Just Having A Bad Day.....

[spastic]

Hi Everyone.  I think I have hit the rock bottom financially, emotionally, physically.  I know everyone has had this problem and I don't mean to complain about it but things have really went from bad to worse.  I just don't know what to do.  My insurance company is telling me that this was a pre-existing condition because four years ago I was treated for bursitis, I have Still's, its completely different than bursitis!  They are denying my payments and they owe me 4 months worth.  I have been keeping afloat with our tax return money but the well has run dry.  I was denied any help from Human Services because the hubby works but its not enough to pay bills and buy groceries both!

Physically, I am a wreck.  With the attack on my hip and the pelvis not healing right, the pain is excruciating, and the bleeding ulcer, well that is another story.  But it is funny how one more pain can make the other not feel as bad.  I should feel lucky that I have an ulcer, it makes the hip pain feel like a walk in the park. :)

Emotionally the only thing keeping my chin up is the wonderful friends here on the forum.  I don't show the family that I am struggling with this.  You all know what I am dealing with here and I appreciate that you all get me and understand me.  Thank you all for your support, it means the world to me.  Well, I am done feeling sorry for myself.

Love to All,

Ada

[grannyhotwheels]

I know exactly what you are talking about Ada. I'm in a huge financial situation right now myself. I have 9 people living in my house and we are all trying to live on my very small disability check.  The funny thing is we make too much to qualify for SSI or food stamps.  It wont even pay all my bills.  I have to stagger them because something is always late.  We are trying to get my husbands disability going but have been turned down twice.  I have an appointment to see a lawyer tomorrow so I need prayers for him to get approved quickly.  Once his check starts we will be OK but I'm afraid I'll loose everything before that happens.  We can cry on each others shoulders if you want. I just wanted you to know that your not alone and I will definetely add you to my prayer list.

I'll be praying,
Carol

[gooddays]

Hi, I know that some of you have never seen my name as many times as you see others in this forum.

I have been reading and posting in this forum since december, but I have become a silent partner since maybe the beginning or middle of March.  I read the forum postings on a daily basis.

I just read your post and the challenges you are having with your medical insurance.  There are a lot of individuals that are having it to.  Because of your challenges I went into the web and found this site that may be of help to you and others.

I really hope you get the answers and the tools you need to fight with your insurance company, who has gottten you into another hurdle to go through with this monster attacking us.

http://www.dol.gov/ebsa/newsroom/fshipaa.html

Keep in mind that WE HAVE MS, BUT MS DOES NOT HAVE US!!!!!!!!!!!!!!!!!!!!!!!!

Good look and let´s keep the Lord on our side, because he knows that we are special.

Zulma (Gooddays)

[spastic]

I want to thank you all for being here for me and sending the warm thoughts and prayers.  I was having a very bad time with this yesterday.  I get so frustrated with this whole process, I spend hours on the phone everyday with these insurance companies.  I was so glad to hear my pcp and rheumy went up to bat for me.  Again, thank you.

Love You All,

Ada

[Deb61]

Your insurance company will be fighting for every nickle than can keep.  I bet it is somehow written in their policy to ALWAYS deny at first.  Maybe they'll back down if you hire a lawyer or when your doctor yells at them!

When my sister's doctor yelled at the insurance people, she got her Tysabri infusions approved (they denied her, too).

We're behind you . . . I hope that you'll be hearing some good news, soon!

Deb

[Super_sally888]

Hi,

I just looked up Still's disease.  WTF!!! Pardon the French.  But, really even a total idiot could see that bursitis has absolutely nothing to do with Still's. Your insurance company's employees must be lower than morons to make such an association.  Or it may just be their policy to ignore every claim outright.

I think you have a very good case for appeal of this.  Don't give up.  It will be worth it when it gets through.

Sally

[floridamom2]

Hi Ada,

I am so sorry you have to fight the insurance company now on top of being sick!  Those companies will do whatever they can to NOT have to pay.

As far as the $$$ things go.  There are a lot of us here barely making it or should I say "by the hair on my chinny chin chin!"  I have trouble having faith that things will work out when I have a big financial stumble come up like you have with the insurance company.  What I know to be true is that my NEEDS are ALWAYS taken care of, maybe not my wants, but my needs.  It is so hard to stay in that spot of faith but knowing others are going thru exactly what I am finacially, emotionally or physically always helps me.  

I have a good friend on this board that has had to sell her house and close their family business and they are making it week by week just like we are.  I don't know your religious background but my belief is that God always provides for me and my family.  

You will be in my thoughts and prayers tonight!!
Take care of your self, Big Hugs!
Kristin

[LATW]

I am sorry to hear you are going through this too.  It is awful when things seem to happen all at once.  

One thing at a time is one thing, buth when it is all at once AND you are not feeling well, that is very difficult.... :(

LA

[Momzilla]

How horrible!

I have dealt with insurance companies in my job now four five years now, and their cold-heartedness and dyscompassion (yes, a new word) never ceases to astound me.  

Of course I realize that insurance companies are just that--companies--not people, but people actually work there and own them, right?  And, I realize, as well, that insurance companies are in business to make money.  Well, some--not the non-profits, presumably.  But, C'MON.  It's been four freaking years.  How can they say that's a pre-existing condition?  That is quite a stretch if ever there was one.

Can I say 'freaking?'  I'm just wondering, because I feel like saying it quite often now.  I am a Christian, and I really try to curtail that kind of talk, but, you know, sometimes the situation calls for that kind of emotion, and I'm left with 'Freaking."  "Freaking" this and "Freaking" that.  All the time.  I just can't seem to stop.  Oh, my good gracious.  

Anyway -- four years.  Doesn't jibe.

Zilla*

[Super_sally888]

Hi Ada,

Sorry things are so bad for  you at the moment.  This feels like the end of the road, but it's not.

The insurance thing will probably work out ok.  Yes you have to appeal and yes you have to get your doctor yelling at them and yes, you shouldd call the commissioner's office.  Nothing to lose there.  I have heard that often they will reject the claim outright in the hope that you'll drop it.  But the appeal should get through ok.

Take care sweetie.  

Sally

[young at heart]

SENDING YOU SEVERAL SOFT CYBER HUGS.

SWEETIE YOU HAVE GOTTEN GREAT ADVICE, I AM SO GLAD YOUR DR. IS GOING TO BATTLE FOR YOU.

WISH THERE WAS MORE I COULD DO FOR YOU.

A PRE-EXISTING CONDITION , NOW THAT HONKS ME OFF!!!!!!!!!!! FROM 4 YEARS AGO.IS THIS THE SAME INSURANCE COMPANY YOU HAVE HAD?

KEEP YOUR CHIN UP, DON'T LET THIS CONSUME YOU,IT WILL ONLY MAKE YOUR STOMACHE WORSE.

WE ARE HERE FOR YOU,ITS GONNA BE A HECK OF A WEENIE ROAST WE GET TO THROW THE INSURANCE COMPANY ON FIRST.

T-LYNN

[doublevision1]

We are all pulling for you, my friend.  I know it is all so overwhelming.

I thought challengecase's advice about the state insurance commissioner's office is a great idea.  It seems denying claims is such a routine thing, whether or not it makes any sense that's the initial response.  I am confident you'll be successful in your appeal - how the h*** can they related bursitis to Still's?  In the end, I'm sure that you will prevail.  It just sucks that they're putting you through all of that.

You are in my thoughts.

db1

ps: don't forget those wise words of Mary Tyler Moore.  

[6-paq]

Dear Ada,

I'm so sorry that you're going through this.((HUGS))  I'm glad your doc is getting involved and I hope that he will be able to get everything straightened out with your insurance company.  You definitely don't need this when you are in such pain.

Sending tons of ((hugs)) and prayers that you get some pain relief soon.

Take care, Pat

[Nerve_Wrecked]

Oh Ada, I'm so sorry.

I wish there was more I could say, or do to make things better.

I hope that our horrid pain stops soon, and you can rest easy for a while!

Hugs
Christine

[challengecase]

I am rather new here and still a bit shy about posting, but you need a lot of cyber hugs today.  

I'm going to venture out and give a small bit of advice on your insurance problem.  When I've had a battle (very few) with my insurance company, I have called my state insurance commissioner's office.  They are very helpful in my state.  Sometimes all it takes is a mention of contacting them to your insurance company.  They do not like to get tangled up with answering to the commission.

Please know I am sending positive thoughts your way and hoping for brighter, pain free days for you.

HUGS,
challengecase

[IUMOM2]

Ada,

I'm sorry for all that you are going through. I'm glad that you called your doctor. Having an advocate (several even) is always a good idea.

I hope you can find some relief for your pain. Dealing with pain just makes everything else worse (at least in my case it does).

Good luck.

Huggsss!!
Shalynn

[spastic]

It never ceases to amaze me how wonderful this place really is.  I am so lucky to have all of you to pick me up when I am down.  Thank you.  It makes me feel so much better.  I made a call to my Dr and he is going to bark at them for me.  They don't have evidence to justify any of this, kind of like the neuro who told me I was having seizures, it just doesn't make any sense.

Thanks Again, I truly love you all.

Ada

[MCBCON]

At this point the only thing you can do is to file an appeal and let that process take its course.  You have to demand an explanation of how a bursitis  episode makes this a pre existing condition.  The auditors for the insurance company make there living finding a way to deny claims.  Most often the find something/anything to justify their reason to decline your claims.  You might find that you will better off brining a lawyer into your fight.

[sllowe]

Hey Ada,

Oh boy, I can see why you've hit the bottom! But, like you say, we all "get it" here.

I think the only thing you can do, is what Heather says.  Absolutely "do not" beat yourself up over this.  You did not do this.  You have a few battles ahead of you with the insurance company, and working your way through a dry well where $$ is concerned. So, we are going to be here w/you, conserve your energy, then hit it later when you have your fight back.

Pre-existing cause of bursitis??? Ok, I'll be the 1st to say WTF!!!!!!!!!!! That is some bull!

thinking of ya, and hanging tough for you,
SL

[Heather3418]

Oh my sweet precious Ada.  I hope that you feel the love and super hugs from everyone on this Forum.  If only they were enough to pull you out of the financial troubles...now that would be fantastic.

You have alot going on, so don't be hard on yourself.  It's normal to feel this way.  It's almost a feeling of being beaten down at every turn.  I hear ya!  I think all of us have been there.

If you need support or just a soft shoulder to lean on, you know that we are always here for you.  Anytime....

Sap some of OUR strength to get through the difficult days, Ada.  We are with you every step of the way.

Hang in there sweetheart.  We DO care.

Heather