Re: SS apt. today/rant and rave

[Guest guest]

hey jen!

good luck with your appt. i got ssi and medicad for christopher in

oct we were approved the first time i applied. i think alot has to

do with how well your doctors responsed to the request for info but

i am not sure. we have private insurance too but the medicad is

great because it picks up his copays (our specialist copay is $40)

hope everything goes well for you guys!!

jodie

(nicholas-5 nonrss, christopher-3 rss 22lbs 33 " , johnathon-7m

nonrss)-

ps-hang in there and remember we are here for you!!

[Guest guest]

I hope your first appointment went well. I guess i should introduce myself.

I am sheldon and i am the grandpa to Laikyn who has RSS. But we all still

love her to death. Now back to your SS appointment. First i will give you a

little background with me. I was injured on the job in 1999 and that led to

3 back surgeries from which i am now declared 100% disabled. So i started my

long unexplained battle with SSI. All doctors aggreed about my disability.

But like many people told you 90% will be declined the first time.Thats what

happened to me. SO i heard of an agency called the ADVOCATES. They help

people who have been denied SSI.If you can find them in your area it worth

looking them up. If you are intiteled to any back services or pay they will

take 25%. But i didn't care because they past was gone and all i wanted was

to be taken care of in the future. But before you see them make sure you

have all your records in a file,i mean everything and it will go much easier

than from than on it's in their hands. they will take care of everything.

Yes it does take time, just like everything else so you have to be very

patient. usually the second time you get approved. It is well worth the

wait. Good luck Jen and if i can help in any other way just ask ok

Sheldon ( G-PA to my little angel Laikyn,RSS)

SS apt. today/rant and rave

> Well, I'm going in for my first apt. with social security today at 9:00

am.

> I'm going in on a not so positive note, everyone tells me to be prepared

that

> they will deny us at least the first time. I don't understand why that

is. I

> looked up the ss websites own definitions of qualifying disabilities, and

he

> definitely qualifies under more than one..did you know that consistently

being

> under the 3% for height and weight qualifies a baby? Weird.

> I'm not even sure what we would be qualifying FOR, other than medicaid.

We

> have private insurance and everything through Lance's job, but he makes

too

> much money to qualify for anything else. Our medical bills so far are

already up

> there at around $50,000.00 because of what our insurance doesn't cover. So

> Medicaid would be an awesome help. We have 2 deaf people in our family,

so the

> hearing aid payment is as much as our house payment! (we pay $1000.00 a

month

> on hearing aids!) Not to mention now that we are going to be getting into

it

> with all these Drs. the formula and stuff that we are going to be paying

for,

> (the insurance co will not cover the first $2000.00 of any medical

expense.

> After the $2000.00 they pay at 80%) it's going to be really interesting

trying

> to afford all of this. We are stuck with this insurance as our only

option

> through his work, and even though it's a major co. (BC/BS) it's the worst

I've

> ever heard of! I've worked in healthcare since I was 18, and have dealt

with

> lots of insurance co's, but this one just sucks. Our premium is $350.00 a

> month, and we have a $2000.00 family deductible, plus a $500.00 individual

> deductible..which means we have to pay $2500.00 before anything is covered

for

> Xavier, and if one of the rest of us needs something, we still have to

cover the

> first $500.00. This is not really feasable..for example, my brother was

just

> killed in November, and I have been having a really hard time dealing with

the

> stress, nightmares, et. especially with the added stress of Xavier thrown

in.

> Pretty much everyone in my family is on some kind of psychotropic drug,

both of

> my parents being bi-polar, and I just was putting off the inevitable, I

> guess, I knew that I needed some help, if only to get through the first

few

> months... I finally got myself to call a shrink and make an apt. and I

was told that

> I would have to pay $500.00 for my first apt. because *my* deductible had

not

> yet been met! Needless to say, I did not ever go to any kind of

counseling,

> especially when Xavier needs so much in the way of Drs....I'm not going to

> blow $500.00 on myself for something non-life threatening! It's

frustrating

> though. I'm still having a hard time getting through the days and

especially the

> nights when I am alone. (lance works the night shift) It's really a catch

> 22...he makes " too much " money for any kind of financial aid, made just

over the

> limit for the child tax credit, but we still have to pay out our rear ends

in

> taxes..we would have more money if he made less! Ugh! This makes no

sense.

> Anyway, so I just wanted to get out a few of my jitters before I leave,

wish

> me luck!

> Jen

> Xavier 14months, 13lbs RSS (?)

> Emerald, 5, Non RSS

> Wyatt,4, Non RSS

>

>

>

[Guest guest]

Jen,

I can empathize with your situation as I went through this 10 years ago with my

son,

and didn't qualify for anything either, despite all our bills. I wanted to

comment on

your comment about BC/BS. I have always had BC/BS for , but I have an

HMO

instead of a PPO. I know that most people bash HMO's, but in our case, I am

very

happy that we have had an HMO. 's medical bills were well over

$1,000,000

initially, as he was in the hospital for 7.5 months. Believe it or not, I

brought these

bills with me when I applied for Medicaid, and was denied! At the time, I was

scared,

and had no idea if any part of this would be covered by our insurance. In the

end,

everything was covered, so I didn't really need Medicaid anyway. We had a case

manager when was younger, so it was easy for me to get whatever

referrals I needed. Although we haven't had a case manager for a very long

time, I

still get any referrals I need pretty easily. My son still sees tons of doctors

in every

specialty, and is always having some kind of outpatient test or another. There

are no

deductibles with an HMO, just your copayments. There is also a maximum yearly

out

of pocket expense just like a PPO. Although, we have paid a lot of money in

copayments over the years, it will never amount to what we would have paid if we

had

a PPO (in addition to the higher premiums for PPOs). If you have a pediatrician

who is

in tune with your child's medical needs, the referral process is much easier.

All I have

to do is call & say I have an appointment with a doctor & the referral is ready

for me

in a few days. If an HMO insurance is an option for you, you might want to

look into

it & see what doctors are on the panel. You'd save a lot of money!

Kim

-- In RSS-Support , ljhess0701@a... wrote:

> Well, I'm going in for my first apt. with social security today at 9:00 am.

> I'm going in on a not so positive note, everyone tells me to be prepared that

> they will deny us at least the first time. I don't understand why that is. I

> looked up the ss websites own definitions of qualifying disabilities, and he

> definitely qualifies under more than one..did you know that consistently being

> under the 3% for height and weight qualifies a baby? Weird.

> I'm not even sure what we would be qualifying FOR, other than medicaid. We

> have private insurance and everything through Lance's job, but he makes too

> much money to qualify for anything else. Our medical bills so far are already

up

> there at around $50,000.00 because of what our insurance doesn't cover. So

> Medicaid would be an awesome help. We have 2 deaf people in our family, so

the

> hearing aid payment is as much as our house payment! (we pay $1000.00 a month

> on hearing aids!) Not to mention now that we are going to be getting into it

> with all these Drs. the formula and stuff that we are going to be paying for,

> (the insurance co will not cover the first $2000.00 of any medical expense.

> After the $2000.00 they pay at 80%) it's going to be really interesting trying

> to afford all of this. We are stuck with this insurance as our only option

> through his work, and even though it's a major co. (BC/BS) it's the worst I've

> ever heard of! I've worked in healthcare since I was 18, and have dealt with

> lots of insurance co's, but this one just sucks. Our premium is $350.00 a

> month, and we have a $2000.00 family deductible, plus a $500.00 individual

> deductible..which means we have to pay $2500.00 before anything is covered for

> Xavier, and if one of the rest of us needs something, we still have to cover

the

> first $500.00. This is not really feasable..for example, my brother was just

> killed in November, and I have been having a really hard time dealing with the

> stress, nightmares, et. especially with the added stress of Xavier thrown in.

> Pretty much everyone in my family is on some kind of psychotropic drug, both

of

> my parents being bi-polar, and I just was putting off the inevitable, I

> guess, I knew that I needed some help, if only to get through the first few

> months... I finally got myself to call a shrink and make an apt. and I was

told that

> I would have to pay $500.00 for my first apt. because *my* deductible had not

> yet been met! Needless to say, I did not ever go to any kind of counseling,

> especially when Xavier needs so much in the way of Drs....I'm not going to

> blow $500.00 on myself for something non-life threatening! It's frustrating

> though. I'm still having a hard time getting through the days and especially

the

> nights when I am alone. (lance works the night shift) It's really a catch

> 22...he makes " too much " money for any kind of financial aid, made just over

the

> limit for the child tax credit, but we still have to pay out our rear ends in

> taxes..we would have more money if he made less! Ugh! This makes no sense.

> Anyway, so I just wanted to get out a few of my jitters before I leave, wish

> me luck!

> Jen

> Xavier 14months, 13lbs RSS (?)

> Emerald, 5, Non RSS

> Wyatt,4, Non RSS

>

>

>