I <3 the Government <end sarcasm>

[Mytical]

Before I begin here.. yes I get government assistance because I am unable to work. Not only not in physical jobs (where throwing up blood, limited mobility, and the possibility that I might go into the hospital for 7 days without notice MIGHT be frowned at), but mentally (Hint Ammonia + Brain = Bad). So yes I am thankful that our government has such things in place. Now, if anybody has an issue with this, by all means I will offer to debate you.. once a machine is invented where we can switch bodies for 24 hours is created. Honestly we could switch for an hour, there would be no debate after. So.. now with that out of the way.

Ah the government. Efficiency at its peak. So smooth, so streamlined, everything nice and .or .. wait why is everybody laughing? Oh because its like wading through a pile of garbage the size of the moons? No that wasn't a typo.. all the moons, everywhere in the universe, all in one place. Yeah..

Ok, so I am not sure if everybody recalls how frustrating and difficult it was for me to convince the government that blood flowing like vomit of the woman of the Exorcist is a bad thing (M'kay?). Everything got settled eventually, and things were great..ish. They love making people jump through hoops, so there have been a few issues...but mostly inconvenience. Being the government, though, they have to try to top themselves. Least we forget how mindnumbingly messed up they can be.

I was on awesome medical coverage (Though I had to fight tooth and nail for it). Yes, it cost me $213 a month, but compared to what bills I would have to pay otherwise, it was AWESOME. The fee did hurt me financially (not exactly rolling in money here), but I tried not to complain too much. So I got some good news! I am being moved to <New insurance> and there would be no monthly fee!!!! Awesome, we done here? Good... /end credits start rolling..

Get to a doctor yesterday, only to find.. I couldn't be seen without $147, because 'I have not met my monthly fee'. *record skips* What?! Wait.. that can not be right....so.. I go all the way back home, rather confused...

We all KNOW how easy it is to weed through the government and get a live person on the other side of a call. So far, it not only is not happening.. but because of budget cuts and such..there is no 'physical' place I can go to to find out what the heck is going on. As of right now, I am completely uninsured medically. Gee thanks Mr. Government.. always a pleasure dealing with you. Oh, what is that? I can go to a specific website and get all my answers? Great.. only.. no .. no I can not. The website may even be worse then the automated phone system. It's a toss up. Ok, enough rant. Going to go back to hitting my head on this wall over here. Think I will break through it before I get any answers..anybody want to start a betting pool?

[Crazedclerkthe2nd]

Just curious, is this a state government or Federal you are talking about?

And if it's state, might it be one of the Republican controlled states that turned down the extra money offered by the ACA (Obamacare)?

[Mytical]

Ok this is where it gets complicated. Buckle up, its a wonderful ride.

I started out with State Insurance (and no, this one took the money). Now since I am long termed disabled they switched me to Federal. Only because I put in for a state card (called QMB..don't ask me what it stands for) that was supposed to pay any fees that the Federal Government might charge. So it is a Federal medical insurance, ran through the State Government. Confused yet? So I called the Federal, they told me "Talk to the state." So far have been having fun trying to get ahold of the state government section that handles this. May have to make a trip to the capital to talk to an actual person.

[Panacea]

I'm still confused, Mytical.

Do you have Medicaid, Medicare, or did you buy a policy on the Federal insurance exchange?

If you are disabled you should qualify for Medicaid or Medicare. Those are different programs, and Medicare Part A shouldn't cost you anything (Part B is another matter).

Can you clarify the kind of insurance you have? What company?

[Mytical]

Ok sorry I will clerify. I was on Medicaid. The good insurance. They moved me to Medicare A and B. However, because I filed for something called a QMB card. (which is supposed to pay for Part B and anything that Part B won't pick up). Since I qualify for the QMB, the Federal government does not handle Medicare now, the state handles it. The good news is.. I have learned some interesting information.

It appears to have been a case of 'wrong place, wrong time'. Medicare does not pay for certain things. Eye exams, glasses, dental exam, dental work, etc. Since I was in a EYE doctor when I was told I didn't meet the 'spend down' (what they call the fee I should be paying) it was ONLY because I was at an EYE doctor. Now I feel like a twit.

[EricKei]

I thought Medicaid paid for a pair of specs and a pair of shades (with associated exams), once every five years each? I'm new to this myself (I am in a state where I qualify for Medicaid purely on a financial basis, but they will only actually grant Medicaid to people who are on Disability) -- and I was under the impression that one can have both -aid and -care at the same time. I'm fairly certain my mom has both (old enough for SS).

[patiokitty]

Brain farts happen, Mytical. I know when I saw the $147 amount I was thinking that you hadn't yet met the Medicare Part B deductible yet and was trying to figure out how that worked with Medicaid, but I came up with nadda.

I think that folks 65 yo or older can have both, but I'm not sure about anybody younger. But then I'm a Canadian and don't understand the ins and outs of the US medical system.

[Mytical]

I thought Medicaid paid for a pair of specs and a pair of shades (with associated exams), once every five years each? I'm new to this myself (I am in a state where I qualify for Medicaid purely on a financial basis, but they will only actually grant Medicaid to people who are on Disability) -- and I was under the impression that one can have both -aid and -care at the same time. I'm fairly certain my mom has both (old enough for SS).

Yes I can have both. However, the income of my household means that I have to pay what is called 'Spenddown' for both. $147 for one, 108 for the other. You are also correct that medicaid will pay for eyeglasses. What I learned is good, however. Only on months that I have an eye or dental appointment do I have to worry about meeting ANY spenddown. So it is a 'Pay as you use it' type deal.

[wolfie]

What I learned is good, however. Only on months that I have an eye or dental appointment do I have to worry about meeting ANY spenddown.

Of course you'll be booking your eye and dental appointments for the same month, so one "spenddown" covers both rather than having a separate one for each.

[Mytical]

All I can say right now is Yay! The government finally got it right. *does the happy dance*. Now I will have coverage AND not have to worry about a spenddown.