Showing posts with label Healthcare. Show all posts
Showing posts with label Healthcare. Show all posts

Tuesday, March 28, 2017

DailyDDoSe: 47 Million Underinsured and Uninsured in America

I am one of them: here's my DailyDDoSe March 28, 2017


We live in a society where no one accepts responsibility for their mistakes; no one is held accountable
for their actions; and one EVER, EVER says they are sorry.

Let me show you a small glimpse inside the typical day of the 47 million uninsured and underinsured in the wealthiest nation in the world: The United States of America.

As someone who spent years as one of the 47 million (source RWJF.org) I spent day after day after day doing the same thing without any result or consequence.

I can only offer
you a glimpse into day in the life because there is no room to sit in my car with all the files, medical records and appeal documents.

I believe my apartment may actually be a fire hazard...

This was my daily update posted at 7:30am:

As for my most recent insurance dispute (2008) little jas changed and I feel I have done everything humanly possible to
protect health care providers who are NOT providing health...

I cannot clean up the slack for my every underqualified, health care provider (who did NOT provide adequate care to my patients or myself). However I feel I have no other choice than
to share what I have learned...

Having been on both sides if the proverbial couch, I have the perspective
that is both enlightening and scary at the same time.

Sometimes I try to look at this fight, (I meant to say this life) objectively.

I can see my own future, and I can see where it is taking me. I know how it will end it I don't thinks I can
keep up the
pace.

It is amazing at how far we will go to have nothing at all.

I have come this far, and on some level I almost enjoy the dance.

No.

On some level, I actually love the
dance.

No. I won't give up now. Because without this turmoil, this means an end to this demonstration project of futility and determination, amd without that I am nothing at all. I can't lose what I never had.

I won't be another sell-out; mostly because I don't know how.

I am the voice of perseverence. I am one of 47 million Americans with sunstandard medical care.

And today I am I am still fighting the good fight.

This battle; this challenge; this half won war has come to define me. And without that, I am really nothing at all.

As someone once told me, if you don't stand for something, you'll fall for anything. I've already fallen, but I sure as shit stand for something.

So for now, I write. Maybe later, I will listen. And if there is any justice left in this world, maybe someday I will actually live.

Just me,

Elyssa D. Durant


^ed 

Saturday, December 21, 2013

Last Writes: A Letter from Ned Vizzini

UNWRITTEN: Last Writes: A Letter to Ned Vizzini

Unwritten:: A letter to Ned Vizzini




From: “Ned Vizzini” 
Hey, sounds like me!  I’m headed towards ruin quick.  Hope all is well

-------------- Original message ---------

From: “Ned Vizzini”

I’m not good, Elyssa. Very depressed.  I was such a different person when I knew you.  But maybe I will be different soon. 

-------------------------




From "Elyssa D:

god ned-- I wish we could talk—based upon what I’ve read (what you’ve posted on line and through your interviews) it seems as though you are going through all the emotions and emotional chaos that I was experiencing the first year we met back in new York.

Another friend of mine just checked himself into a psych ward after a suicide attempt and I feel so helpless because I care and respect you both so much.

it is funny because I always thought that if I could just finish that damn book I was working on ten years ago—or just finished law school, my PhD. or any number of things—everything would be okay.

It confuses me because you finished your book—rob finished law school- I finished nothing.

A few weeks ago, I “lost my shit” so to speak, came across your interview, and was completely blown away—I used to be the crazy one—now I have my sanity back but nothing else.

having been through several crises myself, I came to believe that when you see someone in crisis, they become so overwhelmed and confused that they do not know what to do first—and how to dig out of the hole they have dug for themselves.  I decided that rather than asking, I just try to figure it out and give it to them, no questions asked, no thank you necessary.

How many people have told you, “Call if you there is anything I can do” and when you do call—nothing!  Nothing but disappointment and regret.  So I have decide never to ask somebody what they need—

Mostly because they don’t even know themselves— hen I came to the realization a few weeks ago that my transient existence is so tangential that no one would notice if I never took another breath—I tried to figure out what I needed so that I could give it to myself.
So I started going back through my old journals to see if I could identify the missing element of my life—you know that “thing” that would both make it all go away and make all come together so I could be a whole person again.
That thing is a figment of my imagination.  I used to think it was being loved by a man—I had that.  Wasn’t it.
Then I thought it was having money.  I had that.  But that wasn’t it either.
Then I thought it was health insurance—but no, that was not it either.
Then I thought it would be having that oh-so-critical Ivy League degree.  I have that.  That still wasn't it. 
So obviously, none of those things could have been “it.”
The thing I need most, I lost long ago, and that was hope. Perhaps I never really had it at all.

So I guess some things just can’t be bought, learned, earned, or acquired. 
I think of the long twisted road, and I remember one of my favorite childhood movies, where a girl named Dorothy was so determined to find her way home after a great storm.  Disillusioned and distracted, Dorothy would not yield to the many obstacles that had been placed in her way.  Determined to meet the great Wizard, she stayed one path. 
Yes, there were detours, obstacles, and the Wicked Witch of the West.  Each of these obstacles may have taken her of course, yet she never once lost sight of the road home.   She believed in one thing, the Wizard, and his ability to bring her home.  

Having great faith and determination, she never strayed far off the path to righteousness.  Dorothy had a clearly defined goal, a means to get there, and a bright yellow brick road to guide her.  Through her determination and unyielding faith, Dorothy never once doubted that she was on the right path. 
In the Wizard of Oz, the yellow brick road may have been the path she was taking, but through her determination and blind faith, she was able to bring others onto the road t enlightenment.
The lion found his courage; the tin man got a heart.  The scarecrow got some brains—and even Dorothy got what she needed most. 
Dorothy began her journey looking for one thing.  She needed to get back to place she began, and find her way home. Dorothy teaches us a valuable lesson, but she was lucky enough to know what it was she so desperately longed for... home.
If all I had to do was click my heals three times and find my way home, well, sadly I would not even know where home is.  Yes, they say home is where the heart is, and perhaps that is part of the problem.  But for some of us, out childhood homes were not places of happiness and nostalgia.  They are places from which we run, searching endlessly for that magical place and can only hope that we have come across a road that is clearly marked to guide us in our destination. 
Of course, we know there will be that take us off course, and it will up to us to find our way back.  Unfortunately, there is a certain point when we lose our direction and we lose our faith.  As I grew older, I came to realize recognize that my feeling of detachment went far beyond having a dysfunctional childhood a broken family life that even my sister and I never lived in the same house for more than a year or so in the summertime.

So no matter how long I have been in Nashville, in many ways I am, in fact still a stranger.  I am a stranger because homeless is a state of mind. 
In my mind, I like to think a home is a place of acceptance, shelter, and a place you can find forgiveness, comfort and recognition.  For most, going home means to reconnect in a way so that you are reminded that you have something, someone, who will always have your back. 
Homer represents more than a structure; it represents a strong foundation that will always be there whenever you need to feel safety and comfort.  For me safety is marked by the boundaries that are supposed to keep me safe and protected. 
So this is my home.  I don’t necessarily feel safe here, but I do feel consistent.  I do not have to worry that I will be forced to switch schools, neighbors or friends every six months just because my parents could not get it right.  What they failed to realize is just how very wrong it really was.  Changing schools, changing friends, changing siblings; changing myself just enough each time so that I could fit in. But after 16 years of constant change, I never got the opportunity to find out anything real about myself.  Even my name was changed when I moved--- dad called me Liz, and my mother called herself any number of last names as she desperately tried to hold on to her youth, her beauty, and delusional fantasies of entitlement and sacrifice that I think she may actually believe. 

I have never had plastic surgery, could not afford it anyway, but what do have is a clear memory, vivid nightmares, and a place of my own.  What I also realize, is that until I can live free from fear and dependence, I will never truly be able to know what it feels like to be at home.  If home is where the heart is, then homelessness is clearly just a state of mind.  And today I have some hope that I might someday no longer feel just as homeless at home.  So now I know more than ever, that homelessness is a far more than a concrete structure or family property. 
I will always feel a little homeless at home.  It is knowing that you are the thing that remains constant—regardless of any dreams I may have, I will never have the constant I would need to get bring a child into this world--- as much I  would like to. 

I envy those who feel they have so much in their lives that they can trust without any reservation that the world is a loving enough place they want to share with a child. Especially a child of their own.  No, my mother told me long, long time ago, that I can never have children.  

She also told me last year, that I could not have a dog.  My own mother does not think I am capable of raising a puppy.  Maybe she’s right.  She did put her fears into action when she once donated my cat of 14 years to the animal shelter under someone else name so that I truly was left without any ties to the condo I stayed in for a few short months while I tried to come up with a plan to take him and myself far from a place where we could be safe and live free. 

I adopted him back from the animal shelter 40 miles out after learning that she had used someone else’s name at the agency so I could not find him on my own.

I will not look elsewhere to find the essentials things healthy children receive that in turn makes them healthy adults. 
I will never be “healthy” but I do think I wish I could give more than what I have received.  I regret never being the kind of “community member" I think I could have been, and I doubt I will get over the sheer humiliation of having to love this way for so many years when I should have been doing so much more.
in having truly been able to do the great things for society that I believe I could, but I can’t regret not giving no longer need constant reassurance, recognition, or validation, but I will always question whether things could have been different if only one person had taken the time to show me I was worth it.  That I deserved more than what I could actually afford and realize that I do give so much in so many other ways.  

The ways that people cannot calculate or see just how badly the ones who received them needed those gifts.  It was the little things.  It was Kody, it was Desiree, but above all else, it was me setting goals, the feelings of that my feeling I would never and was no longer subject to bi-annual custody disputes and shifts  and us to realize that homelessness is merely a state of mind. 

Where would I go?  10 years “down the road” and now, more than ever, I realize I am truly and deeply, “homeless at home.”  
You see it is not so much that I doubt myself, I just don’t trust that people will not do horrible things even if that means doing nothing at all. 
I do have much love to give.  Actually too much.  So much that it often pours out of me in inappropriate sentimentality.  I know when I need to keep to myself, and I know when my anxieties starts to make others a little anxious.  I know because as I see you react to me be anxious, it only makes me that much worse. It is one of my worst, but at times sometimes, that sensitivity is also at times a wonderful attribute and god given gift.

But should that prevent me from getting out into the world just because other people think I should be don’t like me … that’s not my job.
I have spent more than half of my life in self-imposed isolation, and the other half wondering how I can be less annoying and high strung so others would want me around.  The sad truth is, yes, I am annoying, but also, I am perceptive and very aware.  

Sometimes I do it purpose. 
I should not have to live in isolation because I have nervous tics or sometimes say the wrong thing.  But regardless of what people seem to think about welfare recipients being lazy bums guess what—FUCK you right back.   I have chosen to keep to myself just in case I really am so horrible to be around and my parents were right. Even my own mother thinks I would be better off dead.
and the rest is still unwritten... 

Elyssa D. Durant, Ed.M. © 2008-2013

Sunday, October 20, 2013

Glossary of Health Insurance Terms

Glossary of Health Insurance Terms



 
Allowed Amount 
Maximum amount on which payment is based for covered health care services.  This may be called “eligible expense,” “payment allowance" or "negotiated rate."  If your provider charges more than the allowed amount, you may have to pay the difference. (See Balance Billing.)

Appeal 
A request for your health insurer or plan to review a decision or a grievance again.

Balance Billing
When a provider bills you for the difference between the provider’s charge and the allowed amount. For example, if the provider’s charge is $100 and the allowed amount is $70, the provider may bill you for the remaining $30. A preferred provider may not balance bill you for covered services. 

Benefit
A financial payment made by your health plan for covered services or drugs.

Co-insurance 
The percentage of health care costs you are responsible for paying – usually after your plan’s deductible is met.

Complications of Pregnancy 
Conditions due to pregnancy, labor and delivery that require medical care to prevent serious harm to the health of the mother or the fetus. Morning sickness and a non-emergency caesarean section aren’t complications of pregnancy.

Copayment (Copay)
A fixed dollar amount you must pay with your own money for medical services, such as office visits, or prescription drugs.

Cost Sharing
The health care costs that are your responsibility to pay, including deductibles, copays, coinsurance, and other costs not covered by your health plan.

Coverage
The costs your health plan pays for your medical services or prescription drugs.

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Deductible
The amount you must pay each year – with your own money – before your health plan begins paying benefits.

Durable Medical Equipment (DME) 
Equipment and supplies ordered by a health care provider for everyday or extended use.  Coverage for DME may include: oxygen equipment, wheelchairs, crutches or blood testing strips for diabetics.

Emergency Medical Condition 
An illness, injury, symptom or condition so serious that a reasonable person would seek care right away to avoid severe harm.

Emergency Medical Transportation 
Ambulance services for an emergency medical condition. Emergency Room Care Emergency services you get in an emergency room. Emergency Services Evaluation of an emergency medical condition and treatment to keep the condition from getting worse.

Excluded Services 
Health care services that your health insurance or plan doesn’t pay for or cover.

Exclusions
Items not covered by a health plan, such as certain prescription drugs or medical services.

Explanation of Benefits (EOB)
A statement from your health plan that shows the amounts it paid for medical services on your behalf and the amount you owe your health care provider. For health plans that include prescription drug coverage, a separate EOB lists drug purchases for the month. EOBs can help you know when you have met your plan’s deductible (if applicable), Initial Coverage Limit, and Catastrophic Coverage Threshold.

Formulary drug list
A list of brand-name and generic prescription drugs covered by your health plan.

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Generic Drugs
Prescription drugs that either have the same active ingredient formula as brand-name drugs (generic equivalents) or that have the same therapeutic effect (generic alternatives). Generics usually cost less than brand-name drugs. They are also regulated by the Food and Drug Administration (FDA) to be as safe and effective as their brand-name counterparts.

Grievance  
A complaint that you communicate to your health insurer or plan.

Habilitation Services
Health care services that help a person keep, learn or improve skills and functioning for daily living. Examples include therapy for a child who isn’t walking or talking at the expected age. These services may include physical and occupational therapy, speech-language pathology and other services for people with disabilities in a variety of inpatient and/or outpatient settings.

Health Insurance 
A contract that requires your health insurer to pay some or all of your health care costs in exchange for a premium.

High-Deductible Health Plan (HDHP)
A health plan that usually pairs a lower premium with a higher deductible than a traditional health plan.

Home Health Care
Health care services a person receives at home.

Hospice Services 
Services to provide comfort and support for persons in the last stages of a terminal illness and their families.

Hospitalization 
Care in a hospital that requires admission as an inpatient and usually requires an overnight stay. An overnight stay for observation could be outpatient care.

Hospital Outpatient Care 
Care in a hospital that usually doesn’t require an overnight stay.

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In-network Co-insurance 
The percent (for example, 20%) you pay of the allowed amount for covered health care services to providers who contract with your health insurance or plan.  In-network co-insurance usually costs you less than out-of-network co-insurance.

In-network Co-payment  
A fixed amount (for example, $15) you pay for covered health care services to providers who contract with your health insurance or plan. In-network co-payments usually are less than out-of-network co-payments.

Maximum Allowable Charge (MAC)
The maximum dollar amount your health plan will pay a doctor, hospital or other health care provider for a covered medical service.

Medically Necessary 
Health care services or supplies needed to prevent, diagnose or treat an illness, injury, condition, disease or its symptoms and that meet accepted standards of medicine.

Network 
A group of doctors, hospitals and other health care providers contracted to provide services to health plan members at a rate that is less than their usual fees.

Non-Preferred Brand Drugs
A brand-name drug covered by your health plan that may have a higher cost share than similar preferred brand drugs.

Non-Preferred Provider
A provider who doesn’t have a contract with your health insurer or plan to provide services to you. You’ll pay more to see a non-preferred provider. Check your policy to see if you can go to all providers who have contracted with your health insurance or plan, or if your health insurance or plan has a “tiered” network and you must pay extra to see some providers.

Out-of-network Co-insurance 
The percent (for example, 40%) you pay of the allowed amount for covered health care services to providers who do not contract with your health insurance or plan. Out-of-network co-insurance usually costs you more than in-network co-insurance.

Out-of-network Co-payment 
A fixed amount (for example, $30) you pay for covered health care services from providers who do not contract with your health insurance or plan.  Out-of-network copayments usually are more than in-network co-payments.

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Out-of-Network Doctor
A doctor with whom your health plan does not have a contract. If your plan allows you to receive covered services from a doctor or other provider outside your network, you may pay a higher share of the costs.

Out-of-Network Pharmacy
A pharmacy with which your health plan does not have a contract. Most medications you get from out-of-network pharmacies are not covered by your plan unless certain requirements are met.

Out-of-Pocket Costs
The amount you must pay out of your own pocket for your medical or prescription drug expenses. These costs include things like deductibles, coinsurance or copays.

Out-of-Pocket Maximum
The most you will pay with your own money – or out of your own pocket – in a year.

Physician Services
Health care services a licensed medical physician (M.D. – Medical Doctor or D.O. – Doctor of Osteopathic Medicine) provides or coordinates.

Plan 
A benefit your employer, union or other group sponsor provides to you to pay for your health care services.

Pre-authorization 
(Sometimes called prior authorization, prior approval or pre-certification)
A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary. Your health insurance or plan may require preauthorization for certain services before you receive them, except in an emergency. Pre-authorization isn’t a promise your health insurance or plan will cover the cost.

Pre-Existing Condition
A condition for which medical advice was given or treatment recommended by or received from a physician prior to enrolling in a health plan.

Preferred Provider 
A health care provider who has a contract with your health insurer or plan to provide services to you at a discount. Check your policy to see if you can see all preferred providers or if your health insurance or plan has a “tiered” network and you must pay extra to see some providers.  Your health insurance or plan may have preferred providers who are also “participating” providers.  Participating providers also contract with your health insurer or plan, but the discount may not be as great, and you may have to pay more.

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Preferred Provider Organization (PPO)
A network of doctors, caregivers and medical facilities that agree to provide health care services to our members at a lower cost; members get the most from their PPO plan when network providers are used.

Preferred Brand Drugs
Brand-name drugs that are medically sound, cost-effective alternatives to higher-priced drugs.

Premium 
The monthly payment made for an insurance policy.

Prescription Drug Benefits 
Health insurance or plan that helps pay for prescription drugs and medications.

Prescription Drugs 
The type of benefits provided for the purchase of drugs prescribed by a physician that are not available over the counter.

Preventive Service
A service such as a cancer screening or a flu vaccine that is given to prevent or detect a condition at an early stage.

Primary Care Physician 
A physician (M.D. – Medical Doctor or D.O. – Doctor of Osteopathic Medicine) who directly provides or coordinates a range of health care services for a patient.

Primary Care Practitioner
A health care provider specializing in family practice, internal medicine, general practice, pediatrics, obstetrics or gynecology, or a physician assistant or nurse practitioner.

Prior authorization
Getting approval for certain medical procedures before you are treated.


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Provider 
Any doctor, health care practitioner (nurse, physician assistant, etc.), hospital, facility or pharmacy that provides you with medical services or prescription drugs.

Qualifying event
A change in circumstances (like marriage, divorce, losing employer-sponsored health coverage) that would allow a member to change plans or add optional maternity coverage.

Quantity Limits
A pharmacy management tool designed to make sure certain drugs, such as those that are often taken inappropriately, are not used in amounts that exceed recommendations for dosage or length of treatment. Quantity Limits are based on recommendations from the federal Food and Drug Administration (FDA) and the drug’s manufacturer.

Reconstructive Surgery 
Surgery and follow-up treatment needed to correct or improve a part of the body because of birth defects, accidents, injuries or medical conditions.

Rehabilitation Services 
Health care services that help a person keep, get back or improve skills and functioning for daily living that have been lost or impaired because a person was sick, hurt or disabled. These services may include physical and occupational therapy, speech-language pathology and psychiatric rehabilitation services in a variety of inpatient and/or outpatient settings.

Rider
An amendment to your health plan that either adds coverage (such as a maternity benefits rider) or specifies a particular condition that will not be covered (a benefit exclusion rider).

Schedule of Benefit or Summary of Benefits and Coverage
A complete overview of the covered benefits provided by your health plan.

Skilled Nursing Care
Services from licensed nurses in your own home or in a nursing home. Skilled care services are from technicians and therapists in your own home or in a nursing home.

Skilled Nursing Facility
A facility that provides inpatient nursing care, rehabilitation services or other related health services. “Skilled nursing” does not include a convalescent home or custodial care.

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Specialist 
A physician specialist focuses on a specific area of medicine or a group of patients to diagnose, manage, prevent or treat certain types of symptoms and conditions. A non-physician specialist is a provider who has more training in a specific area of health care.

Specialty Drugs
Certain highly specialized drugs used to treat complex, chronic conditions that require special handling and administering by the patient or provider.

Step Therapy
A pharmacy management tool that requires you to try a less expensive drug (usually a generic) to see if it is effective before you take a more expensive (usually brand-name) drug.

Tier
A copay or coinsurance level that applies to drugs on a health plan’s formulary.

UCR (Usual, Customary and Reasonable) 
The amount paid for a medical service in a geographic area based on what providers in the area usually charge for the same or similar medical service.  The UCR amount sometimes is used to determine the allowed amount.

Urgent Care 
Care for an illness, injury or condition serious enough that a reasonable person would seek care right away, but not as severe as to require emergency room care.

Wellness benefit
Coverage for routine services and preventive visits, like cancer screenings, mammograms and physicals.



 


Wednesday, September 25, 2013

HMO America

HMO AMERICA 

Hello, and welcome to HMO America where your health maintenance is our number one concern. 

Your call is important to us, so please do not hang up. 

If you think you have a life or limb-threatening emergency, and need to go to the hospital before the end of this message, do so now. 

Remember, however, that if HMO America determines in hindsight that you did not have a life or limb-threatening emergency, you will be responsible for all of the hospital and physician charges which could run into several thousand dollars. 

Please select from one of the following options: 

☎ If you are having head pain, press one now. 

☎ If you are having chest pain, press two now. 

☎ If you are having abdominal pain, press three now. 

☎ If you do not know where the pain is located, press five now.
 
Incidentally, if you are still using a rotary phone, you are going to die! 

Thank you for calling HMO America, where we manage your healthcare so your physicians don't have to!