Girls Just Wanna Have Funds » Health

Senior Healthcare Options: Navigating The Murky Mess That Is The US Healthcare System

Ginger — Mon, 05 May 2008 10:00:05 +0000

It never occurred to me that the health care system for seniors in this country was so dire until my FIL became ill. To have every door closed to us because of a pre-existing condition, age and lack of continuing insurance blew my mind. So what options do seniors have when it comes to health care? Here’s what we found:

Group Insurance

Wikipedia:

Group insurance is an insurance that covers a group of people, usually who are the members of societies, employees of a common employer, or professionals in a common group.

Group insurance may or may not be converted to individual coverage. As group insurance gets big business for an insurance company with minimum operational expenses (under one master policy issued to an employer, union or any recognised group), it is usually less expensive than individual policies.

Now if you’re retired and battling a major illness which prevents you from working and obtaining group health insurance, what are your options?

Exactly, same questions we were faced with. Again, this is something we never thought about until now because we always assumed that Medicare or Medicaid took care of this sort of thing. He isn’t yet 65 and while his income qualifies him for Medicaid, he would still be living with us and they would count our income as I understand it which would make him ineligible. It’s like one frustrating merry go around that just seems so unfair to this section of our population. Don’t get me started on the cost of prescription drugs out of pocket.

Individual Insurance

After a comprehensive internet search we found a few plans that might be worth considering with the only issue being cost. Given his pre-existing conditions (diabetes and high blood pressure) we want a plan whereby he can see a specialist in a network, no deductible, no more than $50 per office visit to the PCP or specialist and emergency room coverage all for less than $300 month. What turned me off was the eagerness and shady behavior of the insurance agents who started calling 10 minutes after submitting the application. I don’t like being rushed into anything and so I had to tell one agent to back off while we get together and make a decision. After all, it isn’t final as to whether or not his stay here will be permanent OR if he will be returning to NJ and if so what level of independence will that mean for him?

It goes without saying that individual plans are more expensive than group plans because group plans get a larger discount for bigger business. This is our primary barrier to getting the best insurance as our preferred plan will run around $515 per month.

Medical Discount Plans

Medical Discount Plans are not insurance. This is a type of plan sometimes underwritten by insurance companies where you pay a set fee as which entitles you to plan benefits similar to that of regular health insurance. I am a bit wary of these plans as Ive never used them and not sure how binding the plan benefits are given that the company we interviewed could not guarantee for us how much they would cover after seeing a specialist. She kept on saying up to 70%, even with telling her he would be seeing a renal specialist and/or endocrinologist. Granted, they do have an advocate but what good does that do if the insurance company’s decision is final?

So, this isn’t a full health insurance policy and does not give one the same benefits and I am not sold in this plan. It merely gives a discount and boasts a large provider listing but what if they aren’t near? Well, we found out none of the 250,000 providers were near us and we live in the DC metro area, come on now. So this plan is a no go and that is final. And about the discount? This can get expensive if you need surgery or need to see a specialist, the latter of which is a reality for us at this time.

I am still waiting for the administrators of the Maryland Senior Health Insurance Assistance Program program and Maryland Health Insurance Plan (MHIP) to call me back to discuss health insurance options. Hopefully, they may be able to provide some information and insight into our options moving forward.

Have you been faced with a similar situation? If so, what were your options and how did you obtain insurance for a senior or edlerly person in your care?

Eating Junk is Expensive!!

Ginger — Sun, 06 Jan 2008 12:00:15 +0000

Eating junk now leads to chronic illnesses later which means trips to the doctor, time off work which then means losing wages if you end up exhausting sick leave. This leads to stress about missing work due to illness which then leads to lower productivity which leads to sleepless nights which begins the cycle again. Let’s not forget deductibles and copays when you do go to the doctor. Make no mistake, you will have these expenses if you think eating healthy is too expensive.

Breathe.

I think you know where I stand on this issue. Eating healthier NOW cuts your lifetime health expenses in the long run.

Leading Causes of Death in Females, 2004

All Females, All Ages	Percent*
1) Heart disease	27.2
2) Cancer	22.0
3) Stroke	7.5
4) Chronic lower respiratory diseases	5.2
5) Alzheimer’s disease	3.9
6) Unintentional injuries	3.3
7) Diabetes	3.1
Influenza and pneumonia	2.7
9) Kidney disease	1.8
10) Septicemia	1.5

(Source: CDC)
Reconsider for a moment as you begin to think about the higher food prices, and fix your mouth to tell me about Whole Foods prices being way outside of your budget. Just how expensive is eating junk food?

Chronic Illnesses

As the chart aboves states, the number one killer of women in the United States is heart disease. Women are less likely to survive a heart attack than men. We are at higher risk for death when we suffer a heart attack and there is no known reason why. The important health factors are smoking, high blood pressure, high cholesterol, family history and age. But since this is about the cost of eating junk, lets have a stab at it:

Health Care/Health Insurance

When you’re eating unhealthy food on a consistent basis this opens the doors for health problems. But we know this right? This may show up in the form of obesity, high body mass index described as over 35%, breathing problems, a waist size over 32, which then leads to a higher chance of stroke and heart attacks. Health insurance companies don’t like people they consider to be a high health risk and often refuse to insure them. But what about those of us who are insured? Well we have to take time off work to go and investigate the chest pains we’ve been having for the last 2-3 months. This means repeated trips to the doctor and having to pay high copays along with fulfilling deductibles. That gets expensive.

Work

While you’re busy going to doctor’s appointments, you’re missing work. Your boss is pissed because he/she has to account for your time off and maybe even assign your work to someone else. You’re taking time off and for some this leads to taking unpaid time off from work depending on how serious the condition. You’re not getting paid and if you’re living paycheck to paycheck that means a bill won’t get paid. What’s the harm in that? The lights being shut off or a late payment reported to the credit bureau which then leads to higher interest rates. When you are at work you’re too stressed out about the high cost of your prescriptions and how you’re going to incorporate taking hypertension and high cholesterol medications and possibly insulin injections into your daily regime. Your productivity is reduced because when you do return to work you have to play catch up and put to the back of your mind your declining health. This leads to stress and sleepless nights which only intensify the cycle.

This post was actually inspired by our trip to Trader Joes today where we made out like bandits!! We paid a total of $99.59 for 4 full bags of groceries! This would have been closer to $150-$175 easy at Harris Teeter or Giant.

I agree that Whole Foods is expensive but consider Trader Joes as a less expensive alternative. We also have our fruits and vegetables delivered weekly by Door To Door Organics. Depending on where you shop for groceries it is more expensive but think of it as a long term investment in yourself, your body, your family and your livelihood. Dropping dead from a heart attack while celebrating your 45th birthday is so unnecessary and puts you and your family through hard times. How you take care of yourself from this day forward impacts not only you, but your children, spouses, significant others, family and friends.

Choose life and choose to live it well. Live it not giving more money to the health insurance machines betting you on your health insurance application that you will lose. Guess what? An average of 30% of us are losing that battle, don’t let it be you or someone you love. This isn’t only about money and the high cost of eating junk, but about your livelihood.

I wish all of you health and vitality in the new year!

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Technorati Tags: higher food prices, Whole Foods, health problems, hypertension, high cholesterol, Trader Joes, Door To Door Organics

Being Poor is Expensive !!

Ginger — Thu, 20 Dec 2007 01:46:00 +0000

I called my bank the other day about a transaction that I needed done and was told the price was going to be $42.00. The price seemed pretty fair for what I needed till he said one moment Mrs. Latte I see here that you are a premium customer so therefore the price will be $9.50. While I’m ecstatic to save myself $32.50, it brings up the question - What exactly makes me a premium customer? I wasn’t applying for a loan or anything that had to do with me having my credit pulled, so the status must have been brought on by past experiences with me and the size of my accounts with them.

Do poor people really pay extra for different things?Well I could start with the biggest examples of poor people paying out the rear but I think I’ll start with the smaller, less-thought-about things and the move on up:

Check cashing places, cash call loans, money orders, collection agencies and bounced check fees.

So the bank works in a particular way- You write a check for $20, they cash the check based on your balance- Now if you write a check with an insufficient balance they charge you $32.00. Some banks give you a week to pay it if not you get charged another $32 now a 20 buck check has run you up a $84.00 debt then if your account is shut down now you have to go pay court costs,collection charges which brings your $20 shortage of funds to a whopping 200.00. Now if while you are waiting for your next paycheck you have an unexpected emergency and need a payday loan- of course it isn’t free so now they charge you for that. PayDay loans are known to carry exorbitant fees in excess of 99%. And that’s being kind.
Along with being poor usually comes bad credit or okay credit with not enough money to fix it and that often means higher rates on credit cards, mortgages, insurance rates to requiring deposits on a rental car. Being poor cost money!!

Job
Think about it, if you’re poor that means you either have no job or a menial job in which you have little control around your schedule, pay rate/grade and duties/responsibilities. You are often at the beck and call of a disconnected scheduler who may give you a schedule that may interfere with other oligations such as picking up your child from the daycare on time which then costs you upwards of $5 per minute, per child if you’re late. If you have no job then you are stressed about how you will pay the rent, mortgage, utilities and put food on the tale. Stress leads to other things like a decline in your overall health and well being.

Health and Health care
When you are already stressed out about barely making ends meet, this brings along with it health related stressors such as ulcers, heart disease (you don’t exactly have the money to shop for healthier, and more costly food options), high blood pressure and other chronic disorders brought on by the daily stresses of worrying about money.

Furthermore, one of the more obvious ways that people pay more for being poor is through their health, often not being able to afford proper health care or dental care and even dying of simple treatable diseases mentioned above. When you’re up all night stressing about a possible eviction, you arent exactly thinking about going for your yearly checkup which could tell you more about your recent bouts with shortness of breath and high cholesterol.

Silver Lining
However, being poor will force someone to make needed changes in in their attitudes towards money. For some this can be a motivator which inspires them to go back to school, seek a part time job, ask for a raise and overhaul their spending habits altogether. So if you happen to be in a bad predicament where you’re finances are concerned, there’s help available. But it starts with you and your attitude towards money. Do you control it or does it control you? Being poor is expensive, think about it!