alchemia: (Default)
My wife is nearly housebound due to MS and other illnesses; is on Medicaid/medicare. There is a service that sends DRs to the house. For the past several months, the Dr we have had has been verbally abusive, doesn't listen to her, demands her aide dog is not in the house, and even then, refuses to treat her. Her health has seriously deteriorated during this time. Does that count as "malpractice" or something else? The company they work for takes the side of the Drs. What legal recourses do we have? We are in Illinois.

ETA: We have asked for different drs and they claim to send them out but they never came. Or they came and so were very very very quiet that our dogs didn't even hear them to alert us (and they alert us to things we don't even hear at the other end of the block, so I doubt that).
alchemia: (Default)
Insurance was covering a $550 med from the start of the year (Celebrex, 400mg AM, 400mg PM (I was on lower doses that didn't work)), which put me into the coverage gap just this mid april!  (usually its late summer or early autumn for me, and that's what I was expecting since my meds hadn't changed, and I dropped one and switched to a generic on another.  But apparently a change in dosage of the celebrex = skyrocket cost)

Now that I'm in the gap, suddenly, insurance is claiming that they don't cover that med/dose, which means that if I pay out of pocket for it, it will not count towards my getting out of the gap (once out, something like 95% of costs gets covered by the insurance)  My other meds, which they still recognise, will not total up to get my out of the gap by themselves ($350/mo).  My dr filled out paperwork they request to review the med and reconsider and they denied it.

Thus, by no longer recognising the med that they were recognising and that got me into the gap, i'll never get out of the gap, and they can never pay any thing for my meds again for the rest of the year.

Fraud?  But I dont know what to do about it (or where to find the spoons if I did)  Of course, I also dont know how I'm going to cover $900/mo of meds for the rest of the year so I have got to find some spoons asap.

Also, I got back my application for medicaid and food stamps- yep, I'm denied for "making too much" (they said they will not consider medical costs impact on income).  The worst part though is that they "combined" bug's and mine this time (even though they weren't supposed to, so that the $175 bug was getting got reduced to $16!!!  So now we have to wait yet ANOTHER month for them to redo bugs form so they will get the right amount, and all of this because they demanded bug come to an interveiw for renewal of services when Bug was IN THE HOSPITAL (we called them every day and left a message every day to this effect, asking to rescedual and never heard back until we got a cancellation letter in the mail.  WTF is the point of having a phone number on there to call if they completely ignore it?)



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