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Long post,but hope you can help

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Old 09-30-2007, 07:50 PM   #1
Join Date: Aug 2007
Location: Tx
Posts: 54
gabbygrace HB User
Long post,but hope you can help

I have chronic neck problems and have been going to a pm for a little over a year. I am self employed and don't have health insurance.I am going thru a plan that helps employed people that can't afford insurance but need medical treatment so they can get back to work and keep paying taxes.I applied for this aid a year ago and just barley got in under the wire with how much we made,expenses and how much we had to pay out.At the time we were renting a building for our business and had to pay rent plus utilities at home and work plus we had to drive 45 miles everyday to work and the gas it took to get back and forth to work is what put us in the bracket to qualify for this aid.Business fell off so much that we just couldn't keep paying the rent on the building, we closed the business and moved it to our home till we can afford to build our own building.So now our expenses are pretty much cut in half but we don't have the customers that we did in the other place cause we live in a small town.We make just enough money to pay our bills.
I have an appointment Wed. so they can re evaluate my file.I'm afraid when they find out that we closed the shop and don't have those bills anymore are they going to drop me from the program?We don't have the business we had either.Then will my doctor drop me? I'm just really worried about this.Also something I'm wondering about is,they know that my pm is wanting to do surgery on my neck.They even made me get a second opinion (which they paid for) to make sure there might be another (less expensive) option before agreeing to the surgery.Are they trying to find a reason to drop me from the program?I'm just really worried cause if my doc drops me I want have my med and I can't function without them cause I'm in so much pain everyday.
I'm sorry to ramble on so but if anyone can shed some light on this I would appreciate it so much.

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Old 10-01-2007, 03:31 AM   #2
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Shoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB User
Re: Long post,but hope you can help

Hi GG, I don't think some agency is looking to drop you to prevent paying for surgery. I do think these programs are monitored and it's likely time for an anual eval to see if you still qualify and deserve the benefits. Many people would much rather have the state pay for their insurance even when it does become available through an employer. So there is a system in place to make sure the tax payers that are paying for this program aren't being defrauded by anyone. Closing a store front may have cost you expenses, but the decrease in income may keep you qualified, you know the program better than most but I'm pretty sure there is a procedure to report changes in status.

As far as loosing your meds, There are cheaper alterantives. 50 cents worth of methadone a day will replace the thousands a month spent on long acting morphine. fentanyl patches or any of the long acting med. I went years without prescription coverage and methadone is the only alternative to whatever med your presently taking if you loose benefits. However I really doubt there is some conspiracy amed aganst you , they just want to see their tax dollars being put to use and used on those that need it. You are either eligable or not, and although it helps now, if your recieving a benefit your not eligable for, most states will demand their money back for anything they payed past your point of eligability. Better to have the program ended now if your don't qualify than to end up owing them tens of thousands of dollars when if at some point you could have obtained your own insurance or qaulified for a different program or no longer qualified for this one.

good luck, Dave

Last edited by Shoreline; 10-01-2007 at 03:34 AM.

Old 10-01-2007, 08:42 AM   #3
Join Date: Aug 2007
Location: Tx
Posts: 54
gabbygrace HB User
Re: Long post,but hope you can help

I'll say one thing for you, you do tell it like it is. and I agree with everything you said.I WILL NOT try to dance around the truth when I talk to them.One thing I do is tell the truth in matters like this. There is enough fraud going on in our country. I'm just going to tell them our new situation and hope I still qualify.If not then I'll go to plan B (whatever that is).Anyway thank you for your reply.

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