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Author Topic: I DONT KNOW WHAT TO SAY OR DO...I DONT THINK THAT I CAN TAKE IT ANY LONGER!!!  (Read 1497 times)

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Offline FindnNemo91

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MY MRI IS GONNA BE CANCELLED CUZ MY INSURANCE IS NOT ACCEPTED OUT HERE. I DONT KNOW HOW MUCH LONGER I CAN TAKE THIS PAIN. I NEED TO DO SOMETHING, AND NO ONE CAN HELP ME. THIS IS TEARING MY LIFE APART AND NO ONE CARES. I HATE INSURANCE. I HATE ALL THE STUFF HAVING TO DO WITH IT. PLEASE,, I AM DESPERATE. ANY IDEAS WILL BE GREATLY APPRECIATED. I HAVE COME TO A HOLE IN THE ROAD. I AM UP THE CREEK WITHOUT A PADDLE. I WILL HAVE TO TRY MY OWN TREATMENTS PROBABLY, CUZ SOMETHING NEEDS TO BE DONE.


PLEASE, PLEASE, PLEASE....
 :'( :'( :'( :'( :'( :'( :'( :'( :'( :'( :'( :'( :'( :'( :'( :'( :'( :'( :'( :'( :'(

JAK :'(
TTT/Lateral Release/Chondroplasty: May 15th, 2009
Brostrom Reconstruction: Oct 16th, 2009

  ~United States Army~
Wheeled Vehicle Mechanic

Offline Silkncardcrafts

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Hi Jak,

Sorry to hear what you're going through. Just glad we don't rely on our insurance companies in Australia to get scans done. Doctors decide on what are the best scans to have done and just refer you for them.

Have you thought about seeing a sports physician to see if they can help ?

Also, are there other scans you could have done instead of a MRI ? Is there another place you could get your MRI done and insurance company would accept ?

Just some ideas for you. Hope you get some help soon. Also, perhaps speak to your specialist to see if they can sort out things with the insurance company.  :)
11/1996 - RK LR
07/1997 - LK LR
11/1998 - LK MPFL Reco
12/2005 - RK LR Repair
07/2006 - LK MPFL Repair
11/2006 - LK LR Repair
22/05/08 - LK Trochleoplasty
11/02/10 - RK Trochleoplasty
07/03/11 - RK Chrondroplasty

Offline tanyap

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Hi Jak,
can you get onto your insurance company and find out where the insurance WILL be accepted for an MRI and then get one where the insurance will cover it?

My insurance didnt cover mine a couple of weeks ago either - or the x-rays - or anything to do with my knee in fact - Im not paying the insurance long enough for them to cover a 'pre-existing' problem :(
So i paid for mine myself - it was very expensive, Ill be paying off my credit card for a while :(

There is a scheme in Ireland where you can claim some medical expenses back off your tax if your insurance doesnt cover you? Can you investigate if there is anything like that available to you?

The only other option is to be a 'public' patient - I dont even know if that distinction is made where you are - in Ireland if you cant afford to have things done privately because your insurance doesnt cover it or you have no money you go onto 'public' waiting lists. the waits are long though.

There must be some way you can get around the insurance issue - ring the insurance company and ask them for more information.

kjwilkin makes a very good point also - speak to whoever ordered the MRI and explain the situation to them - maybe they can help.
tanya

1986 - recurrent dislocations of right patella began
1988 - Modified Hauser Procedure
1991 - dislocations started again
2005 to 2007 - 150 dislocations in 2 years - OUCH!!!
June 2007 - new OS, new physio
Oct 2007 - VMO woke up
Mar 2008 - big quads, still dislocating
Apr 2008 - next OS app

Offline jathib

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You can get around insurance companies by just paying out of pocket. MRIs around here cost about $1500 depending on the body part. Medical expenses can be deducted from taxes at the end of the year if you itemize your deductions.

Offline Dani0009

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Jak,

Here are my suggestions to you.  This is based on the plan I have at my employer.   I also handle the plan for my employees, so I may know some things that others don't know.

a) Out of pocket maximum.  This is the most amount of money your plan will make you pay in a year.  Do you know what yours is annually?  Mine is $1500, and with copays for 2 MRIs, 2 mos of PT and countless specialist appointments, I'm there already.  Maybe you are too.  That doesn't mean they can't deny the MRI, but if they do approve it, they can't make you pay.

b) Out of area dependent.  I believe I read on another thread that you have insurance through a parent that is out of state.  With the insurance company I have, they will automatically up a dependent from a HMO or POS to a PPO if they can't find coverage within a 75 mile radius.  This may be an option for you.

Ultimately though, if you're able to find doctors in your area that take your insurance, surely you can find a radiology center that does.  Even if you have to go to the hospital to have the MRI done. 

Good luck,
Dani
3/1999 - LR - R knee
6/2000 - TTT - R Knee
8/2001 - Hardware Removal - R Knee
1/2005 - Partial Quad Tendon Tear - R Knee
2/2007 - Partial ACL Tear - R Knee
6/2007 - PT and Custom Donjoy

Offline kimmyxs

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Just remember that the MRI is the end all be all.  It doesn't show up a great deal of detail versus the expense of having one.  In my case it showed the tilted patella, but we could see those in the CT and x-rays.  The damage under the patella was not evident.  How is the pain management going?  I do think that people care, but sometimes the pain doesn't show up on anyting and it confuses the doctors.  I should have had work done to keep my patella in place years before I did.  Even with several falls and dislocations, I wasn't able to prove the pont until the patella broke during a dislocation. 

Keep your chin up and focus on things other than the pain.  I know that is hard, but it helps at times.
6/03/89 - First Knee Cap Disclocation
7/05/89 - Returned to work
6/17/06 - Tramatic Knee Cap Dislocation and Vertical Fractured Patella
6/28/06 - ORIF - Screws - no wires
8/24/06 - Ditched the brace - start PT
9/20/06 - First spinning
1/15/07 - screw removal, LR , VMO Advanc  & patella cleanupl

Offline TIBBAR

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Jac Even tho we on this forum can't physically reach out and give you a hug doesn't mean that we wouldn't want to. If we could come to your house right now and help you many of us would. Short of that I guess the next best thing is letting you tell us about it and try to give you the best suggestions we can think of. You seem very mature and have handled this much better than most kids your age. You have been a "Super Trouper" through all this. At the very least you have many virtual friends who want to help.
My first suggestion is the same as some others. Call the doc who arranged it in the first place and see if he can help at all. My town has a free clinic that takes patients with no questions asked. Maybe your town does too. I remember that you might be moving to N. Carolina. Is it any time soon? If so maybe you can find help in a new place. Duke is one of the best in the country. Does your mother have insurance where she works? If you are losing your fathers maybe your mothers will pick it up or maybe your father will get a new job soon and you can continue with him. In my town we also have a large nonprofit hospital that takes patients no matter what their ability to pay. That too you might have near you. They tend to reduce your bill if you can prove you don't have the means to pay. Do you feel you can call your insurance company and explain how desperately you need their help? If you get a symphatic case manager they may have some suggestion for you.
I know what it is to be so frustrated that you just want to take things into your own hands. Do it constructively and not destructively and makes things worse for yourself. Vent to us !!!!!!   Cry to us!!!!  There are many people why would come to your house right now to help ,but we can't . So we will do the best we know how to help. Stay the strong NEMO that we know and love.   Talk to mom. I know she loves you and is probably as frustrated as you not knowing how to help.
 Bunches of hug to you.                   CAROL
« Last Edit: July 17, 2007, 08:03:27 PM by lafalot »

Offline FindnNemo91

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thanks so much. i am trying to stay strong, but i am so frustrated right now. i dont know of any free clinics, and i dont know how long it will be before i move. my mom does have insurance, she registered me on it, but they said that she didnt. i also have an application to go to the Shriners hospital, but i have to get in contact with my friend whose dad said that he would sponser me. thanks again for ur reply. it really helps to hear from people and i will continue to keep yall updated. everything that everyone says really motivates me. they did cancel my appt this morning, which was at 9.


thanks again,
jak :-\
TTT/Lateral Release/Chondroplasty: May 15th, 2009
Brostrom Reconstruction: Oct 16th, 2009

  ~United States Army~
Wheeled Vehicle Mechanic

Offline TwoBadKneesUSA

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Hey there kiddo, I am so sorry that you are having so many issues with insurance.  The insurance companies can be a real pain in the.. well you get the idea.  It makes you want to bang your head on the wall for sure.  Have your mom call both insurance companies and see if they will explain what the deal is. Sometimes if you are far enough away the insurance will pay because there is no one close enough that accepts what you have.  It's just seems so wrong doesn't it.  Hang in there and keep fighting.  I'll send you some hugs.  For me I have not been able to see the sports doc I love because he won't accept my insurance and I can in no way pay his fees.

One thing that just popped in my head...sometimes you can send the bill to your insurance yourself for reimburement.  Unfortunately you often have to pay up front first, but it's another thing to check out.

Take care kiddo.

Milly
'83 lt knee scope
'88 lt knee LR
'89 rt knee LR (6 mos. after left)
'05 rt knee scope (clean up)
7/5/07 - scope, LR left, right clean
3/19/08 - LR failed, Supartz failed
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=47974.0
8/21/08 - new OS apt
8/5/09 - TTT, LR, PFJR sched.

Offline kaci74

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Hi Jak,

You have received some great advice about your sticky situation.  I'm not sure if this will help, but have you tried COBRA insurance?  It is meant to cover individuals who, for whatever circumstances, are between insurances from graduation, no longer being covered under a parent's insurance or those between jobs.  I found a lot of information on COBRA through web searches and talking with my doctors at the student insurance at the time of my graduation.  If I remember correctly, it offers short-term insurance as well as insurance for up to a year.  If you are in the middle of a move or transitioning insurance companies you may want to investigate more.

I hope you find something that helps.  Have you tried PT?  My PT was the only person who was able to find something that would help with my pain.

Best wishes,
Kaci

Offline FindnNemo91

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i tried PT and they quit on me because it was making it worse. i am currently trying to get into the Shriners Hospital. Its free orthopedic care, and i have scoliosis and a leg length difference thingy. maybe they can help, though i am not sure if u have to have insurance. i looked at the COBRA thing and i sent the website to my dad. maybe he will want it.

maybe... ???... :-\


thanks for all the responses.

jak
TTT/Lateral Release/Chondroplasty: May 15th, 2009
Brostrom Reconstruction: Oct 16th, 2009

  ~United States Army~
Wheeled Vehicle Mechanic

Offline Silkncardcrafts

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Hi Jak,

It doesn't sound like the physios were very supportive. With patella problems or any knee problem for that matter, it can take a while to find out what level you're at and what you can do without flaring your knee up too much. I've had to do that a lot along the way.

Hope you can get some help soon.

Like you, I am so frustrated at the moment. Seeing my knee surgeon this afternoon. I hope he's in a good mood and has some good suggestions. :)
11/1996 - RK LR
07/1997 - LK LR
11/1998 - LK MPFL Reco
12/2005 - RK LR Repair
07/2006 - LK MPFL Repair
11/2006 - LK LR Repair
22/05/08 - LK Trochleoplasty
11/02/10 - RK Trochleoplasty
07/03/11 - RK Chrondroplasty

Offline TwoBadKneesUSA

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Hey Jak,

It sounds like a good idea to check in the Shriner's Hospital.  I hope it works out for you.  Did anyone you've seen look into the leg length issue?  I had that when my hip was tilted back after a fall and it made my knee hurt too.  All that stuff is so interconnected.  The hip thing caused back pain, hip pain, knee pain and made my IT band tight as anything.  Just a thought.  Hang in there and keep looking for answers.

Milly
'83 lt knee scope
'88 lt knee LR
'89 rt knee LR (6 mos. after left)
'05 rt knee scope (clean up)
7/5/07 - scope, LR left, right clean
3/19/08 - LR failed, Supartz failed
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=47974.0
8/21/08 - new OS apt
8/5/09 - TTT, LR, PFJR sched.

Offline rrg091

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hey jak -
i'm sorry i don't have any good advice, but i just want you to know that i've got you in my thoughts and i'm rooting for you so hang in there! :)

rrg