To be sick in the US

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afidz

afidz

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Joined
Jun 7, 2012
Messages
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If you live in the US, you know that once you turn 26, you can no longer be covered under your parents health insurance.
Guess what age I am turning in 10 weeks?
I AM SO STRESSED OUT.
It is IMPOSSIBLE for a sick person to be able to afford insurance. Great, Obama made it so pre-existing conditions can't be held against you. Its great that you can't be charged more because you have a health history. And, its even better that most of the states are changing their medicade laws so people that need it can get it. You know whats not great? Living in a state that hates Obama and his health care reform. (this is NOT a political discussion, please don't be deterred from the subject)
I can't work. There is absolutely no way. If you follow my story, you know why. Therefore, when I file my 2014 taxes next month, I will have a big whopping ZERO for income. My boyfriend supports me.
I can get insurance, but I can't get assistance in paying for insurance because I didn't make enough money. YUP. Didn't make enough money to qualify for assistance. Tell me how that makes sense. So the healthcare.gov people's solution is medicade because "most states are reforming their medicade laws". Not Texas. I tried getting approved for medicade, since I am below poverty. Unless I get knocked up or approved for disability, I can't get it. So I can't afford health insurance, I don't make enough money to qualify for assistance to pay for health insurance, and I don't qualify for medicade. I have 10 weeks to figure this out.
 
Ugh, I'm so incredibly sorry you have to go through this, Afidz. I routinely wish I could just bring all my American friends over to Canada with me so they could have access to our healthcare instead. :hug: I hope you can find a solution, somehow.
 
Can you get a disability lawyer ...
Most times that is what is needed so the claim for ssi goes through .
A little more up front but bigger savings long term in the end .
Might be worth asking around at least
 
Hey, hey, don't stress-out yet, have you been working? Please go down to your social security,,and sign up for SSDI[ if you worked long enough] or SSI,, and even if you don't get on ssdi,ssi, yet,, you still should be able to easily get Medical insurinse that will literaly pay for everything if you get SSI, but you will only get like $6-$700 dollars a month, but you should be able to get it. It may take a while to get on it, but same your Dr. bills, prepsrciptions bill, they will remimburts,, but , you NEED to go down now to fill out everything, you should have been down there at 18 years old,, atleast for the medical.. You need to do it now....I'm serious..Rodney
 
Afidz has already applied for Disability through Social Security and is using a lawyer. She's already been denied twice (which boggles the mind if you've read her story).

Ashely, have you written your local congressmen or higher even to bring this issue to their attention? I know that would never be a quick fix even if they did read your letter but I'm running out of ideas myself. :(

Also junae, your numbers are way off. The amount is different if you have SSI and/or SSDI, it's also different depending on how much you worked or what your income is and it's different in each state.

Afidz, have you applied for assistance with the Johnson & Johnson Patient Assistance Foundation to help with the Remicade cost? http://www.jjpaf.org/eligibility/index.html You'll need to speak with your GI and work something out with them because they need to prescribe it in order for you to get assistance. Also apply for Remistart as well. http://www.remistart.com/
 
I've been denied 3 times, I'm on my fourth. My lawyers are working on my appeal.
I can't get Medicade because I'm not pregnant or labeled disabled. Texas state law.
Right now, I'm not paying for Remicade, but I will be by my next dose so I will look into it
 
Hi, Don't give-up appealing the SS, don't let the denies go past the re appeal date go past, it took me 4 times before I had to go to court,,I went without a lawyer, Judges really like to see people without lawyers, I felt like I'm not giving a lawyer that did nothing for me for years, im not giving him 1/3, 1/4 of a 4 1/2 years of being super poor noincome ,worst time in my life,,if your sick, they know about C.D. just go in to court and just like the Crohns do its job, and just embellish the pain, because we know if that was somebody without C.D. they would probably be in TEARS, we just learned how to deal with pain much easier that most anyone.. Sit and stand every few minutes from back, bowel issues and keep putting your arm to your belly because of the pain,, tell him/her you cant be dependable because of being so sick from C.D. and its By-issues,[Malnurishment, anemia, always tired, dizzy when standing, maybe arthritis in your bones,,if you are in court sitting and standing this will let them [ a employment agence will be there to see if you can do sit down work] getting up down says that you cant be comfortable for more than a few minutes,, and there are no jobs for sick people...The great thing about all this , is, web DONT have to LIE,, just say exactly what is happening to your body and how it stops you from working more than 1 hr. so you/I cant hold a job because of this....Don't be afeid to go to court the judges are mostly nice and understand, so just show all your pain so he knows that you cant work like this...
 
The amount varies from person to person. If I get approved I will get about 1k a month.
Telling someone not to get a lawyer is horrible advice. There are things that lawyers know that we do not, plus they have experience and report with the judges. The most that a lawyer can charge is 6k unless there are special Circumstances.
 
I didn't say DONT get a lawyer.. Im telling though Judges like and Rather see a REAL life sick person, not someone that needs to prove to him by somebody else [lawyer] Ive don't it and he told me this out right..I don't just say anything...and first of all I was ONLY guesstamating on a basic average I wasn't saying that's what it is, it was just to give EXAMPLE.
 
Last edited by a moderator:
Please keep your responses civil junae. Thank you. :)

Afidz did go to court. The judge saw it all and she was still denied. It's not always that easy unfortunately.
 
I'm so sorry to hear you're going through all of this afidz. :( I wish I had some ideas for you. But for what it's worth, I want to give you all the hugs and support I can from across the states! :hug:
 
Hello afidz

Unfortunately I cannot imagine what is like for you to have CD and live in the US where you need health insurance.

I just hope that you can get something sorted in the next few weeks.

I am sending you my very best wishes and hugs from across the pond.
Take care
 
I have been on the phone with blue cross blue shield. I have been doing a lot of research online about my situation and I think I found a solution. I just have to keep calling until I get a representative that knows what I am talking about.
My boyfriend pays all of my living expenses, I don't have an income and I lived with him for all of 2014. He can claim me as a dependent on his taxes. According to health insurance law, that makes me family. But every time I call BCBS they say "no, you have to be married." Finally the last time I called, the guy that I talked to actually took the time to look up the loophole and he THINKS we can get a policy together. I have his direct number. Andrew IS eligible for payment assistance, so I can afford the policy that I need, We jus thave to wait for tax season to start to be able to prove that he can claim me.
 
I so hope this approach works afidz. Good luck!

What is the law regarding defacto relationships? I am gobsmacked that the insurance company is saying they only recognise the definition of a family as a married couple?! I have never been married and we have family private health insurance coverage, different country I know.

Dusty. xxx
 
Most states after living together for 10 years -you are considered "married" under the law as some other term.
just a side note may not apply on your case
Some employers are no longer covering spouses at all starting in 2015 .

Hope you can get through this one .
 
I don't know about any other state, but in Texas in order for it to be considered a common law (or I think what you are talking about Dusty) is we have to live together (check) age to be married (eh, we know we will get married, does that count) and you have to hold yourself out to the public as husband and wife (we don't)
We have been living together for 3 years, been together for 5. Yes, eventually we will get married, but it will be an actual wedding not a common law. I am crossing my fingers thatthis works. I really cave afford 300+ a month plus paying for any expenses
 
my little penguin said:
Most states after living together for 10 years -you are considered "married" under the law as some other term.
Click to expand...

Whoa, ten years. :ywow:

afidz said:
I don't know about any other state, but in Texas in order for it to be considered a common law (or I think what you are talking about Dusty) is we have to live together (check) age to be married (eh, we know we will get married, does that count) and you have to hold yourself out to the public as husband and wife (we don't)
We have been living together for 3 years, been together for 5. Yes, eventually we will get married, but it will be an actual wedding not a common law. I am crossing my fingers thatthis works. I really cave afford 300+ a month plus paying for any expenses
Click to expand...

Yes common law, we don’t use that term in Australia. Well you are of an age to be married. :) But what does holding yourself out to the public as husband and wife mean and how do you do that?
It sucks afidz. As far as I know in Oz, once you are living together as a couple in a domestic situation you are deemed to be in a defacto relationship, there is no time limitation. After 2 years you have the same rights as a married couple under the law if you split up and there is property to be determined…length of time spent living together, contribution to the relationship and so on.

Dusty. xxx
 
Holding your self out to in public to be married is simply just telling people that you are husband and wife even though you aren't married. "My husband works at..." "My wife's family is in town this weekend" That sort of thing.
As long as Andrew can claim me as a dependent, it should all work out. I am not going to count my sheep until it hatches. But this is why I brought up a health insurance forum. If a few months from now someone runs into a similar situation- I would be able to give them advice. Our system is so screwed up (unless you are healthy and don't really need it but once or twice a year)
 
:rof:
"I'm not going to count my sheep until it hatches"
Its been a long day. Apparently sheep hatch!
 
I really hope it all works out for you! You've gone through so much, you should be proud of yourself for continuing to fight.
 
I got the proof I needed to prove that Andrew can in fact claim me as a dependent, so hopefully something goes through when I call Blue Cross Blue Shield on Monday.

As of right now, I don't have insurance. Hopefully nothing happens between now and February 1 when the new insurance would start. I have Remicade on the 22nd. I am going to try to get assistance from Johnson and Johnson for my next dose, calling them on Monday as well.
 
Move to New Zealand we don't have to pay in the hospital but unless u go to the a&e u be waiting monthes to be seen the gp for me they cost $43 a visit
 
The person I have been talking to at Blue Cross Blue Shield finally came through. I CAN go on my boyfriend's policy because he pays for my living expenses.

PHEW.

Going to be on the phone tomorrow with the Market exchange or whatever Obamacare is called and getting insurance to start on February 1st. I can breath again.
 
Oh, thank goodness!!! :dance: Glad you've finally been able to get somewhere and be able to get taken care of! Hopefully after tomorrow things will start calming down with this for you... :hug:
 
I found out some great information about Remicade and health insurance (in the US, of course). I am going to post it in the treatment section at some point today, but I think I'm going to make it through this headache after all!
 
I spent 2 hours on the phone yesterday just trying to get insurance that I can afford. I was told the same thing, the health care market place can not give me a discount because I am too far under the poverty level and texas has not expanded their medicade laws.
I have no choice but to pay full price for a plan that I can't afford. I have student loans that I use to cover my living expenses until I either go back to work or get approved for disability. I am going to pay enough up front for the premiums to get me through September. By then I am HOPING I will be back to work to where I can afford to pay for the premium, be on a company insurance, and/or recieve more student loans because it is a school new year.

The good news is, my health care will be free for the remainder of the year because Remistart will take care of my deductible and out of pocket max. At least I have that going for me, I guess
 
I'm reading your reply a second time in the hopes to be able to reply better. But, I'm afraid all I can come up with is to tell you how sorry I am with all that you've been through and are continuing to go through. I know I've said it many times before. But, you don't know how much I wish we lived closer so I could give you some real hugs for support.
 
Thanks Cross Stitch.
I feel like I'm being punished for being sick. I'm tired of everything in my life being complicated. And most of all I'm tired of pretending like **** doesn't bother me. Anyways, I found a solution. It's still crappy and more money than I can afford. But I don't have a choice.
 
Good news!
I was approved for the Johnson and Johnson patient assistance program for Remicade. My next dose of Remicade will be free and it will give my doctor plenty of time to approve Remicade on my new policy.
 
May I just say that your man is amazingly generous? That can not be easy for him, but that is love, right? :) I'm so glad you are getting things straightened out. As a fellow Texan I am curious to hear what happens next.
 
My boyfriend is absolutely amazing. Words can not express how grateful I am to have in my life.
 

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