Wanna fight?

[Deborah]

I've never heard of the term "dual coverage". Where can I read about it?
I had forgotten that MediCARE covers disabled and renal failure, but is it only those who have long-term disabilities? Just curious how someone could be in both CARE and CAID.

And my point, in case it wasn't clear, was that it's not only the middle class that get shafted, but about 60% of the population, including some of the middle class. That's if you look only at the person's/family's earning ability to determine class status. In that case, I'd say 60% of the population are working class and poor. The cried that the "middle class is shrinking" are true? It's not a conspiracy theory.
Instead of facing this reality, the government simply increases the poverty levels every year soes it doesn't look as bad as it is and to avoid paying benefits to a growing populations of needy. Only the destitute and disabled get aid, a small percentage.

[try another castle]

Oh no, I totally agree. The middle class is a rapidly shrinking population. I don't really know anyone in my life who is middle class. We are all relatively poor, and our parents are either right along with us, or upper-middle to upper class.

I don't know if the term is officially called dual coverage. It just means that you are on medicaid and medicare. If you are on medicaid, and are also on SSI or SSDI, you will receive an invite to join medicare after about a year. It's really not an invite, actually. You are required to join. It's like one of those record of the month letters... if you do nothing, you will be enrolled. You get parts A and B. Now, of course, you also get part D, which is the drug coverage.

A lot of people who are on federal disability have dual coverage like this. It's really the best way to go if you're poor and disabled, because medicaid serves as a supplementary insurance, so whatever medicare doesn't cover in terms of doctor's costs, medicaid will. Although I'm sure it varies from state to state.

[Deborah]

Okay, I'm too lazy/tired to go look it up. Are you saying that if one has a long or life time disability then they are required to go on CARE for part A (hospital expenses), and CAID covers part B (regular medical expenses).
As it pertains to retired persons, they have part A through CARE and must purchase part B through a private provider.
Wondering why its not the same with disabled. Guessing that it's assumed that they can't pay for part B, so it's covered by CAID? Or covered by CAID if they are eligible.
Is that accurate?
And I don't think this is true for poor, only disabled.

And are disabled required to get part D? Not so with retired, it's optional.

[try another castle]

If you are disabled and receiving social security, and have medicaid, you are required to be on medicare when they offer it to you. Although I'm sure you can get it beforehand if you want. Parts A, B and D are all medicare. It's just that when a doctor or hospital bills medicare, medicare won't always cover the entire cost. Whatever is left over afterwards is then picked up by medicaid.

[Carmel]

Im not sure this still rings true for Medicaid, it did when I had coverage for my first pregnancy, but at least when you have coverage...you have COVERAGE.  I mean that they dont nickel and dime what they are gonna cover for you.  Again, this may have only been my experience under a certain circumstance...but it beat out any private insurancce by a mile.  I didnt pay 1 red cent to have my first child, and they covered her for 2 whole years after birth.  That was 10 years ago, however under my current "private" insurance...I often find myself wondering why I have coverage at all.  They only pay a certain percentage of the standard care regimen and then they gouge you with lab and ultrasound fees.  And prescriptions? FORGET IT.  If you get lucky and get prescribed something they even cover, generic or otherwise...its still at least half that you pay for.

The actual baseline COST for healthcare services is another issue entirely.  Talk about a racket.

I never felt guilty about telling a lie about my circumstances to get the coverage either back then.  To be honest, my situation was certainly qualifiable (no job, unwed mother) just not according to their standard.  Had I even mentioned that the father was still with me I would have had a hell of a time, even if HE were jobless and homeless.  Even trying to get coverage for you kids in the state provided programs is impossible if you are married.  Besides, Ive paid for it ten times over in payroll contributions since then anyway.

[try another castle]

I never felt guilty about telling a lie about my circumstances to get the coverage either back then. To be honest, my situation was certainly qualifiable (no job, unwed mother) just not according to their standard.

My old psychiatrist joked that medicaid turns people into criminals, because almost everyone has to falsify their records in order to qualify.

When medicaid still did drug coverage, there was some arguing sometimes about what they covered, but it was normally resolved. I know that I was only allowed to fill 6 prescriptions a month. Anything more than that, or if it wasn't on their formulary, and you would have to submit a TAR, which could take up to a week to clear. However, if you had a good repor with the pharmacist, they would normally advance you some pills.

I know that I actually have an easier time with medicare part D drug coverage, but that's because I chose a good provider with a huge formulary. That's the tricky thing, you have to know the ins and outs of the system to get ahead. I didn't even bother with the book medicare sent me. It came with a phone number, so I used it. I gave them a list of all my meds, told them what pharmacy I used, and they gave me a top 3 pick. Then I called my pharmacist and listed off those three companies and asked him which of those three were the least pain the ass to deal with. If you are EVER in doubt about an insurance drug plan, ALWAYS call your pharmacist. They deal with these fuckers every day and know who is difficult and who is not.

[Oz girl]

it amazes me that in a system where you have to pay for health insurance unless you are really poor, you are only covered by 1/2.
Does your employer pay your insurance Carmel or do you do it yourself?

[Carmel]

it amazes me that in a system where you have to pay for health insurance unless you are really poor, you are only covered by 1/2.
Does your employer pay your insurance Carmel or do you do it yourself?

I am actually under my husbands benefit program.  So technically, its his employer.  We still pay around 100 dollars a month for the coverage though, thats outside of our medicare/medicaid deductions.  It covers both of us and our children.  Its still cheaper than private insurance, which can run around 300-600+ a month....not to mention private insurance almost never covers maternity care, which is what is typically most needed...along with childrens well-care.

[Deborah]

Looks like the trend for the future may be Mandatory Health Insurance

http://fornits.com/wwf/viewtopic.php?t=16494

[Antigen]

How do these poor people get money? Breaking into the establishment. Working for an extremely low minimum wage because regardless of what kind of profit their employer is making they will pay what they want? By picking it from a money tree?

No, you just go into business for yourself doing whatever you're willing to do for whomever is willing to pay you to do it without even thinking about getting permission from or paying taxes, fees and other kinds of extortion to government.

[Antigen]

Even if in some states of the US hospitals are abliged to treat those who come through the ER dept regardless of their ability to pay, what about all the other medical conditions which are more minor? Nobody is abliged to treat those.

That's nation wide as far as I know. And the preverse effect is that people who can't afford private medical care go to the ER for everything from a cold to a skinned knee. That's why you wait forever to be treated.

[Antigen]

Know anywhere a family of 4 can live for $400 a month?

Yeah, my neighborhood. Or pretty close to that, anyway. This is the land that time forgot in so many ways.

[Antigen]

http://liberalvalues.org.nz/

[try another castle]

Even if in some states of the US hospitals are abliged to treat those who come through the ER dept regardless of their ability to pay, what about all the other medical conditions which are more minor? Nobody is abliged to treat those.

That's nation wide as far as I know. And the preverse effect is that people who can't afford private medical care go to the ER for everything from a cold to a skinned knee. That's why you wait forever to be treated.

Exactly. SF General is the one indigent hospital in the city, besides the Tom Waddell clinic. If you go to the ER at General, you are normally waiting there for about five hours. Fortunately, there is a family health clinic in the hospital, where you can get what amounts to a primary care physician, and then you can make appointments to see them as needed. Unfortunately, most people who go to the ER don't know about it or don't bother to investigate. You definitely have to be resourceful and actually have the smarts to ask questions about other means of treatment.

The other reason the waits at SF General are so long is that it is the only trauma center in the city. I know. San Francisco, and only one trauma center. They are dynamite, though. They specialize in gunshot wounds.

On the whole, San Francisco has a pretty good set up for people who don't have insurance, and can provide medical care for physical and mental conditions. This includes people who are here illegally. (SF never really adhered to prop 187.) You just have to actually get off your lazy ass and find out about them, and stop thinking that the ER is your only recourse.

Fuck, it beats Kaiser, IMO.

Apparently, SF is drafting up a citywide plan to provide health insurance to the uninsured. I have no idea what the status is on this, though.

[Oz girl]

But why is paying tax extortion? If you want to go to public school or drive on sealed roads, or even get and recieve mail then what is so bad about tax? I live in a country. I use it's essential services, it is fair enough that i pay tax. i would be prepared to pay for services that i rarely use like public health and education in the knowledge that fellow citizens and residents have access to such essential services.

As to the Idea that an ER dept is used like a GP surgery this to me seems just wrong. It makes emeregencies harder to tend to and people with more minor ailments cant possibly get the amount of time and attention they need in a proper surgery. And what of routine checkups like Pap smears and innoculations? How do all the people not ocvered by insurance get them?

There is a similar mob in Australia to that New Zealand link Cassandra but i can not for the life of me remember what they are called. Will try to find the link.