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so, medicare, or cal i can't remember which, will no longer be covering Pych related ER visits


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so, medicare, or cal i can't remember which, will no lo... - 1/1/2014 3:50:46 PM   
LittleGirlHeart


Posts: 1427
Joined: 4/4/2013
Status: offline 		i found out Tuesday, that medicare or medical which ever one, will not cover pych related visits to the er, you will be held responsible for the whole bill and visits to hospitals, the last one i got, was 3000 dollars, n that was for a bladder infection, I can't imagain what being 51 50'd and the resulting stay would be.


there are some ppl who have both care n cal an in that case, cal i think it is, will cover some but you're still liable for the rest, an that's a ton of money. i have both.im just saying it was a shock, and it certainly would keep me from going n getting help if i was coming unglued mentally an couldn't hack it again.


so, hopefully that won't happen again.

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RE: so, medicare, or cal i can't remember which, will n... - 1/1/2014 4:48:07 PM   
kiwisub12


Posts: 4742
Joined: 1/11/2006
Status: offline 		Or you could be responsible and seek help in legitimate avenues before you "come unglued", I am fairly sure that psychiatric crisis' don't arrive fully blown. They slowly (or not so slowly) escalate.


and yes this sound snarky. Its meant to be. I worked in the ER for a decade and put up with people abusing the system the whole time. There are very few "emergencies" that couldn't have been better handled at the doctors office - but that would have entailed cash up front, or being put out a bit.

(in reply to LittleGirlHeart)
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RE: so, medicare, or cal i can't remember which, will n... - 1/1/2014 5:32:02 PM   
LittleGirlHeart


Posts: 1427
Joined: 4/4/2013
Status: offline 		kiwi, i ttry to keep a good grip on things mentally, But sometimes i often do come "unglued with no warning . Or very little warning, and or it's been builind on and off all day and i thought i was fine and one tiny thing, that normally i'd struggle to, but i could blow it off, sets the keg off.,and my pych dr won't get appointments to people for a month. couple weeks into December, and i had a panic attack and also was struggling really hard with having desires to slam my head into a wall until i passed out or the wall gave, and i was kicking off my covers and kicking my feet and James grabbed me and i flew into a rage, i just started kicking nd screaming and hitting my bed and just, totally lost it, and i almost thought i would have to go in and be sedated because i was that out of control. i would have attacked him too if he was not smart enough to leave me alone. i have rages and out bursts and i go from fine to completely pycho not fine in . seconds sometimes. when i do, i won't and can't resist self harm. and yes i need medical intervention. and it's not me not taking my care seriously enough, or not doing everything i can to stay safe, it's just a fact. i can go from 100 percent fine to 2000 percent unglued, crazy and unsafe in certain situations.

Now, it very much IS an issue of call 911 and get taken in because I WILL try to bash my head through a wall or grab what ever is sharp and handy and begin attacking myself, in these situations if James wasn't there to try and stop me, or go ahead and do it. and i don't care if you disapprove, but when i am rational i very much do not want to try to kill myself. I do think in that case calling 911 ND GOING in is appropriate, and so does my therapist. and no you can't " go to a dr's office and have your pych issues dealt with" when it's after hours and you're litterally steps away from self harm.

And one year, a depressed suicidal person in my life went out to find something to kill themselves with with on their birthday after we had a fight after, i had a panic attack and we faught cuz they were being an ass during my pa.no warning they were, fine and we were arging and then they said fine, well im just going to go kill myself, they got up and went to go get the tool kit with a hamme rin it, and no it was not some power play stunt, if i hadn't called 911 they would have taken the hammer or anything else they could have found to their head, so naturally i called 911 which the police said i was right to do, and depressed person thanked me later for having done so.

Pych emergencies are not these nice, neat, things you can wrap up in a box and not be affected by suddenly. with no warning it was coming.or not warning enough in time.


But anyway this isn't about me an my issues, i was posting so as to have a discussion about did any one else know these changes had come.

< Message edited by LittleGirlHeart -- 1/1/2014 5:56:35 PM >

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For someone must stand up for what's right
'Cause where there's a man who has no voice
There ours shall go singing

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RE: so, medicare, or cal i can't remember which, will n... - 1/1/2014 6:11:18 PM   
littlewonder


Posts: 15659
Status: offline 		I would say if you are that bad you need to be committed and not be able to just walk out whenever you want. You need a very, very long stay at one. I'm sorry but anyone who acts in the way you said you do there is more wrong than just losing it. You need long term care...not days, weeks or months but years, maybe even institutionalized to the point of staying if you can't handle life on your own. It doesn't seem that your boyfriend or your parents have any clue how to take care of your mental incapacities.

Not trying to be mean to you. Just calling as I see it over the many years of seeing you here.

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RE: so, medicare, or cal i can't remember which, will n... - 1/1/2014 6:19:41 PM   
kalikshama


Posts: 14805
Joined: 8/8/2010
Status: offline
quote:

medicare or medical which ever one, will not cover pych related visits to the er, you will be held responsible for the whole bill and visits to hospitals


Do you have a link for this information? I cannot imagine that a psychiatric crisis in which you are at risk of harming yourself or others would not be eligible for emergency room care coverage.

(in reply to LittleGirlHeart)
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RE: so, medicare, or cal i can't remember which, will n... - 1/1/2014 6:42:02 PM   
LittleGirlHeart


Posts: 1427
Joined: 4/4/2013
Status: offline 		no. i was in the ER for a bladder infection, and she said you have a 25 dollar co pay and i said no i don't and the clerk said yes i do, and how did i want to pay, and i said just bill me because we;d gone through this before, and i called the number on the bill letter, and she explained to me, they say you have a 25 dollar co pay when you don't, because they don't know your coverage, and there's been changes, and pych issues are not covered any more. but if you have both, then one will pick up part of it but you will be liable for the rest.
quote:

ORIGINAL: kalikshama

quote:

medicare or medical which ever one, will not cover pych related visits to the er, you will be held responsible for the whole bill and visits to hospitals


Do you have a link for this information? I cannot imagine that a psychiatric crisis in which you are at risk of harming yourself or others would not be eligible for emergency room care coverage.



_____________________________


We'll fight, not out of spite
For someone must stand up for what's right
'Cause where there's a man who has no voice
There ours shall go singing

(in reply to kalikshama)
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RE: so, medicare, or cal i can't remember which, will n... - 1/1/2014 7:12:15 PM   
servantforuse


Posts: 6363
Joined: 3/8/2006
Status: offline 		You seemed to have plenty of money for vet bills not so long ago.

(in reply to LittleGirlHeart)
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RE: so, medicare, or cal i can't remember which, will n... - 1/1/2014 7:19:42 PM   
LittleGirlHeart


Posts: 1427
Joined: 4/4/2013
Status: offline 		It's called the good graces of a father loaning you money cuz he loves you and he cares for you an the dog.
quote:

ORIGINAL: servantforuse

You seemed to have plenty of money for vet bills not so long ago.



_____________________________


We'll fight, not out of spite
For someone must stand up for what's right
'Cause where there's a man who has no voice
There ours shall go singing

(in reply to servantforuse)
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RE: so, medicare, or cal i can't remember which, will n... - 1/1/2014 7:20:58 PM   
littlewonder


Posts: 15659
Status: offline 		so can't he loan you the money for your own health care since he did so for the dog?
Maybe it's me but if I have to choose between my daughter or her cat, it's gonna be her.

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RE: so, medicare, or cal i can't remember which, will n... - 1/1/2014 7:37:45 PM   
SweetAnise


Posts: 480
Joined: 8/23/2013
Status: offline 		If you have Medicare it means you have another health plan in addition to your Medicare. With your Medicare plan you need to make sure you have both Part A and Part B. This means calling Medicare to find out you have all the coverage needed. With your additional health plan you need to simply understand your benefits. That means another phone call. Perhaps it has change it isn't the hospital or anyone responsibility but yours. You need to understand your coverage or you will continue to get bills. Most plans will not pay for something that they feel could have been handled by going to your primary doctor. However you need to call them and work this out with them.

I remember your bladder infection/mental health break down posting saga and you were given great advice by many. You need to be accountable and not be the victim here.

$3000 is a lot of money and the last place I would be is on CM- I would be on the PHONE.

< Message edited by SweetAnise -- 1/1/2014 7:38:15 PM >

(in reply to littlewonder)
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RE: so, medicare, or cal i can't remember which, will n... - 1/1/2014 7:39:10 PM   
anniezz338


Posts: 1183
Joined: 8/17/2010
Status: offline 		From what i understand, if you are seeing a psych doctor, you usually have a caseworker and a crisis line that they encourage you to use. Using the ER because you do not have to pay for it is not an effective coping mechanism. I bet you have coping mechanism's but i wonder if you are using them.

Whoever does or does not pay the medical bills is not the issue here. Use your crisis line, your caseworker and do the things you need to be doing to make sure you can handle yourself. But I have also read most of your posts here and agree with lw that you may need to be institutionalized.

I cannot imagine what you are going thru but I can imagine what your family is going thru.

(in reply to littlewonder)
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RE: so, medicare, or cal i can't remember which, will n... - 1/1/2014 7:54:52 PM   
LittleGirlHeart


Posts: 1427
Joined: 4/4/2013
Status: offline 		Nope. no case worker. i have someone i see once a month, and if it''s a crisis or emergency he will try to get to me when ever he can, last time it was a month. And when you're out of your gourd with rage or whatever else is riding you, crisis lines don't work. not for me. i am beyond talking to someone helping me.


I dont go to the er because it's "cheap" I go because i litterally am imploding and on the verge of self harming myself to the point that once i am done with myself there qwouldn't be anything left to put back together,. yes i have coping skills. yes i use them, but when you're so far down the rabit hole you need 911 or you WILL go ahead and self mutilate yourself to the point there's nothing left to put back together, "coping skills" don'tdo jack shit.

When you call 911 and the cops come and you get taken to the ER, or you drive with someone and the cops escort, , you get 5150d. that's a mandatory hold with evaluation from pych in the morning, and if you start panicking or going nuts or trying to further hurt yourself, medical ppl WILL step in. and they DO have the tools and capabilities to effectivly restrain and deal with a patient going 5150. THAT'S WHY i use the ER, when the shits hitting the fan. If getting the help i need in those situations, is going to further make my situation worse, and further stress me out cuz now i owe 4 k and i am already maxed out on my budget just trying to repay my dad's loans,, i will choose to just go ahead and mutilate myself. THAT will be my"best option" to my ut of control mindl. it's "far better" to give in mutilate the shit out of myself while i am still in control of the desires, and can control the damage i do. The longer i fight not to mutilate myself and hang on the worse the impulse is, till it's to hard to contorl.
quote:

ORIGINAL: anniezz338

From what i understand, if you are seeing a psych doctor, you usually have a caseworker and a crisis line that they encourage you to use. Using the ER because you do not have to pay for it is not an effective coping mechanism. I bet you have coping mechanism's but i wonder if you are using them.

Whoever does or does not pay the medical bills is not the issue here. Use your crisis line, your caseworker and do the things you need to be doing to make sure you can handle yourself. But I have also read most of your posts here and agree with lw that you may need to be institutionalized.

I cannot imagine what you are going thru but I can imagine what your family is going thru.



< Message edited by LittleGirlHeart -- 1/1/2014 7:55:40 PM >

_____________________________


We'll fight, not out of spite
For someone must stand up for what's right
'Cause where there's a man who has no voice
There ours shall go singing

(in reply to anniezz338)
Profile   Post #: 12
RE: so, medicare, or cal i can't remember which, will n... - 1/1/2014 7:59:42 PM   
LittleGirlHeart


Posts: 1427
Joined: 4/4/2013
Status: offline 		800 dollars is a far cry easier to loan than 3-4 k.
quote:

ORIGINAL: littlewonder

so can't he loan you the money for your own health care since he did so for the dog?
Maybe it's me but if I have to choose between my daughter or her cat, it's gonna be her.



_____________________________


We'll fight, not out of spite
For someone must stand up for what's right
'Cause where there's a man who has no voice
There ours shall go singing

(in reply to littlewonder)
Profile   Post #: 13
RE: so, medicare, or cal i can't remember which, will n... - 1/1/2014 8:00:49 PM   
angelikaJ


Posts: 8641
Joined: 6/22/2007
Status: offline 		I think something must be messed up or you aren't understanding something.

There are mental health parity laws that should prohibit this.



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RE: so, medicare, or cal i can't remember which, will n... - 1/1/2014 8:12:59 PM   
kalikshama


Posts: 14805
Joined: 8/8/2010
Status: offline
quote:

ORIGINAL: LittleGirlHeart

no. i was in the ER for a bladder infection, and she said you have a 25 dollar co pay and i said no i don't and the clerk said yes i do, and how did i want to pay, and i said just bill me because we;d gone through this before, and i called the number on the bill letter, and she explained to me, they say you have a 25 dollar co pay when you don't, because they don't know your coverage, and there's been changes, and pych issues are not covered any more. but if you have both, then one will pick up part of it but you will be liable for the rest.
quote:

ORIGINAL: kalikshama

quote:

medicare or medical which ever one, will not cover pych related visits to the er, you will be held responsible for the whole bill and visits to hospitals


Do you have a link for this information? I cannot imagine that a psychiatric crisis in which you are at risk of harming yourself or others would not be eligible for emergency room care coverage.




I'm fairly certain the nurse was referring to routine issues, not crisis in which you are in danger of harming self or others.

Do you talk to people at NAMI? Maybe they can help you learn more about this.

(in reply to LittleGirlHeart)
Profile   Post #: 15
RE: so, medicare, or cal i can't remember which, will n... - 1/1/2014 8:23:54 PM   
SweetAnise


Posts: 480
Joined: 8/23/2013
Status: offline 		To the OP you are very intelligent most individuals who are mentally ill are quite smart. Stop using the ER for mental health services when you need to be hospitalized. The only reason a plan will not pay for services if you are not following medical advice. If the doctors want you admitted or for you to be hospitalized somewhere else and you say no...they will tell Medicare and the insurance plan and they won't pay. You need to be hospitalized and the fact that you don't have a case worker tells me even more you are doing what you want and not following medical advice. You just want your medications filled and to be calmed down and to go back home. But the fact is you need hospitalization. Your plans see you are using the ER system for mental health care and they are not going to pay for it.

< Message edited by SweetAnise -- 1/1/2014 8:24:27 PM >

(in reply to angelikaJ)
Profile   Post #: 16
RE: so, medicare, or cal i can't remember which, will n... - 1/1/2014 8:45:57 PM   
LittleGirlHeart


Posts: 1427
Joined: 4/4/2013
Status: offline
I get a and b yes. And since my Er trip was bladder infection related, i don't have to pay, but if i didn't have coverage, or i did, but my coverage didn't cover the issue i went in for, it woulda been 3k.
quote:

ORIGINAL: SweetAnise

If you have Medicare it means you have another health plan in addition to your Medicare. With your Medicare plan you need to make sure you have both Part A and Part B. This means calling Medicare to find out you have all the coverage needed. With your additional health plan you need to simply understand your benefits. That means another phone call. Perhaps it has change it isn't the hospital or anyone responsibility but yours. You need to understand your coverage or you will continue to get bills. Most plans will not pay for something that they feel could have been handled by going to your primary doctor. However you need to call them and work this out with them.

I remember your bladder infection/mental health break down posting saga and you were given great advice by many. You need to be accountable and not be the victim here.

$3000 is a lot of money and the last place I would be is on CM- I would be on the PHONE.



_____________________________


We'll fight, not out of spite
For someone must stand up for what's right
'Cause where there's a man who has no voice
There ours shall go singing

(in reply to SweetAnise)
Profile   Post #: 17
RE: so, medicare, or cal i can't remember which, will n... - 1/1/2014 8:47:46 PM   
LittleGirlHeart


Posts: 1427
Joined: 4/4/2013
Status: offline 		they might know, yes. and yes i have called nami, and all they would do for me if i needed them was set me up to see someone once every 4 months for meds only. and i can't use them, since i have kaiser. But no harm in calling an asking them about this new change.
quote:

ORIGINAL: kalikshama



I'm fairly certain the nurse was referring to routine issues, not crisis in which you are in danger of harming self or others.

Do you talk to people at NAMI? Maybe they can help you learn more about this.




< Message edited by LittleGirlHeart -- 1/1/2014 8:48:10 PM >

_____________________________


We'll fight, not out of spite
For someone must stand up for what's right
'Cause where there's a man who has no voice
There ours shall go singing

(in reply to kalikshama)
Profile   Post #: 18
RE: so, medicare, or cal i can't remember which, will n... - 1/1/2014 9:23:43 PM   
DesFIP


Posts: 25191
Joined: 11/25/2007
From: Apple County NY
Status: offline 		Actually kiwisub, you're incorrect. When my genetic depression returned about 15 years ago, it was not a slow progression. I was fine and then I was suicidal. It really did recur full blown after having been in remission for almost 20 years.

I did not go to the psych hospital the way my doctor wanted but it did qualify as a psychiatric emergency.

In NY mental health must be covered the same as physical health problems.

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RE: so, medicare, or cal i can't remember which, will n... - 1/1/2014 10:04:36 PM   
littlewonder


Posts: 15659
Status: offline 		so you keep getting 5150d. How the hell are you getting out each time? Usually they won't let you out unless they feel you are not suicidal and that you are better. You're obviously not better and any doctor would be able to see that after questioning you for about 10 mins. I mean, I'm not a doctor and I notice each time you come on here. It doesn't take much to see and I think most would agree.

If I were your boyfriend I'd be telling the docs exactly what's been going on at home and how many you have been committed. If they refuse to keep you in, if I were your boyfriend I'd be finding new docs to talk to about you. But it really doesn't seem you have anyone at all who is taking care of you at all since you are not able to do so on your own. I wish there was some way you could get that help but it seems you can't do that and you have fallen through the cracks of the system.


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