Question:
Nyle care verse Medicare
My insurance right now is nylcare, however Dr. roll is out of network and they are fighting me on approval to see him, they have said that even if they approve the office visit they would not approve the surgery, as of March 1 I will be eligable for Medicare, would it be better and easier to wait till march to see the doctor and get the surgery approved through medicare???? — ann shelia J. (posted on February 3, 2000)
February 3, 2000
I don't mean to sound snotty, but it really puts me in an uproar when I
hear people who are content to be supported by the governments and
taxpayers like myself, go out get a job with better insurance, or even
maybe go PURCHASE insurance privately.....but please don't waste my time
and my money being a leach that milks hard working people like me.
— [Anonymous]
February 4, 2000
Why don't you tell us how you really feel Paul! You don't know her
circumstances so DON'T judge!
— [Deactivated Member]
February 4, 2000
This is to the person who is too afraid to sign his/her name to his/her
opinion. Who died and left you a god? How dare you throw stones at
someone when you live in a glass house. I thought this site was created
for those people in need of support and information... not for people to be
criticized and condemmed. Be ye male or female...you had no right to be
judgemental and inconsiderate. If you have a problem with this then deal
with it and move on, but DO NOT judge lest you be judged by someone higher
and found lacking.
— TERRY L.
February 4, 2000
Hey anon. I myself am disabled and on medicaid.. I worked for years
and paid my taxes to help those before me and will work for years after
surgery and help those after.. you are a selfish SOB if I can help
someone by paying my taxes i will.
— BBD
February 4, 2000
Hi Ann Sheila, I bet you didn't know you were opening such a pandoras box.
It is sad when a sincere person seeking
help can't get a simple answer. My heart goes out to Paul as well, somthing
has really hardened him. I know it is hard to ignore such comments but
please try Dear. As overweight people ,most of us morbidly obese, we have
to endure to many slanders anyway. We really should hope for better from
our pears. Remember once a man far greater than I said forgive them Father
for they know not what they do. Ann Sheila , I know it is hard to forgive,
but it is better for us if we can . "I must not let my burdens
paralyze my progress". So now Ann Sheila lets put this behind us and
see what we can do about getting you your needed surgery.
I had a freind who went through medicare, all she needed was a
personal recomendation from her PCP, along with weight history and
co-morbidities. We live in Mich. and I understand it does varie from state
to state.
Also you might try getting in touch with Ray Hooks on this sight,(look
in the people search). he has the name of some lawyers that help. They can
be reached on line. And they have much knowledge about appeals.
Just to add a sparkle to this note. My freind who was helped by
Medicare is now a productive member of society
her self esteem has risen, and she is helping others with a local mission
group. Her taxes are going to help people who probably bad mouthed her not
long ago. Keep the faith Sheila, and keep your chin up. e-mail me if you
want. My surgery is the 7th of Feb. so I might be out of touch for a while.
— C S.
February 4, 2000
humm let's see Medicare Insurance is taken from our checks as a payroll
deduction for the reason being insured if we should become disablied..Now,
morbid obesity is a disability so that makes Medicare an Insurance policy
like any other... Seems to me "The Anonymous person" (figures
he/she would choose this option) is misinformed and needs to visit the
Wizard of OZ and ask for Courage, a Brain and a Heart..
— Victoria B.
February 4, 2000
I know I'm not really answering the post. But, I just had to add my .02
regarding Medicare. This Paul person is MISINFORMED if he thinks that
Medicare is a program for indigents! A Medicare recipient pays for Part B
Medicare benefits every month (this covers NON hospital services).
Medicare is categorized by the government as an "entitlement".
Please Paul, do not insult every disabled person or senior citizen in this
country by calling Medicare charity!
— Morgan B.
February 4, 2000
I must say how dissapointed I am that Someone would attempt to be
annonymous and say such hurtful things! Please don't let his words (that's
all they really are) put you down or defeat your goal. I was grateful my
hubby had great insurance, but not too long ago in my life (pre-hubby) I
was going back to school; on my own, and scraping to make ends meet... I
used state assistance; I was and still am grateful everyday that it was
there for me to use!
This sight was set up as a support forum PLAIN AND SIMPLE!! and when
someone has the nerve for whatever reason (I could careless why) to put
someone down for what they need support in doing, for all you know Paul...
someday in your life you may not be so lucky... you know that saying what
comes around goes around?
I feel you get this anyway you can... if this is what you want! And since
Paul has been so petty as to attempt to be annonymous saying such hurtful
words... only to think he can sit back and be so proud and all-mighty... we
here that support one another have email addresses we stand behind our
convictions... if you are so proud of your words and stand behind them...
then I invite you "Paul" to step up to the plate and let us know
you, and your email address. Whatever you decide to do... just remember
this is a support web site, and soley made and created for SUPPORT... think
about this before you decide to be so hurtful and annonymous at the same
time!
— Jamie T.
February 4, 2000
Dear Ann Shelia: I, too, am on disability and have been since 1994. What
that creep Paul overlooked is that you have to be off work so many
days/months before you are ELIGIBLE for disability insurance. I had my
employer's insurance during that waiting period. I didn't even know that
being on disability qualified me for medicare until I was notified that as
of a certain date, I would automatically be put on medicare as my primary.
I had no choice. I didn't ask for it, you insensitive snob, it just
happens to be the law. I would wait, and see what medicare will do. What
a creep, and if that isn't plain enough for you, I might be persuaded to
let you know what I really think!
— Sandy C.
February 4, 2000
Dear Ann shelia-
Please excuse the misinformed, cold hearted, inhumane person
who doesn't have the nerve to post who he is. That was just terrible what
he said. I hope you can over look such an uncaring person's evil lash with
his serpent tongue. Don't be discouraged, There is alot of caring good
hearted people that are here for you, and wish you luck.
As for you who didn't asign your name to your distructive words, whether
you meant to sound snotty (as you put it) or not, your words not only hurt
the person who was seeking advice but, you have hurt all of us just by
knowing that there is a person on this support site that is hateful and
rude. For only would a hateful person post such a remark. If I had control
over this site I wouldn't let you be a part of it, unless you apologise to
this woman and all of us in this support group.
— Cheryl W.
February 4, 2000
Dear Ann Sheila, Obviously the "person?" named "Paul"
is woefully uninformed as to value of persons with disabilities. Many of
us have worked for many years paying into Medicare and Social Security. We
did not choose to be disabled. Personally, I would have preferred to
continue with my Nursing career, than to have spent many years fighting to
regain my health and my life. While disabled, I have continued to work as
a volunteer whenever I can. After surgery, I hope to return to the working
world and pay into Social Security and Medicare so that others may have the
chances that I now have.
Medicare is a government funded for people with disabilities that have
lasted for 2 or more years. Medicaid is a State and Federal program for
people who do not yet qualify for Social Security Disability or who meet
certain income and disability requirements. I do hope that these programs
continue to be there to help you and "Paul" if for whatever
reason you become disabled enough to require them. They have been there
for your parents and for your children, if need be. They are for ALL
persons in need.
"Paul", your comments are hurtful and do not belong in a site
dedicated the to support of those who are trying to improve their lives and
the lives of their families.
As for whether Medicare will pay for WLS: Medicare does not pre-approve
for WLS. However, with the proper documentation and comorbidites, Medicare
will pay for WLS. Medicare is a Federal program and therefore coverage and
policy is the same in ALL States.
Ann Shiela, it will probably be easier to wait and use your Medicare to pay
for this surgery. I wish you good luck in your weight loss journey.
Please let me know if you have further questions about Medicare and WLS. My
E-Mail is [email protected]
— Anne L.
February 4, 2000
Dear Ann Sheila,
First of all please accept an apology on behalf of all the
wonderful,caring,and down right good people on this website
who are absolutely apPAULled at the deliberate and hate filled
response you received. Remember that this one bad apple WONT
spoil the whole bunch. I along with many others stand behind
you and hope whatever route you have to take to get things
accomplished will come true for you. We do care! :-)
— Cheryl S.
February 5, 2000
Dear Ann Sheila
I am one of those "people who have milked the government" for
help. I have been on assistance for medical for almost a year and a half
now. Had it not been for the fact that Medicaid approved and paid for all
but $100 of my surgery, I would not be in the position that I am in now...A
HEALTHIER STATE OF LIFE!!!! I urge you to use your resources, and use them
wisely. If you qualify for Medicare, then try and get them to help with
the surgery. They may try to get your "primary" insurance to
cover some of it too. It's worth a shot...To be living this life 90 pounds
lighter today was worth every effort I made to get Medicaid to approve my
surgery. And I don't feel bad at all about getting help from the
government for my surgery. I needed help and won't be on it
forever...Plus, for Paul's information, if you have surgery you may not end
up on disability forever, this may cure what is disabling you (if it's your
weight). Good Luck and I hope all goes well with your quest for a solution
to this dilema.
Marni
— Marni
Click Here to Return