ultimately eliminated. Instead, the bill called for the creation of an advisory committee to study air ambulance prices and surprise bills. "The air ambulance lobby did a very good job playing defense during FAA authorization," says Gelfand. The panel, which was supposed to be formed within 60 days of the law's enactment date — Oct. 5, 2018 — still has not been created.

Another anecdotal health care story.

Last October, I was having some chest pain and went to the hospital in the US. Had a blood test, EKG, and X-ray, and was sent home after about 90 minutes. (All seemed fine - likely gastric issues.)

My bill, after insurance covered “their share?”

$600, divided among the hospital and various labs.

I have a friend who’s working in Cote d’Ivoire (Ivory Coast). She had a repeat of some strange symptoms: tingling in half her body, dizziness, racing heart. She went to the hosptial there.

She had an EKG, MRI of her brain, and multiple blood tests. All seemed fine; her diagnosis is atypical migraine. (This one is a mystery.)

Her bill upon leaving the hospital?

$0.

What is the Coastal Barrier Resource System (CBRS)?

The CBRS is a system of protected coastal areas that includes ocean-front land, the Great Lakes and Other Protected Areas (OPAs).

Coastal barriers serve as important buffers between coastal storms and inland areas, often protecting properties from serious flood damage. Also, coastal barriers provide a protective habitat for aquatic plants and animals.

The Coastal Barrier Resources Act (CBRA) of 1982 restricted development on the CBRS in an effort to protect the barrier system and prevent future flood damage. If you live in a CBRS area, you are eligible for federally regulated flood insurance only if your property was built before 1982 and your community participates in the NFIP.

anonymous asked:

(I’m in the US) My mom is in the military, which means transition expenses aren’t covered by my insurance. I’m going to be moving out soon, and I won’t be able to afford my own insurance, and I know my parents won’t help pay for transition expenses. I feel stuck. Do I have any options with this?

Lee says:

Depending on what you’re doing once you move out, your college may have an insurance plan for students that you can opt into or you may be covered by employee insurance if you go into the workforce.

If you aren’t going to college or getting a full time job & can’t afford your own insurance, you may qualify for Medicaid! You may qualify for Medicaid even if you are in college &/or working so definitely look into that. Most Medicaid insurances cover transition, but it depends on the state.

This post has more info on insurance.

There’s a Facebook group that might be able to help too: Medicare and other health insurance transgender surgery information.
What is a Non-Special Flood Hazard Area (NSFHA)?

A Non-Special Flood Hazard Area (NSFHA) is an area that is in a moderate- to low-risk flood zone (Zones B, C, D, and X Pre- and Post-FIRM).

However, it’s important to note that structures within a NSFHA are still at risk. In fact, over 20 percent of all flood insurance claims come from areas outside of mapped high-risk flood zones. Get the facts before you decide that your property is not at risk.

What is a Special Flood Hazard Area (SFHA)?

Land areas that are at high-risk for flooding are called Special Flood Hazard Areas (SFHAs), or high-risk floodplains. These areas are indicated on Flood Insurance Rate Maps (FIRMs).

In high-risk areas, there is at least a 1 in 4 chance of flooding during a 30-year mortgage.

majorxbuddyxboy replied to your chatan actual convo I just had:

do people not…do people not check what insurance covers…before they sign up for it?

Nope! Most people are entirely ignorant that Home & Auto insurance (generally speaking, as every US state has different insurance laws):

  • Does not cover mechanical breakdown and/or wear and tear
  • Does not cover you for utility bills resulting from broken utilities services
  • Does not cover for damage occurring due to shoddy craftsmanship
  • Most companies are only going to give you actual cash value for your roof, meaning the depreciated value of the roof, not the actual value to replace the damn thing (like in the event of a storm/tree falling on it/etc)
  • Does not cover nuclear war, terrorism, or meteorite strikes (separate endorsements can be purchased for terrorism, and likely the other two but I’m not 100% on that one)
  • Only covers the estimated cost to rebuild a home, does not include the land value
  • Is a binding legal contract once you sign the damn paperwork
  • Is a risk pool, wherein people pay premiums calculated by the company based on risk assessment algorithms into a money pool from which claims can be paid back out. I once explained this to a gentleman who started raving about how that’s unAmerican and “sounds a lot like socialism”
  • This is why car insurance premiums generally are more expensive in urban areas and home insurance premiums are more expensive in rural areas; the risk for accidents in cities is greater, mathematically speaking, and in rural areas it’s more difficult for first responders to get to say, a burning house to save it.
  • Claims on Home and Auto (or ‘Specialty’ like motorcycle, boats, rental homes, etc) will last THREE YEARS. Water claims stay on your record for five years; however after the three year period companies will more likely be able to write you again, but that water claim will still affect your premium for another two years.
  • Is actually necessary because humans are notoriously bad at assessing risk without the assistance of computational algorithms. That doesn’t mean that big insurance companies won’t gauge you though, so it’s good to shop around, but…
  • If you shop around every year for home and auto, that will show up on your auto insurance record, and might also negatively impact your rate.
  • Is also based on your credit score, age, and other factors. Every time you do an insurance quote, there’s a soft check on your credit (so it won’t affect your actual score).
  • Goes up every year with inflation, as well as with the rising cost of materials and labor. Even if you have a 15+ year old car, it’s still going to cost more to replace it every year because of inflation and because it’s literally just more expensive to maintain and repair heavy machinery, for the above reasons.
  • Doesn’t necessarily cover everything that’s insured. I kept hearing people squawk that Notre Dame will be fine because it’s insured, but… that doesn’t necessarily mean squat. This is mostly some speculation because I am not familiar with French insurance practices, but here in the US if you have a decent company, and your home burns down, you have to go through a claims process. If the house is deemed to be of an “acceptable loss”–i.e., if the cause of the fire is covered under your policy provisions–that must be determined first. And then, there’s the matter of cleaning, restoration and rebuilding, as well as replacing contents. The rebuilding takes priority, and can take up to or over a year. Replacing contents can take even longer if there was a total loss on the home.
  • Notre Dame would be considered a partial loss. However, what complicates things further is that it is an extremely old building. There are, no doubt, provisions in its insurance policy that cover historic preservation and restoration in the event of a covered loss. Here’s where things get even weirder. You can’t just insure a building for a billion dollars when the estimated cost to rebuild is only, say, $50,000,000. No company in their right mind would do that. Notre Dame may be covered for restoration, but there may be policy limits regarding the particular restoration materials and methods used, plus there’s the cost to prevent further damage while the restoration is occurring, and all the monetary ails involved. That’s nothing to say about adhering to modern building codes besides, which hopefully is also covered for the cathedral (as a historical monument I’m sure it is).

This only applies to US property and casualty (I am licensed in the state of Tennessee) and while every state is different, there are commonalities like the above on how the mechanics and principles go. I’m not sure how it works in other countries but I’d imagine it’s somewhat similar.

Sorry for the long post, but these are just some things that Grind my Gears and more people really ought to know about property & casualty insurance coverage.