I Love A Good Medical Drama. My Mother, A Nurse, Raised Me On ER And General Hospital, Always Pointing

Do people know about Vocational Rehab? If you're USAmerican they have this in every state.

It's a program that helps disabled folks access education, training, and employment. For FREE.

You only have to be disabled to qualify (autism, ADHD, mental illness, physical illness, etc) and they cover very broad categories of disability. You do NOT have to be officially diagnosed yet when you walk in - they will even help pay for your diagnosis if you are struggling w disability.

I applied with my suspected autism and fibromyalgia, and they paid for 100% of my formal autism assessment.

Once your disability is established they will give you career counseling to learn about your interests and skills, and depending on the plan you create with your caseworker they will then help with school or finding employment. They paid for 100% of my college tuition and books, and even provided a laptop for me to use.

You do not have to pay anything for this program. If you make above a certain income, you will have to contribute to educational costs but will still receive assistance.

They will also help with the cost of things like mental health counseling while you work towards your goals, clothing for interviews, etc.

They cannot discriminate based on your race, gender, or sexual orientation.

They won't make you do excessive meetings.

They will allow you to do meetings with your caseworker remotely.

They will not drug test you.

They want you to succeed.

I'm sure that individual experiences vary but my caseworker was exceptionally easy to work with and very kind.

Vocational Rehab is a phenomenal resource every disabled person should be aware of. Here is the list of offices in every state:

it shouldn't be a controversial take but:

disabled people are allowed to hate being disabled

My face is having uncontrollable spasms. Great. It hurts really, really, really bad.

I think part of why I have trouble explaining pain to the doctor is when they ask about the pain scale I always think “Well, if someone threw me down a flight of stairs right now or punched me a few times, it would definitely hurt a lot more” so I end up saying a low number. I was reading an article that said that “10” is the most commonly reported number and that is baffling to me. When I woke up from surgery with an 8" incision in my body and I could hardly even speak, I was in the most horrific pain of my life but I said “6” because I thought “Well, if you hit me in the stomach, it would be worse.”

Introduction

Hello! If you've found your way to this blog, congratulations! Or condolences, if the circumstances that brought you here suck. Either way, welcome!

I am someone who works in the health insurance field (and will be remaining anonymous due to my obligations to my employer), so I've got some insider tricks. Not only that, I have multiple chronic conditions which means I've dealt with insurance from both ends.

The purpose of this blog is to help people (Americans, mostly) understand health insurance, how it works, and how to make it work for you.

All this to say, I see a lot of bullshit in my day to day life. I watch people pay more than they should or not receive the care they need because of a lack of understanding and knowledge.

I want to change that, one person at a time.

Below the cut are important posts and resources for basic information. Always feel free to write an ask if you don't see your question answered or want more detail.

**Disclaimer: No information on this blog is legal or medical advice. This is meant to be a resource for common questions or problems people run into. All information on this blog is generalized, and may not apply to your health insurance policy. This is based solely on my experience and is not binding information. The information here does not reflect the opinions or policies reflected by my employer. Always consult a medical professional for health questions, your insurance policy for benefit/claims questions, or a lawyer for legal advice.**

Basic Terminology

Types of Insurance Plans

Calling Your Insurance

So you want to make a doctor appointment...

Preventative vs Routine Services

Investigate Your Providers

Medical Malpractice/Lawsuits

What the &$#* is a claim?

My claim got denied...now what?

How to Pay Your Bill

Collections Agencies and Credit Scores

Medical Binder

HIPAA Part One

Resources:

United States Preventative Services Task Force

Healthcare.gov Preventative Services

Before you pay that not-covered hospital bill:

I want to take a min to spread awareness for the No Surprises Act after noticing a reddit post earlier.

This protection for patients just popped up in the past couple years, and the one major downside is that it's up to the patients to speak up to make use of it, but not everyone knows what it is.

"If you have private health insurance, these new protections ban the most common types of surprise bills. If you’re uninsured or you decide not to use your health insurance for a service, under these protections, you can often get a good faith estimate of the cost of your care up front, before your visit."

Consumer fact sheet

Typically, health insurance companies will help pay for bills from "in-network" providers, AKA their VIP inner circle gang turf. They won't help pay if you get medical care from another gang's henchmen (out of network).

This means that sometimes, a person would go to the hospital, which they knew had been covered by their insurance before, so they expect it's going to be relatively affordable. But they didn't know that multiple medical "gangs" were working in the same hospital. Their anesthesiologist, for example, was from a different gang. That specialist was out of network even though the surgeon and nurses were all in network.

Boom. Big bill for thousands of dollars and their insurance refuses to help pay it.

But now we have this law! The No Surprises Act means that insurance companies need to cover "surprise" expenses (under certain conditions).

If you don't have health insurance, hospitals and clinics need to give you an accurate quote before you get services, then foot the bill if they were too far off the mark.

The Fact Sheet section of the Centers for Medicare and Medicaid services have some wonderful user-friendly resources for you about health insurance and how this act works.

Keep in mind that Medicare and government-run programs always have weird rules for everything, so you might have different (yet similar) protections through those programs.

If you have a medical bill that wasn't covered by insurance and you think it might count as a surprise bill, please check out your rights and consider fighting it instead of letting it become a stressful expense or debt you can't repay.

Go here to start figuring things out for your situation:

Health insurance companies have way, waaaaay too much power over our lives. We need every drop of protection we can get - but it only counts as much as we can understand and use those protections!

𝐍𝐀𝐕𝐈𝐆𝐀𝐓𝐈𝐎𝐍

Some people don’t want to hear this but sometimes accessibility is not sustainable or eco-friendly. Disabled people sometimes need straws, or pre-made meals in plastic containers, or single-use items. Just because you can work with your foods in their least processed and packaged form doesn’t mean everyone else can.

hey guys psa regarding hospital bills

don’t just pay it. do not automatically pay the hospital bill when you receive it. call your health insurance provider and POLITELY say, “excuse me, i just received a bill for $1200 for my hospital visit/ER visit/etc., is that the correct amount i’m supposed to pay?” because hospitals bill you before your health insurance and they will take your money no matter how the amount due may change based on your health insurance looking at it. 90% of the time, if your health insurance is in any way involved in the payment of that bill, you do not have to pay as much as the hospital is billing you for. call your health insurance provider first, and POLITELY request clarification, always remember that the person you are talking to is human and this is just their job, and then you will very likely find out you actually only owe $500.

don’t shout at anyone about it, don’t get mad, just understand that this is The Way Things Are right now and call your health insurance provider before paying the bill your hospital just sent you. there’s a chance the hospital bill might be correct, true, but call your health insurance provider.

what are your thoughts on ibs diagnosis

78% of people reporting to ERs due to IBS have chronic gastritis.

population studies on microscopic colitis are rare, but have found that rates are much much higher on a population level than previously assumed

the symptoms labeled as ibs (diarrhea and constipation with no obvious flags for inflammatory bowel disease) are often treated as an issue of simple dietary intolerances, or as a psychosomatic condition, and people with ibs are told to follow various diets, or to "reduce stress."

these diets tend to be high fiber, which could literally kill someone whose actual issue is gastroparesis, or could severely aggravate microscopic colitis. i know that when i was trying to eat high fiber, my symptoms were completely unmanageable, and switching to a low fiber diet is the only thing that's helped at all. the food intolerance stuff can be really helpful for people who do have rare food intolerances, but for people who actually/also have autoimmune gastritis, it wastes time that could be spent monitoring for gastric atrophy, metaplasias, and precancerous lesions.

the worst part of this is that things like microscopic colitis and h-pylori related chronic gastritis are treatable, either with steroid medication or antibiotics to kill the h-pylori. but if you're dismissed with "dietary changes" or "reduce stress," then you're not getting treated for conditions that can cause really serious tissue damage and increase your cancer risk.

basically ibs is a "fuck you get out of my office" diagnosis