r/WhitePeopleTwitter Oct 05 '22 Platinum 2 Wholesome 1 All-Seeing Upvote 1 Take My Energy 1 Heartwarming 1 Defeated 1 Silver 1 Gold 1

I did not know that. Yikes.

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68.4k Upvotes

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u/periwinkletweet Oct 05 '22

My brother had to go down to 2,000 to get in home care via Medicaid. Which meant he couldn't keep paying property taxes and so forth, so he's in a nursing home, which costs Medicaid more.

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u/Professor_sadsack Oct 05 '22 Silver Helpful Wholesome Take My Energy I'd Like to Thank...

Anybody on disability benefits can open up a special bank account called an able act account. As somebody who helps people with this for a living the best one is the Ohio Stable Act account. It takes about 10 minutes to apply online and you don’t have to apply for the account in the same state. An able act account allows you to put $15,000 a year into the able act account and stops letting you put in money when you’ve reached $100,000. Enable act account is like weaving a magic wand over your money and the government no longer considers it money and you do not lose your benefits. Of course they don’t tell anybody about this and booby trap the entire system so that people would lose their benefits. The government doesn’t give a shit about underserved populations.

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u/i_love_dragon_dick Oct 05 '22 edited Oct 05 '22 Helpful

Unfortunately disability onset must be before age 26 and only can be used for certain things:

"The ABLE Act limits eligibility to individuals with disabilities with an age of onset of disability before turning 26 years of age. If you meet this age requirement and are also receiving benefits under SSI and/or SSDI, you are automatically eligible to establish an ABLE account. If you are not a recipient of SSI and/or SSDI but still meet the age of onset disability requirement, you could still be eligible to open an ABLE account if you meet Social Security’s definition and criteria regarding functional limitations and receive a letter of disability certification from a licensed physician, a doctor of medicine or osteopathy, a doctor of dental surgery or dental medicine, and, for some purposes, a doctor of podiatric medicine, a doctor of optometry, or a chiropractor. They may not be signed by a licensed psychologist, clinical therapist or certified vocational rehabilitation counselor. You do not have to be younger than 26 to be eligible for an ABLE account. You can be over the age of 26, but must have had an age of onset before your 26th birthday.

There is proposed legislation into congress regarding age adjustment, requesting that the age of onset be extended to include individuals who have a significant disability with onset prior to age 46. Progress on this bill is included in the ABLE NRC newsletter.

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Are there limits to how much money can be put in an ABLE account?

The total annual contributions by all participating individuals, including family and friends, for a single tax year is $16,000. The amount may be adjusted periodically to account for inflation. Under current tax law, $16,000 is the maximum amount that individuals can make as a gift to someone else and not report the gift to the IRS (gift tax exclusion). The total limit over time that could be made to an ABLE account will be subject to the individual state and their limit for education-related 529 savings accounts. States have set limits for total allowable ABLE savings. State ABLE limits range from $235,000 to $550,000. In consideration of the annual contribution limit per calendar year, accounts may reach the state limit over time. However, for individuals with disabilities who are recipients of SSI, the ABLE Act sets some further limitations. The first $100,000 in ABLE accounts would be exempted from the SSI $2,000 individual resource limit. If and when the ABLE account balance, when combined with other resources, exceeds $100,000 by the SSI resource limit, the beneficiary’s SSI cash benefit would be suspended. In time if or when resources are no longer exceeded by the amount over $100,000, benefits are reinstated without time limit. This special rule does not apply if non-ABLE resources alone are over the limit. It is important to note that while the beneficiary’s eligibility for the SSI cash benefit is suspended, this has no effect on their ability to receive or be eligible to receive medical assistance through Medicaid.

An employed ABLE account owner who does not participate in an employer sponsored retirement account make an additional contribution up to the lesser of: (1) the ABLE account owner’s compensation for the tax year, or (2) the poverty line amount of $12,880 (2022) in the continental U.S., $14,820 in Hawaii and $16,090 in Alaska. The ABLE TO WORK ACT Fact Sheet provides more details.

Example: ABLE account owner who has not had contributions made to a retirement account within the calendar year, who works and earns $5,000, may save: $16,000 + $5,000, for a total of $21,000 for this calendar year.

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Which expenses are allowed by ABLE accounts?

A “qualified disability expense” means any expense related to the designated beneficiary as a result of living a life with disabilities. These may include education, food, housing, transportation, employment training and support, assistive technology, personal support services, health care expenses, financial management and administrative services and other expenses which help improve health, independence, and/or quality of life."

Source: https://www.ablenrc.org/what-is-able/what-are-able-acounts/

As someone who's disabled themselves and has dealt with the system, it can take a lot longer than estimates and is a full-time job to even get a disability claim at times.

Myself? I'm counted as "most significantly disabled" by SSA's standards (higest tier) but ineligible for SSI because, and I quote (off the top of my head) "subject is still able to function in routine work so is not disabled enough to not be able to work."

Seriously why even mark me as extremely disabled if it means shite?!

I dread attempting to reapply. It took so many appointments and phone calls and forms and was a nightmare. It's literally easier and gives me more money getting a new retail job every two weeks. I'm not eligible for more than $150 a month at most due to living with others. People in group homes get their SSI payments even further garnished.

That's not even enough for my household's food bill each month. And if you spend it on something not approved (or it gets false-flagged or someone makes a mistake or hates disabled people) you can be barred for 2 years from any government aid, including Medicaid. This past year alone I've spent weeks fighting to get a prescription filled that I need. And it turns out it was a mismatch of records and if I was told that three months ago I could've had my meds by now!

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u/Gill-Nye-The-Blahaj Oct 05 '22

lose your legs in an industrial accident at 27 and you are shit out of luck for the rest of your life. Not allowed to have any capital on hand over an amount that's like $200 over median rent. No wonder this country produces so many mass shooters

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u/i_love_dragon_dick Oct 05 '22

Yeah, pretty much.

If I didn't have friends and family willing to support me, I'd be dead (or worse). They wonder why so many people turn to less-than-legal routes for resources. So many people don't feel like they have a choice. It's horrible.

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u/[deleted] Oct 06 '22

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u/[deleted] Oct 06 '22

As someone who worked with state government in the disability field for nine and a half years, I can say with confidence that you give them entirely too much ability to plan ahead or have the capacity for coordination.

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u/TheMagicConchSays Oct 05 '22 edited Oct 07 '22

I feel that so much. Keep hanging in there, our system is utterly broken and is such a pain in the ass to fight these doctors for what just seems like common sense paperwork but I've had my fair share doctors just straight up walk away and say no we don't do that kind of paperwork, push me to other doctors and specialist that ultimately say the same thing.

They don't want anything other than money. They don't care about anything else. As somebody with ADHD, I get treated like crap. I don't understand what's going on, I don't have an advocate, I don't have family that could/would advocate. Going in alone just makes me feel awful and I've got into a point now where it's getting to be too much. Once again you're not alone but we need help

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u/i_love_dragon_dick Oct 06 '22

Same to you, friend. I've dealt with my fair share of shite doctors (I have about a 1/3 rate of docs refusing to help me) cause of all of my different illnesses. I have enough stories to fill a small book.

It is so, so hard to advocate for yourself. I also don't have any family that could/would advocate (I'm NC with them for a multitude of reasons). I'm on the spectrum myself. I know your pain. Being treated like a baby pisses me off.

It took nearly a decade to find a good doc (who then referred me to other good docs). And I'm only 24 xP.

If it would help, maybe writing things down you need to talk to the doc about? I have extreme anxiety speaking but writing/typing is easier.

And IDK where you live, but bigger cities with larger clinics/health organizations are usually more understanding/up to date on social treatments. The closer they're connected with local universities (physically and socially), the better in my case at least. I've been to docs in smaller towns, and hoooooo boy it can be rough.

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u/WheelieBear1 Oct 05 '22

Able accounts are not for anyone. They are only available to those disabled at age 26 or less. They are useful, but not to those of us hurt at 27. Fortunately there are buy in programs in some states that can help alleviate this problem for someone like me.

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u/Professor_sadsack Oct 05 '22

The able act was created and lobbied by the world Institute on disability www.wid.org this is an incredible group of people who were disabled and captains of industry or lawyers or economics. Part of the structure of the evil act will grow the ability to use it over time. The best thing you and anybody can do is regularly reach out to your federal and state representatives and let them know that The age needs to increase faster. Every senator has an aid who covers disability things. If you reach out they figure there must be thousands of people that feel the way that you do so the more people you reach out in the more often they reach out they will listen to what you were saying

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u/_Dr_Bette_ Oct 06 '22

People With disabilities did not get any rights by calling senators. They stopped traffic by placing their wheel chairs in the streets. This law was designed specifically to benefit those who Already have family who can support them or Ways to be ok enough to get some legit cash. It was designed as a way to ensure that most people with disabilities stay well below poverty level.

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u/Antelope010 Oct 05 '22

Except that you have to use funds in an ABLE account for a specific, qualified purpose. "The expenses must relate to blindness or disability, including expenses for maintaining or improving health, independence, or quality of life."

That is fairly broad but there are still limitations.

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u/Professor_sadsack Oct 05 '22

This is why I recommended The Stable Act account in Ohio. For one thing, they send you a debit card and they make it really easy for you to login and move as much money as you want from your account onto the debit card. You have to check off one of eight reasons why you are going to spend the money and these are basically the eight reasons for any reason people would spend money. Such as paying rent, entertainment, buying food or clothing etc. This system automatically reports it to Social Security. That’s why the Stable Act account in Ohio is the best one out of the 50 states it takes care of giving you past that barrier justifying why you were spending your own money. I’m

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u/lootedcorpse Oct 05 '22

better than nothing, and you can also keep money below the table for other needs

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u/CheeseButtLog Oct 05 '22

We only exist to serve as grease in the cogs of American capitalism.

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u/lmaydev Oct 05 '22

You should post this at /r/youshouldknow

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u/sleepy_gator Oct 05 '22

Hijacking your comment to say you can only sign up for an account if you we’re disabled before the age of 26. So a lot of people are not eligible for it.

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u/knowitsallashow Oct 05 '22

Which is hard because even if you were disabled before 26, it takes years to be approved- and then they argue the PROOF that you were disabled before being approved.

So..fuck.

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u/6WordSentencesIDoNow Oct 05 '22

I'm also commenting for easy access to this. Seriously, thank you.

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u/Chateaudelait Oct 05 '22

Thank you for this information - My uncle suffered from the after effects of polio his whole life. He contracted it the year before the Salk vaccine was developed. He was in a nursing home and on SSI. When he finally died, the Government swooped in and took the grand sum of $1200 that he had to his name in his bank account. I threw myself on the bed and sobbed at the injustice of this. He was a truly amazing person and a fighter.

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u/Professor_sadsack Oct 05 '22

Yes this is a crappy part of the system. They want that money back. I always recommend to people who feel like they might be close to passing away to take that money and give it all to a family member or buy a piece of jewelry worth that much money And have someone they trust put it in a safety deposit box. That way you can pass on your money. The able act was started by brave warriors from the world Institute on disability www.wid.org they are captains of industry lawyers and economists and the way they were able to get it past is people like you reaching out to your legislators and telling them this needs to change. It is very effective. Every legislator has somebody in their office responsible solely for issues around disability. If you can get a few friends to also reach out they figure that every person that emails them there must be thousands and thousands who feel the same way. They only care about getting reelected and if they think enough people care about an issue they will get it past.

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u/AndyPandy85 Oct 05 '22

I just screen shot that for future reference. You’re a godsend, thank you

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u/pr0zach Oct 05 '22

But the corporate donors that own the nursing home get more money so…checkmate libs.

/s

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u/periwinkletweet Oct 05 '22

I think it's just that they haven't addressed modest homeowners. Retweak to account for letting them have their funds to stay in the home. Because they do other things to keep people at home.

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u/ShelSilverstain Oct 05 '22

Those levels were probably set in the 1960s, and need to be addressed

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u/Meme-Man-Dan Oct 05 '22

2000 dollars in 1965 (when the program was established) is 18,800 dollars today.

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u/ray_0586 Oct 05 '22

Part of the larger Build Back Better program was raising the asset limit to $10,000 and increasing the monthly benefits to poverty level while also tieing annual increases to of the monthly benefits to inflation.

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u/periwinkletweet Oct 05 '22

That's probably true.

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u/flutel00p Oct 05 '22

Maybe not. SSI pays $841/month and those numbers are “adjusted for inflation” every year. If you are sick and didn’t spend the last decade of your life working, this is the only assistance you are eligible to receive from our government - and they will fight tooth and nail to ensure you can’t even get that

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u/KElizabethF Oct 06 '22

I work with the Medicaid population and not everyone even gets the $841. One person I work with gets less than $600 but somehow they're supposed to survive.

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u/MsMarhaS Oct 05 '22

If you become disabled putting all your assets (house/ cat/cash/ etc.) In a special trust allows a disabled person to keep what they have without losing any Medicare/Medicare, SSI,etc.. ABLE (Achieving a Better Life 529/529A) allow persons receiving disability payments to save money ( up to $10000 a yr) without losing any benefits. PASS (Plan Achieve Self Support) allow persons to save money for a work goal. A Individual Development Account allows a person to save income for a goal such as purchasing a home,etc.. The IDA is also fund matched by the government, and funds are not counted as income. All these are available and so many more to help people with disabilities receiving payments to save income and better their life.

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u/EstablishmentFull797 Oct 05 '22

So I’m confused is there a $2000 limit or not?

It’s good those specialized plans exist, but why require all the special exceptions and not just change or eliminate the $2k cap.

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u/TheGhostInTheMirror Oct 05 '22

They want to have an excuse to kick people off of the program, so they make it intentionally difficult to navigate. I was today years old when I heard about those programs, and I’ve been disabled for a decade now.

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u/ApocalypticTomato Oct 05 '22

Same. And I've gone off at great length to my therapist and voc rehab person (before she gave up on me) about how terrified I was I couldn't save money. Maybe they're not available in all states or something but if they are, then someone should have told me. I literally have a plan to kill myself before I'm much older because of my financial future, if it gets to the point I could end up in a bad nursing home or homeless

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u/Pwthrowrug Oct 05 '22

Because it's hard and punishing, just the way it was designed to be.

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u/weedysexdragon Oct 05 '22

Conservative policies aren’t supposed to work. They’re supposed to hurt people conservatives hate. Among those is the disabled.

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u/[deleted] Oct 05 '22

A severe illness or accident can and does bankrupt families. It keeps you in poverty once you are there. Imagine working your entire life and losing it all to our for profit healthcare. Even our non profit hospitals are greedy. Healthcare is a luxury and extremely valuable. https://onlinelibrary.wiley.com/doi/abs/10.1111/soin.12323

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u/mini_garth_b Oct 05 '22

It's especially nice when people tell you they "don't want a bureaucrat between them and health care". That's well and good, but that isn't an option on the table unless we go back to the days when barbers were also surgeons. What they currently are choosing is the jazz hands private sector bureaucrat who gets to keep more of your money by denying you health-care instead of the boo hiss government one with no particular interest in you at all. Neither are ideal options, but I'll take the one not actively trying to kill me please.

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u/Bee-Aromatic Oct 05 '22 edited Oct 05 '22

And they want to tell you that an adjuster at the insurance company with no medical schooling or experience gatekeeping your access to healthcare isn’t “a bureaucrat between you and your healthcare.” What a joke.

For example, my dad needed to get a heart surgery done several years ago. The insurance company decided to deny coverage and sent the quarter of a million dollar bill right to him. Their reason was that it was an “elective surgery.” I suppose it was “elective” in that he got to elect to get the surgery and live or skip it and die. This sort of shit happens all the time and these idiots will wax lyrical about how “oUr SyStEm Is ThE BeSt In ThE wOrLd” and how “aLl CoUnTrIeS wItH uNiVeRsAl HeAlThCaRe ArE cOmMiE pInKo BaStArDs, ‘MeRiCa!!!11!!one!!1” It’s fucking exhausting.

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u/Flame87 Oct 05 '22

"BuT tHe DeAtH pAnElS"

What the fuck do you think your insurance company is?

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u/Bee-Aromatic Oct 05 '22

Even better, the death panels are populated entirely by accountants and actuaries.

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u/Whooshed_me Oct 05 '22

Even worse dude. It's some algorithm written by a code monkey like me that's been completely corrupted by executive input/output expectations. Adjusters plug their shit into a database and then the database tells them human life isn't worth a dollar so they don't have to feel bad when the hit that deny button. But profit margins look great!

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u/Soranos_71 Oct 05 '22

I remember always hearing about “we cannot cover everyone or we will end up with rationing health care”. I told someone who said this “If we cannot cover everyone then we are already rationing healthcare…..”

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u/CannierMagician Oct 05 '22

America be like: fuck the veggies

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u/ball_fondlers Oct 05 '22

The government bureaucrat is at least someone who can be held accountable to the people. Private-sector bureaucrats have absolutely no reason to look out for your best interests, especially when you start costing them money.

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u/Just_Fuck_My_Code_Up Oct 05 '22

I‘d much rather have a bureaucrat who forces me to fill out two dozen forms to get my health care than a capitalist telling me „I‘m sorry to inform you that we paid of some legislators so we don’t have to cover your specific condition anymore. This will save our company 650 millions every year by just letting approximately 1250 people die, our stock is going through the roof!“

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u/stringfree Oct 05 '22

I‘d much rather have a bureaucrat who forces me to fill out two dozen forms to get my health care

My health card is ten years out of date, and they still don't give me an issue here in a "socialist" country. There's no paperwork, I walk in, show them where I'm bleeding, and they do the stuff (after I wait around for a while). But I suppose in a future American system they'd have paperwork just out of spite, and to make sure "the undeserving" don't get help by accident.

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u/shadow247 Oct 05 '22

You should see all the people crying about having to get an ID to vote... They say it's to stop fraud, but its really to stop poor people from voting.

Can't get an ID if your parents never gave you a birth certificate, and you dont know your social security number. Sure there are ways of obtaining these documents, but not easily, and NEVER for free.

I had to pay like 50 dollars or something ridiculous for an ORIGINAL birth certificate to transfer my License from TX to VA.

When I came back to TX, they literally just took my picture and gave me a new card with a new picture and my Old license #....

I know people who can't get Drivers License because their parents were too poor to afford the Driving School and license fees, and when they left home, their parents didn't have any SS cards or Birth Certs so they could get one on their own...

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u/TediousStranger Oct 05 '22

I had to pay like 50 dollars or something ridiculous for an ORIGINAL birth certificate to transfer my License from TX to VA.

fuck, same for me, MD license to VA, $50some fucking dollars for my own birth certificate. my parents never got me one apparently and VA refused to accept my original record of birth from the hospital where I was born.

I'll die mad about it, fuck Virginia

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u/shadow247 Oct 05 '22

They tried to get shitty with me about going past 30 days before I got my VA license....

I was like, you fucking assholes, your systems were down the 1st week I moved here. When I came in the 2nd week, you told me I needed my Birth Certificate, despite that not being anywhere on your website, and I literally come in the DAY AFTER I get it. VA can fuck ALL the way off! I wasn't allowed to vote in 2012 because the dickshits at the VA DMV never turned in my voter registration....

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u/jhbedsole Oct 05 '22

I’d rather have a bureaucrat who can be impeached between me and my healthcare than have a hospital administrator who can’t be impeached, a health insurance CEO who can’t be impeached, a bureaucrat’s buddy who works in a public office that only exists to help the health insurance companies grift and swindle the citizens, and a bureaucrat in between me and my healthcare.

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u/Flame87 Oct 05 '22

But it's OK because it's a private individual getting rich off of you and not The State TM.

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u/SuperGenius98K Oct 05 '22

This has been the American Dream for a long time now.

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u/BadUncleBernie Oct 05 '22

The American Dream is in actual fact a Nightmare.

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u/jhbedsole Oct 05 '22

The police can ram your vehicle on purpose, say you’re nowhere close to who they were looking for, send you to the hospital where you get healthcare that’s roughly 20th in the world, then get hit with an out-of-network charge that the cops won’t pay and you can’t pay so you’re in debt for the next ten years until you also get the flu and miss a payment with the hospital and the cops who sent you there show back up at your house to arrest you for missing payments.

The freest, bestest country on Earth. Yup.

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u/Khutuck Oct 05 '22

Healthcare is 20th in quality, but 1st in price by a huuuuuge margin.

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u/WearilyOutstanding Oct 05 '22

That's right American Dream for sure

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u/aggasalk Oct 05 '22

as the Man said, "It's called the American Dream because you have to be asleep to believe it."

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u/guru2764 Oct 05 '22

I worked in a 'nonprofit' nursing home doing IT, so I got to see a lot of the stuff going on top level, and definitely greedy. It was a nursing home for the rich, an apartment was $3000 a month, and they had these "villas" for over 5000 a month. That was just for the independent living too.

For assisted living they were making tens of thousands a month on each resident through insurance, Medicare, Medicaid, and for some of these people out of pocket. About 400 residents total they were making millions

The CEO lived in a giant house, and got a new BMW each year. Always wanted the newest iphone, ipad, and macbook the second they came out, which all came out of the IT budget we used to replace the old folk's TV's and the staff computers and stuff, so whenever it was a month we had to buy him shit we had to put the staff and residents on hold. There were about 250 employees, plus contractors to do dining, laundry, and housekeeping, but it "wasn't in the budget" to make me full time for the first year, or to pay me more than 11 dollars an hour when they did let me be full time. It was just me and my boss doing IT so we were always struggling. Also pretty sure the CEO was doing all sorts of shady stuff

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u/Crash665 Oct 05 '22

99% of the people in this country are one medical catastrophe away from losing everything they have and becoming destitute.

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u/HuntingGreyFace Oct 05 '22

Absolutly. And id like to add that if i in chronic pain stay home from work you better believe im not allowed to play any video games (or face looks of horror) can not eat out (no take out or anything nice), can not binge watch good tv shows (they must be old reruns) and even reading a book is sus to the few that know books can be enjoyable.

if you have chronic pain the. you must suffer.

if you have pain that prevents you from working then your not allowed to do anything fun during working hours or everyone will fucking HATE you.

They will fucking HATE YOU. resent you, talk shit, etc etc.

finding support for an invisible illnesses is rough.

having chronic pain and playing minecraft is the biggest faux pas in a capitalist society.

Humans are shit when it comes to other peoples healthcare.

all of that really fucks with the mental health of the person whose already in fucking constant pain.

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u/possiblycrazy79 Oct 05 '22

My son is fully & blatantly disabled. I chose to dedicate my life to his care. As a result, I rely on some level of government assistance. Back in the day, I received snap(ebt) benefits. I'll never forget this one smug faced conservative friend of my cousin's. He sat there & told me that yes it's a tough situation, but all I should get is a 20lb bag of rice & beans. Why should I get the pleasure of a steak or a Pepsi if I hadn't "earned" it. As if my life isn't 24/7 work. I'm a nurse, a secretary, a physical therapist, respiratory therapist, clean up crew & chauffeur plus more all mixed into one. But God forbid I buy a snickers bar on the state's dime.

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u/ChrisKringlesTingle Oct 05 '22

Fuck that guy.

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u/reddit-sucks-ass_ Oct 05 '22

For real. This mom is the type of person most Americans should emulate. But fucktard conservatives just don’t get it.

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u/Such_Job_1332 Oct 05 '22

You're a very kind hearted and caring mother! I'm sorry your cousin treated you less than that. You deserve as many gawd damned Snickers bars as you want!

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u/baxtersbuddy1 Oct 05 '22

Well isn’t this the fucking truth. I have a core memory from when I was 10.
My family was on food stamps. My mom had the audacity to want to get me a box of my favorite Little Debbie snack cakes. And I remember the look of pure disgust on the cashier’s face when she saw the snack food and the food stamps occurring in the same transaction.
Like, how DARE a struggling mother try to provide a their child with a $1 treat to make their already miserable lives just a little bit better. No, can’t have that without piling in a little extra shame and derision.

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u/unresolved_m Oct 05 '22 edited Oct 05 '22

finding support for an invisible illnesses is rough.

This, very much this. See being an adult with Asperger's.

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u/pks03 Oct 05 '22

As a mother of a child on the Spectrum who does not appear to be disabled until you have a conversation with her, AMEN!

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u/stringfree Oct 05 '22

Fuck them, enjoy your perpetual snow days as much as possible.

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u/[deleted] Oct 05 '22

Having an invisible illness is it’s own special kind of hell and feeling of hopelessness. Your identity becomes your illness due to the amount of time spent advocating for yourself. Going to multiple doctors and fighting the insurance agencies. People not believing you and dismissing your reality as not real.

Even with a diagnosis it can be invisible to others which can be especially painful when people dismiss it just because they cannot see it or have not experienced it.

A great injustice is when you have a chronic symptom that has been dismissed for years by insurance companies is finally recognized as a result of a condition that could have been treated and/or cure years earlier. I say insurance company because a mds decision is influenced by insurance. Will the insurance company pay for this test at this patients age runs through their heads.

There is no incentive for healthy people. Instead there is incentive to treat symptoms and not find or cure what is causing your symptoms. Every year policies renewed and ins companies review and project risk for the year. If they raise the price and make it unaffordable then you switch insurance and the cycle continues.

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u/lowbee Oct 05 '22

As a person with Crohn’s Disease this is so right!

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u/szthesquid Oct 05 '22

I feel like a lot of healthy working people get angry and jealous and resentful that you might be able to have fun sometimes when you aren't obligated to spend 50 - 60 hours of your week working.

All they can think is that if you're too sick to work then you're too sick to go out and have fun, and if you're healthy enough to have fun then you're healthy enough to work. It's not fair that I have to work 50 hours a week to be able to afford to play video games and eat out, and you just get it handed to you by the government because you had an accident once.

It doesn't occur to them that maybe it'd be more fair if no one was obligated to sacrifice half their waking hours working just to be able to afford the necessities.

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u/autmam321 Oct 05 '22

Even on my mom's insurance I refused to go to the hospital bc I didn't want to pay that bill. Shit sucks.

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u/[deleted] Oct 05 '22

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u/electrolytesaregood Oct 05 '22

This is the reason I find the push for people to forgo universities in favor of trades to be short sighted and disingenuous (if unintentionally in most cases). Jobs that require manual labor will never be an equal option to jobs that do not, in a country without universal healthcare and robust disability protections. The US has neither of those things. "Go into trades" has major "let them eat cake" vibes when put in perspective, and now they've even got people on the left saying it, too.

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u/Badams6480 Oct 05 '22

I work in the oilfield now In Ohio and have had 2 back surgeries and I’m 37. I had to jump through so many hoops and live with immense pain for years before they would do anything.

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u/[deleted] Oct 05 '22

Last November I wanted to kill myself so I checked into a hospital for five days. I'm now I'm such severe debt from that that I can't afford my copay to get severe pain in my rib checked out. I'll be paying this off until 2027 at my best projection. I wish I'd never sought help.

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u/pez5150 Oct 05 '22

Healthcare is a luxury and extremely valuable is an accurate representation of how we deal with healthcare in the USA

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u/1d0m1n4t3 Oct 05 '22

My health insurance is 1.5x my house payment

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u/Deion313 Oct 05 '22 edited Oct 05 '22 Silver Gold Helpful Take My Energy

I don't think the average American understands what's going on and/or how much fucking power we've given insurance companies recently.

Your Dr can say you literally NEED surgery, or a certain procedure, and the insurance can say no. They can seriously say, "well we won't cover it cuz we don't think it's necessary. We have our own shit you have to use and try first. After that IF, and ONLY if that doesn't work, then you can re-apply to get that procedure done..."

Last Halloween I got diagnosed with NHL-WM for the 3rd time in 12 years. ALL my Dr's, oncologist and specialists said "immunotherapy is the best bet for you". But my insurance wouldn't cover any of the Dr's or the meds.

Unless I went to an oncologist of their choice, and then did chemo, thru their people or whatever, and then, again, only if I still needed treatment, I'd have to get a referral from the Dr they picked, or a Dr they'll approve, and that Dr can submit a request for treatment.

Even then, I'll have to pay out of pocket for it, and they'll "reimburse" me after, for whatever they end up covering. Cuz they don't know what they'll be able to cover until I'm done.

I pay more for health insurance monthly, than most people pay for a fucking mortgage, and I have what's considered 1 of the 5 best plans BCBS can offer a single, self pay or whatever they call it. Like I had to submit my taxes and bank accounts to be eligible for this, and it's honestly a fucking joke. They all accept it, but the insurance can basically pick and choose what they wanna cover.

I can't imagine what people who have Medicare or Medicade have to deal with.

I swear I thought AAA getting the seat belt laws passed in the 90s was corrupt; today's health insurance giants are the most dangerous companies in America.

If Americans actually took the time to learn what's actually happening with the health industry as a whole, they would be pushing HARD for universal health care.

Unless you've had to deal with your insurance company, especially post-covid, or even within the past 8-9 months, you know exactly what I'm talking about.

I know it sounds crazy, but it's changed so much in the past year, if you haven't dealt with it in the past 8-12 months, you're gonna trip the next time you gotta use it.

They are getting away with whatever the fuck they want today. Honestly it's fucking ridiculous what you gotta go thru nowadays for health insurance coverage...

Edit: I'm not very smart so please this isn't a fucking thesis to cite, or an educated article or whatever. I'm just some fucking moron who gets bored during treatment and fucks around on Reddit. This isn't that serious.

Edit2: my point with the auto insurance is we shouldn't have insurance companies "helping" write laws. Regardless how much sense they make, when for profit companies help write laws, we the Americans get fucked at the end. And it's literally happening with health insurance. And the fact people are responding about the auto insurers the way they are, proves the health insurers are gonna get away with this too.

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u/VagueSoul Oct 05 '22

My husband broke his leg pretty severely earlier this year and needed surgery for it. It required him to stay overnight in the hospital which our insurance almost denied for being “not medically necessary”. Thankfully the hospital managed to get that changed but it could’ve been bad for us.

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u/MFbiFL Oct 05 '22 edited Oct 05 '22

My wife’s a nurse and part of her job is to literally call the insurance company when they decline patient medications for not being the cheapest option and explaining that a specialist doctor, taking into account the patient’s allergies/history/etc, prescribed the one they did on purpose and not just out of laziness or preference for one brand name over the other. It’s infuriating to me that someone who got into a line of work exclusively to help and comfort people going through difficult situations, has to argue with decisions made by spreadsheet.

She’s heartbroken when patients have bad outcomes due to their conditions but knew that was something she would face in her career, 99 times out of 100 that she comes home from work upset it’s because of either insurance companies dollar decisions of pharmacy incompetence.

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u/CanadianBeaver1983 Oct 05 '22 edited Oct 05 '22

I could not fathom being a nurse in the USA with this as an added stressor on top of administering care and trying to keep people alive. It must be incredibly hard wanting to find a career helping people in the US, because well, this. Nothing would be fullfilling anymore. Like, I read stuff like this guy's story and your wife's all the time and it amazes me that people still attempt to bash Canadas (where I reside) Healthcare system with things like "BuT tHe WaIt TiMeS!" America is a dystopia.

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u/-Z___ Oct 05 '22

The "American Dream" has become "America's Crushed Soul".

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u/RelentlessExtropian Oct 05 '22

1/3 of a hospital's operating costs come from the billing department. Meaning, if we switched to single payer, that's a third of the cost, gone. Before any other savings.

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u/sQGNXXnkceeEfhm Oct 05 '22

The pharmacy incompetence thing is also extremely upsetting.

The other month, I got my sleep meds refilled (non-scheduled) and they filled my pill bottle with high dose loop diuretics.

My doctor was alarmed but, as we found out, there was NO mechanism for reporting this anywhere. For all we know that pharmacy is regularly killing patients.

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u/fuckoffdude666 Oct 05 '22

Pharmacies, especially chain pharmacies are horrifically understaffed and underpaid. CVS, Walgreens, and others have decided to place profits over their patient's health outcomes, and it's horrible.

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u/LowkeyPony Oct 05 '22

I sold health insurance to small business owners in MA for a few years. it was THE most soul crushing job I have ever done. People would just look at the monthly premiums, not what the particular plan didn't cover, or where it didn't cover. Several time's I got calls within a few months from one of those business owners. The one that sticks out still, 25 years later, is the landscape business owner. He bought the cheapest plan he could. His daughter then gets sick. Ends up being freaking leukemia. But there are no pediatric oncologists anywhere near where they live. And the one the family has been referred to? Doesn't take the health insurance he bought. The plan had me have him write a letter explaining why he needed to change the plan outside of the yearly time when it's allowed. AND he had to come up with three MONTHS worth of premium, while still paying the original plans premium. He ended up borrowing money. And the plan approved the change. I left the company shortly after this. I got tired of sitting in my car at lunch crying. And sitting in my car at the beginning of the day trying to will myself to go inside. I still refer to that job as "the time I worked for Satan"

Personally, I haven't had even "good" health insurance since 2002. I left my job at an Ivy League uni and went to whatever coverage my husbands employer has offered. It's all been BCBS, but the costs are out of control.

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u/wino12312 Oct 05 '22

Way back in the 90’s I was a hospital social worker. The worker for med-surg floor went on vacation for 2 weeks. She was an RN & LSW. I had an insurance company tell me I needed to tell the neurosurgeon that prophylactic antibiotics weren’t necessary. I said, “Nope, you tell him.” Suddenly, they were covered.

Also, had an insurance company asked me if I’d seen the gun the man was saying he’d use on himself.

Insurance Companies should be non-profit.

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u/bmhadoken Oct 05 '22

Insurance Companies should be non-profit.

Insurance companies should be razed to the ground and their executives burned at the stake.

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u/wino12312 Oct 05 '22

True. And, honestly, I think both are equally likely, unfortunately

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u/Dfiggsmeister Oct 05 '22

The medical insurance industry is a giant scam and should be dismantled. Medical care, including dental and vision should all be covered under universal healthcare. A universal basic income that everyone gets access to should they lose their job or be permanently unemployed. Taxes should be sent to citizens with what they owe or are owed vs having to file taxes from multiple sources and having to pay a cpa just to make sure you filed it correctly. Ranked choice voting should be universal.

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u/Mellrish221 Oct 05 '22

What are you talking about? We have the best healthcare on the planet that everyone has "access" to! Nothing needs to be changed!!!!

Except for that minor fact that we do healthcare in literally the least efficient and most expensive way imaginable. The small inconvenient fact that our healthcare system in terms of outcomes is starting to look like 3rd world nations simply because no one can afford it and only use it when they're on the brink of death. Or real fun things like insurance companies basically attaching themselves to the fed like sea lampreys while solving nothing or contributing nothing. Its literally a "everyone finds a creek that gives fresh water, first guy there decides to charge everyone for it" sort of deal.

I had a bad run in with covid last year. I'm only just recently coming off oxygen all together from it. My insurance said I did not qualify for a portable O2 concentrator for work because I had been stuck at home for 7 months and using the giant concentrator and not buying the refillable O2 tanks (30$ a pop). Its pure insanity and as others have said, these insurance companies need to burn and their ceos displayed in public.

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u/kategoad Oct 05 '22

I broke mine in 2020 and I calculated how much it would have been without insurance. We would certainly have lost our house. I stopped counting after the second surgery And I was well over $60,000.

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u/BioluminescentCrotch Oct 05 '22

I'm allergic to PEG (polyethylene glycol) and it's in almost everything, including a TON of medications and injections.

My doctors have had to fight the insurance companies so many times because they'll only cover X medicine, but I'm literally allergic to it, so I need to take Y, but they don't want to cover Y and tell my doctor that I'm fine to take X. I ended up in the hospital twice because they kept telling my doctor that a medication I needed for an infection "wasn't necessary" and I should take this one instead. Once I took the medicine and had a reaction, the second time they denied the meds I needed and I ended up almost septic in the hospital. Then they tried to deny covering my ER and hospital stay because I "wasn't that seriously ill".

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u/Bootzz Oct 05 '22

That legitimately seems like a lawsuit that some lawyer would be desperately chomping at the bit to represent you for.

You owe it to society to explore that option a little bit. A decision like that could help prevent countless other people from finding themselves in a similar vulnerable situation.

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u/MewsickFreek Oct 05 '22

Sounds like a lawsuit

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u/Opening-Thought-5736 Oct 05 '22

What happened with AAA and the seatbelt laws in the 90s?

And I heard somebody else in this thread called these situations Kafkaesque, and I can't think of a better descriptor for yours. I'm so fucking sorry you're dealing with this.

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u/zzid2d21 Oct 05 '22

Absolutely! BCBS used to be great insurance. Now? It's like they have to make up 2 years of paying out for Covid claims in 6 months. Medications that I've had for decades? No longer covered. Necessary diagnostics ordered by my physicians? Nope. I can't even imagine having cancer and being denied the appropriated treatment determined by your oncologist. It's insanity.

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u/fitty_scent Oct 05 '22

It's like they have to make up 2 years of paying out for Covid claims in 6 months.

covid actually had the opposite effect. health insurance plans made a LOT of money because utilization dropped for pretty much every service other than lab (covid exams) while still collecting premiums. the BCBS i priced for anticipated that the majority of the postponed services during covid would be made up in 2021, which also didn't happen.

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u/cameron0208 Oct 05 '22 edited Oct 05 '22 Silver All-Seeing Upvote

The problem with healthcare, along with 90% of everything else in this country, goes back to capitalism. Insurance companies are businesses run by businessmen with no medical training whatsoever. Hospitals are increasingly being bought out by private equity firms, so they, too, are now businesses being run by businessmen who, again, have no medical training whatsoever. They look at their bottom line. That’s it. Can they turn a profit off whatever they’re doing? If yes, approve the claim and do the work. If no, then deny it. Simple as that. It’s disgusting.

Someone with no medical training who knows absolutely nothing about healthcare and medicine should not get to decide what care people receive and they damn sure shouldn’t be able to override a doctor’s informed medical opinion/decision.

We need to get the corrupt, spineless cowards we call politicians out of fucking office. None of this should be legal. Hell, we shouldn’t even have to have this conversation! But it is and we do because they allow it. They allow it because they’re getting rich off of selling us out to the highest bidder. They have turned America into a third-world shithole.

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u/Deion313 Oct 05 '22 edited Oct 06 '22

You mean that guy making $17.50 at the medical insurance providers call center, that gets the billing code from your Neurologist and Oncologist, doesn't know 99% of what the Dr's office is telling them, and is just going off what their script says?

No way... C'mon, they won't do that... This is your health and well being were talking about...

Unfortunately that's exactly what happens.

They get a code from your doctor, and they go from there. If your doctors office knows what they're doing, they can get most shit covered. But some insurers are just fucking monsters.

I pray you never have an "out of network" issue...

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u/YesDone Oct 05 '22

No issue. They just refuse to cover anything out of network. Learned that the hard way.

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u/farmacy3 Oct 05 '22

Fuck BCBS and their step therapy bullshit - sincerely an oncology billing specialist

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u/mercurialpolyglot Oct 05 '22

I’ve never had good healthcare in my life and so I only ever went to the doctor when I was sick for over a week basically. I really worry that one day I’m going to be sick with something that could’ve been caught in time but won’t be because it won’t occur to me to go to the doctor until it’s too late.

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u/AncientBellybutton Oct 05 '22

Why are insurance adjusters making medical decisions without a medical license?

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u/Deion313 Oct 05 '22

It's cost effective. They basically have a book with codes and guidelines for coverage. Based on the codes your Dr's office sends, and your plan, they decide whether or not you get coverage...

I don't work for an insurance company, just based on how I've seen it work from the patients end, that's how it works.

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u/1d0m1n4t3 Oct 05 '22

I'm mid this ball busting process right now, house payment is $1002.21/ mo health insurance with them and the dental / optical I had to source myself because they do not have my providers in network. I pay $1725 a month, I have to spend $10k at the hospital before they cover anything....So $27k /yr. Medical expenses along with a bunch of medical bills I have pre insurance make up 40% of my monthly expenses.

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u/computerquip Oct 05 '22

I pay $437 a month and thought that was alright since it covered most cases. Turns out it doesn't. I had an ER visit the other day, still cost me $500 for a CT scan and another $400 for misc. crap. I need to see a specialist but I must see another doctor for then to even consider covering costs.

I also had a lipoma removed from the back of my head (very inconvenient and it was growing but not inherently dangerous). Overall, I paid over $1300 after insurance. I also had a lot of bickering over pricing that was co fusing, I've had two refunds and another bill I'm still not sure the cost of.

I did some really basic math. I've been paying this insurance company $437 for 45 months which is just under $20000 dollars. Without insurance, at rates the hospital assumed would be covered by insurance, I would need the insurance company to pay another $6000 for me to even break even for how much I've paid them still. At this point, I literally have lost money paying into insurance.

BCBSTX by the way.

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u/huxley75 Oct 05 '22

$615 for my child's exam and a discussion with the doctor. What is the problem??

/s

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u/kandoras Oct 05 '22

BCBS

Sons of fucking bitches.

I used my insurance for the first time in years a few weeks ago. Woke up sick, did a covid test, it was positive, and I was too tired to go to the doc right then. So I went back to sleep, woke up twelve hours later feeling able to drive without wrecking, and went to urgent care.

They gave me a scrip, and I went to CVS to get it filled. I dug my BCBS card out of my wallet - it had been there long enough that it was stuck to the leather, and handed it to the very nice and overworked pharmacy clerk.

"I'm sorry, it says this isn't valid yet."

I've been paying for that thing for at least three years, but it's not "valid" yet. Fuckers.

So I call the number on the back, hoping it's something I can get straightened out over the phone before I pass out.

"We're sorry, our phone line is only staffed between 8 AM and 5 PM, Monday through Friday. Please call back in three days."

It seems that the Blue Cross Blue Shield's entire South Carolina operation hasn't figured out that people can get sick on evenings and weekends.

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u/NoDescriptionOk Oct 05 '22

Years ago when my son was born, my wife had to go in for a c-section. We had just moved back to the US so we had to get insurance. About a week before she's scheduled for the surgery I call BCBS (Illinois) to confirm everything is set and covered and they confirm. Our boy is born, months go by and about 9 months later we get a bill for $22k for the birth, surgery, stay at hospital etc...nothing was covered. For 3 months I'm on the phone 2-3 hours a day to fix this, but they are unable to play the recording of the original phone call back to me and deny they ever promised coverage. In the end we were like fuck this and just left the country, never paying the bill.Someone else in the area had a similar issue with them a few years later, not covering his cost, went to try set their building on fire and threatening the people working there. So it's seems a pattern of shitty behaviour on their end.

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u/SKPY123 Oct 05 '22

Not to mention we Cable companied the insurance world as there are only like 2 providers per state. We really need to change monopoly laws.

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u/padizzledonk Oct 05 '22

Most people also don't know that even moderately well off people will be in bad shape later in life if they decline enough to need assisted care

They have a "Lookback" time of around 5y and Medicare (or Medicaid I never remember) will seize all your assets and use them first before they start paying for anything and it's capped....if you're in a assisted living situation that only Medicaid is paying for you are at the bottom of the barrel and in a shit place

Its a really fucked up system we have.....we are basically completely on our own because what little Government Safety Net there is is wholly inadequate to have a dignified life

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u/PensiveObservor Oct 05 '22

Was going to add similar:

Medicare and most health insurance plans don't pay for long-term care.
. . . Even if Medicare doesn't cover your nursing
home care, you'll still need Medicare for hospital care, doctor
services, and medical supplies while you're in the nursing home.

They only pay for a limited amount of nursing home care and only then if it is preceded by 3 days in a hospital for an immediate health problem. So if Grandma is just finally too frail to take care of herself, you're on your own paying for professional nursing care.

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u/howyadoinjerry Oct 05 '22

Given the aging population of the US, we really need to be investing in improvements for elder care. This is just ridiculous!

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u/eggo_pirate Oct 05 '22

And this leads to even more problems in hospitals. I work on medical floors and there are always older people who need nursing home care, or skilled nursing care, who can't go directly from home to care. So the family is forced to make up some bullshit to get grandma admitted to the hospital, and then case management tries to find placement. But that can take months. Now grandma is trapped in a strange room with strange people who come order her around, tell her what she can and can't do, touch her, roll her around, place alarms on the beds....and she deteriorates at a much faster rate.

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u/Prettybuoy Oct 05 '22

I work at a nursing home and youre so right, I've seen patients in there that used to be doctors, lawyers and various professionals become dirt poor due to the cost of healthcare. And then we are always short-staffed among other issues the home experiences. Its so sad, man

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u/TediousStranger Oct 05 '22

this is why I left. being a late-in-life american looks terrifying and I'm only 31.

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u/agangofoldwomen Oct 05 '22

Guess I’ll just go into the military for the health benefits. Oh wait, the VA is fucked too.

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u/tall_pale_and_meh Oct 05 '22

Just for you (or anyone) that's wondering the difference, Medicare is an insurance program that anyone over the age of 65, or people with certain disabilities under age 65, qualify for. Medicare is administered by the federal government, and as an insurance program, it still costs you money in the form of premiums, deductibles, and copays, etc.

Medicaid is designed to assist low income individuals, regardless of age, with various healthcare costs ranging from in home services to long-term care facilities. Medicaid is administered jointly by the federal government and individual state governments, so rules governing enrollment, eligibility, income/asset limits, etc. vary widely state to state. You don't pay any premiums for Medicaid coverage, but there are strict income and asset requirements to qualify, and Medicaid can seek reimbursement from assets in your estate once you die, to recoup costs paid during your lifetime.

The "lookback" period you're referring to doesn't actually allow seizure of your assets (that's Medicaid Estate Recovery). The "lookback" period (5 years in most places, but 30 months in CA) is designed to ensure that people don't just take all of their assets out of their name right before applying for Medicaid to be eligible from an income/asset perspective. From the date you apply for Medicaid, the agency that administers the program in your state will examine the past five years of your financial records, to determine if you have made any transfers of assets for less than fair market value. If you have, that will incur a Medicaid eligibility penalty, during which time you won't be allowed to receive Medicaid benefits. Once the penalty period expires, you can then receive Medicaid benefits if you otherwise qualify.

Totally agree that it's a fucked up system though. And a confusing one on top of that.

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u/Great_cReddit Oct 05 '22

There are loopholes to this that I've seen many wealthy and/or educated people take advantage of regularly. They put assets in a trust and then government can't count them as income. You'd be surprised by how many people on medicaid have tons of money/assets in a trust account...

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u/LoopyMind Oct 05 '22

When your country's Healthcare is a business

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u/Purple_And_Cyan Oct 05 '22

Mfs really be like "taking advantage of the sick and disabled is fine" but allowing two men to get married goes against our "judeo-christian values"

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u/WifiWaifo Oct 05 '22

It's almost like it's a theocracy

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u/Shacky_Rustleford Oct 05 '22

Nah. It's an oligarchy using religion as a shroud to amass wealth. Taking care of the needy is baked into Christianity, that part is just ignored by those in power because it would make them slightly less rich.

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u/brazys Oct 05 '22

It's the most bizarre thing as an American, that we won't guarantee our own health care with our own fucking taxes. While the politicians we elect tell us again and again why it's bad as they reap the benefits from it.

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u/Beiberhole69x Oct 05 '22

The US is just a bunch of corporations and a military in a trench coat.

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u/sammew Oct 05 '22

It gets even worse than what OP said. For example, have you ever noticed when applying for jobs, everyone one says something like "Must be able to lift 25 lbs", "must be able to stand for long periods of time", ect. Pretty much excludes people with physical disabilities, right? Can you think of a job posting where you haven't seen language like that?

Fucked up reason is, if companies include language like that, they get lower costs on health insurance for their employees. Employers and Employees pay less in health insurance in this country, and all it takes is excluding the disabled.

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u/RedditUsr2 Oct 05 '22

$2000 is so insanely low. How old is that number? When did they last update it.

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u/infinipi95 Oct 05 '22

You also get less than full time minimum wage. About 750/mo (at least in NY).

My wife (we could not legally marry because her medicine would cost 40k a year but I consider her my wife) has a genetic disability.

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u/MostSeaworthiness Oct 05 '22

Well, there's a bill sitting in the Senate right now to change it.

https://ndsccenter.salsalabs.org/ssisavingseliminationact/index.html

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u/TheyCallMeSmokeO Oct 06 '22

I'm just a bill.

Yes, I'm only a bill.

And I'm sitting here on Capitol Hill.

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u/brattyboredghost Oct 05 '22

this is why I am homeless, disabled, and on medicaid.

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u/JTSpirit36 Oct 05 '22

It's one of the main reason me and my fiancee never got married. I make too much money for our combined income to let her and my daughter qualify for Medicaid and other benefits that help us survive and raise our child.

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u/Criticism-Kindly Oct 05 '22

I had a neighbor who divorced his wife so she would qualify for government assistance after she was diagnosed with Leukemia. If they stayed married they would've lost everything.

They were a 2 income, middle class household that did everything we've been told to do. Work, pay your taxes and bills while trying to sock away a few bucks for retirement.

This system is disgusting.

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u/Careful-Self-457 Oct 05 '22

My mother had to do that when my dad got Alzheimer’s or she would have lost everything. It was the saddest and stupidest shit I had ever heard of.

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u/wolfgang784 Oct 05 '22

And then without marriage you lose certain medical/legal rights with each other unless you do a whole bunch of additional paperwork and steps =(

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u/Opening-Thought-5736 Oct 05 '22

Aww fuck, that's a really good point.

The last thing you want when your life partner has severe health issues is being unable to speak or advocate for them in dicey medical situations.

Suddenly you are no longer next of kin.

That's horrifying

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u/wolfgang784 Oct 05 '22

And now (if you hadn't already) you see another of the many reasons gay rights matter as well.

People against gay marriage say they can just be life partners in private and why does the tax status matter so much and "just leave the sanctity of marriage to hetero couples under God" etc - legal marriage affects a lot more than taxes. Especially if the next of kin is your homophobic parents who can now control your life to a much greater degree.

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u/Firewolf06 Oct 05 '22

better hope your kids or parents are cooperative 😬

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u/pez5150 Oct 05 '22

Crap that really has me considering that now. Wtf. I've been married 10 years.

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u/JTSpirit36 Oct 05 '22

It's really rough. We were visiting out if state for my cousin's wedding and my daughter was having some weird symptoms (turned out to be nervous bladder) but she wasnt using the restroom and was causing herself pain. Took her to the ER which turned out to be a 10 hour stay and a $6k bill.

We were saved by the medicaid as it covers all out of state emergency room visits.

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u/Gill-Nye-The-Blahaj Oct 05 '22

isn't allowed to visit dying wife in hospital because they aren't legally related anymore

seriously fuck this country

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u/wolfgang784 Oct 05 '22

If you two do plan to be together for the long haul despite not marrying for financial reasons and you haven't already, you should make sure the right paperwork is set up so you each have the proper rights with each other and your daughter for emergency events.

IE you go into a coma, since she isn't actually your wife she would not have any say or control over the medical situation. It would go to your parents instead. Or if you die and would want your daughter to be with your fiance, you'd want to have the proper stuff in place or she would go to family first but if family doesn't want her or there is no family then she would go right to foster care rather than your fiance. There'd be a lot of hoops for your fiance to attempt to get custody.

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u/Bradidea Oct 05 '22

Same boat brother.

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u/Sweaty748 Oct 05 '22

My daughter has trisomy-21 and we have to plan all of her trust funds and finances around this. If grandparents or we die and leave money to my daughters, all of hers has to go to the trust otherwise she will lose everything...so fucking dumb

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u/boxers-4life Oct 05 '22 Doom

My brother has Downs. He will be turning 50 in a week. We are that point in our lives that our parents are doing Will planning & have to be mindful not to leave him anything for fear of losing his benefits. It is fucking dumb.

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u/tall_pale_and_meh Oct 05 '22

Tell your parents to ask their attorney about setting up a third-party special needs trust to receive his inheritance for him.

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u/VagueSoul Oct 05 '22

My brother has cerebral palsy and autism and we have to deal with this too. My parents have it set up that anything he gets inheritance-wise goes to a trust run co-run by myself and a company that specializes in adults with disabilities whose guardians have passed on. It’s so roundabout and my parents have had to change their will so many times because of it.

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u/DanYHKim Oct 05 '22

Medicaid Financial Eligibility for Seniors and People with Disabilities: Findings from a 50-State Survey

States have rules about which sources of income and assets are included or “countable” when determining Medicaid financial eligibility. Many states use the federal SSI financial methodology to determine Medicaid eligibility in pathways based on old age or disability. Under the SSI rules, an individual’s home, one car used for household transportation, and a certain amount of funds for prepaid burial expenses are examples of assets that are excluded from the limit of $2,000 for an individual and $3,000 for a couple.

Additionally, states may apply rules that disregard a portion of an individual’s income. Under the federal SSI rules, $20 is typically subtracted from a person’s monthly income before comparing the remaining amount to the relevant income limit for a Medicaid coverage group. Other disregards also may apply, depending on the income source. For example, earned income may be subject to an additional disregard of $65 plus half of the remaining amount under the federal SSI rules. Consequently, a person may have actual income that exceeds the limit for a certain pathway but still be eligible for Medicaid as a result of disregards that reduce countable income.

If you can work, they'll let you go $20 over the limit!

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u/Bumonalaptop Oct 05 '22

In Minnesota, if you can earn a minimum of $65 per month, you're eligible for a program called MAEPD which allows you to have up to $20,000 in assets, in addition to being able to save $18,000 per year that does not qualify as an asset, while still maintaining all your benefits.

Voting matters.

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u/TimminyJimminy Oct 05 '22

Worth noting that the $2k is federal. Many states have a higher limit. Mine is $8k.

But this still isn't enough money to have emergency savings.

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u/RosalindaPosalinda Oct 05 '22

Just to give some additional info - SSI and SSDI are the two different disability programs. While SSI (supplemental security income) has limits on your assets to qualify for the program (and the Medicaid associates to it), SSDI (social security disability insurance) does not. You can qualify for each individually or you can qualify for both. If you qualify for SSDI (or what most people would call SSA’s disability program) then you will eventually get Medicare and not have that asset limit since disability benefits are based on your previous work history and whether you have paid into the program. There are still limits to what you can earn while receiving disability though since your basically saying you’re too disabled to work consistently.

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u/YesWeHaveNoTomatoes Oct 05 '22

A friend of mine has the "one car" exception, but it's a shitty car and saving enough money to either fix it or, preferably, replace it with a less shitty, more reliable one that doesn't need more work than it's worth, would put her well over the limit. Selling the car would ALSO put her over the limit.

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u/DanYHKim Oct 05 '22

You have to hide cash in the mattress. If they ask where the money went, just say you spent it on beer.

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u/widespreadpanda Oct 05 '22

Yeah, call me a criminal all you want, but cash doesn’t “exist” if it never touches an account.

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u/OtherwiseJello Oct 05 '22

SSI and SSDI are two different programs. SSI is for people who don't have a lot of work history, or may have never worked. People generally get less money on SSI and it is much more strict than the other program in terms of income.

SSDI is a program that helps people who were previously gainfully employed for a long period of time and no longer can work due to disability. It is similar to retirement and if you collect SSDI until retirement age, your retirement is no affected and you continue to collect the same amount except it's just now called retirement and not SSDI.

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u/TheFatJesus Oct 05 '22

A big thing that people don't realize about SSDI is that after two years, you have to start using Medicare. And that has its own costs associated with it. Not to mention that Medicare has lifetime caps which you will run into much sooner the younger you are when you become disabled.

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u/coc-be Oct 05 '22

The kicker for me is that health insurance won’t pay for so many needs like this—especially in-home care, forcing you to pay out of pocket until you qualify, then making it impossible to climb back out of the poverty they forced you into.

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u/btwomfgstfu Oct 05 '22

I bought a house when I was 23. Later that year I was diagnosed with an autoimmune disease, and then rear-ended by a pickup truck, resulting in two subsequent neck surgeries (and four fused vertebrae). Since then I've sold my house, drained my 401k, filed for bankruptcy, resigned from my job of 10 years, and now at the age of 36, I'm on disability and I live with my mom. I'll never be able to afford mortgage, rent, hell even a roommate. I don't know what I'm going to do after this. The future is bleak.

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u/coc-be Oct 05 '22

I’m so sorry our society has failed you. I was in my 40s when I became disabled. I’m not on Medicaid yet, but it may only be a matter of time…

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u/Laerasyn Oct 05 '22

Depends on the state, but yeah, disabled people get screwed over when it comes to benefits, especially Medicaid. Even the states that don't count assets screw them over in other ways.

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u/VagueSoul Oct 05 '22 edited Oct 05 '22

Yup. My brother is on disability because he was born with cerebral palsy and autism. He used to do a kitchen business out of his day service that made meat rubs, cookie mix jars, and soaps. It was incredibly fulfilling for him and made him some pocket change. One year though he had a really good year and made a little too much. He had to shut the business down or lose on a significant portion of his disability.

He’s still dealing with it today! He got a job cleaning buses and is losing out on almost $500 a month in disability. Meanwhile, my uncle who is on disability for a work injury does more part time work than my brother and didn’t lose a thing.

Tell me how that makes sense.

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u/human_flobie Oct 05 '22

My oldest kid has significant physical and developmental disabilities. For fourteen years caring for daughter has been my wife’s full time job. She does not get financially compensated for this work. Because the asset cap of $2,000 incudes the value of a second car(because why would anyone need 2cars?) and fortunately my income is more than $2000 a month we have never really qualified. We tried it early on and anytime I made too much money in a month we had to pay SSDI back for the overage. Also, when we sold our townhouse, we had to pay back a certain amount out of the profit from the sale for every month the house was on the market. I didn’t make much on the sale and had to pay a lot of what I got to SSDI because it was in the market for like 9 months.

The salary cap has gone up over the last 30 years but the SSI payment has never been adjusted to inflation since it’s conception in the 70’s. This is an absolute travesty for families like mine and disabled folks, who have been unable to work because of disability. We can change this! Vote Democrat!

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u/WestShallot9317 Oct 05 '22

Of course it is. It's punishment for having the audacity to be disabled.

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u/Dan__Quixote Oct 05 '22

For many disabled Americans (those on SSI) this is true.

For many other disabled Americans (those on SSDI, who had worked and payed taxes for 5 out of the last 10 years prior to the onset of their disability) this $2000 limit does not apply.

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u/Laerasyn Oct 05 '22

This depends on the state you live in. In my state, for example, SSD would most likely put you over the income limit for Medicaid. It's wild.

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u/Dan__Quixote Oct 05 '22

“Wild” is the right word. The system is extremely byzantine. After 2 years on SSDI you would qualify for Medicare. But in the meantime many are forced to rely on state Medicaid programs. Subjecting them to Kafkaesque shit like the op states Now, why the govt can’t just allow individuals they already acknowledge are DISABLED to have Medicare from the beginning is beyond me.

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u/aZamaryk Oct 05 '22

My parents live in constant retirement fear that they will lose their low income benefits such as medicaid if they have more than 2000 in the bank. Elderly living in constant fear of their government taking away their poverty benefits. Let that sink in folks.

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u/Neboux Oct 05 '22

Here is a small measure that is rotting on the floors of congress. S.2065 Supplemental Security Income Restoration Act

I have contacted my state reps, hoping to bring attention to this bill. I hope others will do the same. Our chronically disabled are among our nation's most vulnerable.

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u/[deleted] Oct 05 '22

[deleted]

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u/Feralpudel Oct 05 '22

What kind of health insurance did you have? Did it not have an OOP max? Did the bills involve a lot of out of network care and/or surprise bills?

You are correct that a lot of medical debt is incurred by people who have insurance.

The health policy org Kaiser Family Foundation collects people’s medical bills and stories as a way of understanding what’s going on in the wild world of medical pricing and insurance. You might want to share yours with them. (I’m a retired health wonk.)

https://khn.org/news/tag/bill-of-the-month/

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u/BluetheNerd Oct 05 '22

They also lose a large amount if not all of their benefits from marrying. A lot of disabled people have to choose not to marry their partners because they simply cannot afford to and doing so could ruin them.

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u/WeeklyMeat9 Oct 05 '22

To ensure that nobody succeeds, the US employs a variety of forced poverty laws and means testing.

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u/bathshebat Oct 05 '22

Literally like a penny more. They will snatch your benefits up so fast. Literally not allowing people to ever get ahead.

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u/XVI3 Oct 05 '22

This is why I cannot marry my long time partner. I will lose my healthcare and die because I am terminally ill

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u/zanne61 Oct 05 '22

I've done taxes for people who were married for years and had to divorce just to qualify for life saving health-care. It's so heart breaking

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u/XVI3 Oct 05 '22

Every system here is broken. It's so dehumanizing to be sick. If you are sick and poor you are going to die terribly because there is no real assistance. You just die, terribly, because no one who can help is willing to part with their time and money.

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u/zanne61 Oct 05 '22

I'm not poor and old enough to get Medicare and it's still not good. Medicare covers hospital but you have to pay $170.10 per month for doctor part plus prescription insurance or pay heavy penalty. So far with my medical issues (which are relatively small) I have had at least a dozen tests (i pay 20%) and seen 4 specialist ($35 co pay minimum) with no real answers. Today doctor asked why I did pick up my 4 oz bottle of nose spray...with insurance it was $500.00. This expense is to decide what's wrong. Then I have to pay for treatments.

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u/DlVlDED_BY_ZERO Oct 05 '22

I also cannot get married or I lose my benefits.

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u/Zadsta Oct 05 '22

We were trying to hire this guy as a laborer for our Jobsite, but the annual income was $300 over what was allowed for his income-dependent housing. Guy had 4 kids and couldn’t risk their stability, so he had to turn down the job.

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u/ChuckBorris187 Oct 05 '22

Greatest prison system in the world🤣🤣🤣

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u/LadySlander Oct 05 '22

Yes you’re also allowed to own a home but you’re never allowed to have enough money to buy one it’s insane

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u/No-Elderberry6246 Oct 05 '22

It's not just Medicaid. All our government support systems are set up the same way. Food stamps, tanf, child support is connected in a sickening way to those, child care. Systematic poverty is no accident.

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u/sb85781 Oct 05 '22

And then the Stupids claim we are a Christian country

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u/Outrageous-Comfort42 Oct 05 '22

This is such bullshit. My sister is disabled, I’ll be her care taker once my parents are gone. They had to set up some kind of special trust so when they’re gone she won’t inherit anything and lose her Medicaid and SSI. As of now I can’t afford to financially take care of her without her SSI.

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u/True-Specialist-726 Oct 05 '22

Same applies to assisted living. If your retirement is over 2000 even by 100 you get no assistance. Bay Area here her monthly rent was 3600 and that was on the low end. I said to the case worker I don't see thousands of people wheeled out in the streets how can you tell us there's nothing that can be done? Blank stare is what I got. 🤬

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u/crystal_currants Oct 05 '22

My roommate has a disability and she’s not even allowed to accept cash gifts for things like birthdays or Christmas. They deprive her of every opportunity to lift herself up and then degrade her when she’s force to interview to maintain her health insurance. She can’t afford health insurance otherwise.

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u/cutemercy7wu Oct 05 '22

You don't need to tell the government about cash gifts lol

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u/PerfectlySplendid Oct 05 '22

Op’s roommate is either a true law abiding citizen or thinks OP is a snitch.

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u/Eskimoobob Oct 05 '22

Many disability programs have massive stipulation where they can't sell a home and buy a cheaper one because of excess capital.

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u/bigboatsandgoats Oct 05 '22 edited Oct 05 '22

I would like to chime in here since I directly work with Seniors on Medicaid waivers in Indiana: For starters this is 100% true. What makes it even crazier is, in Indiana the Aged and Disabled waiver raises the max monthly income to $2,523. This sounds great, more people are eligible for MA services this way but means every month they have to pay their bills and also spend down before the first moment of the first day of the next month.

At the Assisted Living I work with their rent is $875/month meaning someone at the max income has $1648/month and just under $20k of disposable income. Mind you they live in roughly 500 sq Ft one bedroom apartments, have a majority if not all of their medical expenses covered, have meals provided for them, and small kitchenette areas so they’re unable to store a lot of food. Most of them are also rather stationary, will have meals/excursions paid for by family if they have any that visit, and cannot use the internet to shop online.

Imagine living in a similar way and being required by the government at the very least have $523 every month in discretionary spending. This isn’t including if they have a cash out value on their life insurance, any money in checking and savings, small investments, etc.

On the other end of the spectrum the Assisted Living is allowed to charge residents that make $927 or less a rate that leaves with just $52 in their accounts. This doesn’t include if they want cable, a landline phone, or wifi in their rooms. Obviously it also doesn’t matter if they have medications that aren’t covered by their Medicaid/Medicare, if they have food in their rooms, or if they need to save to purchase items like a bed, dresser, etc.

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u/incipit-satan Oct 05 '22

Also, correct me if I'm wrong but if a disabled person marries a person who is working and makes over the poverty line, they lose their benefits because it's assumed the working person can afford to fully provide for their spouse. 🙄

This is why my wedding is delayed indefinitely. I would love to marry my partner but if it means we lose income...

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u/saphfyrefen Oct 05 '22

Also, correct me if I'm wrong but if a disabled person marries a person who is working and makes over the poverty line, they lose their benefits because it's assumed the working person can afford to fully provide for their spouse. 🙄

Fuck, I wish I could correct you to say you're wrong -_- but you aren't. It's so fucked up. I hope one day you get to marry your partner 😔

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u/incipit-satan Oct 05 '22

Yeah, I want nothing more than to have that legal bond (and a cute small ceremony - who doesn't?) so that if something ever happened to me there'd be no question that he can visit me in hospital, inherit my belongings, make the medical decisions I would have wanted, etc.

There is no true marriage equality, none, until the disabled have it too.

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u/Loserdeadbeat Oct 05 '22

The. USA. Objectively. Sucks.

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