# A Virgin in the Medical World



## SifuPhil (Jun 18, 2015)

After my bout with mortality it was decided by the powers-that-be to prescribe a dozen medications for my condition(s). You have to remember that for the last 35 years I have not visited a doctor nor seen the inside of a hospital. 

I am saddened and shamed to report that my medical world virginity has been taken from me as a result of these recent events.

Suffice it to say that I am considerably below middle-class when it comes to financial affairs, so I decided (actually, it was decided FOR me) to enlist in the state medical assistance program, aka *Medicaid* (seems I'm too young for Medi_care_ at this point).

Poor but still in possession of a laptop and 10 semi-functional fingers it occurred to me to apply online. The Medicaid website promised easy enrollment and quick results, so I set about entering my information. I thought it a bit strange when the first set of questions came up 5 minutes into my session ...


*"Do you own a car?"

"Do you travel to other countries?"

"Do you enjoy fine dining?"*​
Being focused on my medical info I neglected to be on-guard against scams. Turns out this site was NOT the "official" state Medicaid one but a clever copy, designed to get me on as many spam lists as possible. I quickly backed out, glad that they had at least not gotten any vital info such as my SS number or medical info.

My second attempt at losing my medical cherry came when I finally discovered the REAL state website and began entering my info. Of course, everything was not unicorns and rainbows here, either. For some reason this demented site would not accept my username and password (which it had only moments before asked me to create). 

Nothing like having your very reality questioned.

Quitting in a pique of anger I decided to try again the next day. Lo and behold I got into the members area and was presented with the next challenge - 

*"Choose a PCP". *

My excitement was short-lived when I found out that the PCP referred to was a Primary Care Physician. 



Eeny-meeny-miny-mo 
Grab a doctor by the toe
If he's not in your plan, though,
Another office you will go.​
Yeah - every doctor that I had ever heard mention of was either too far away or ...

Wait - now I have to choose a PLAN as well?!? Oy!

Okay, that's a lot easier - only two plans to choose from. I pick "A" and start looking for local docs participating in this plan. I find one whose name I can pronounce and is within a 2-bus-ride area, click "SUBMIT" (not sure I liked the implications of that word) and gave a happy sigh.

Yeah, right. As if losing my virginity would be THAT painless. 

A week later I receive an email from the state asking me why I have not yet chosen a Plan or a PCP, and that I'd better hurry else they'd choose them FOR me in 7 days. Panicking and figuring - wrongly - that perhaps a different choice of Plan and PCP would work. I chose Plan "B" and a doctor whose name contained more syllables than a championship spelling bee, once again Submitted to the State's will and crossed my by-now arthritic fingers.

On the same day I received a letter - you know, the kind that appear in your mailbox - from the State, informing me that I had been assigned Plan "B" and a doctor whom I had never heard of and whose office was evidently used for the filming of the Marine Corps "Wilderness Survival" film series. Google Maps refused to show me where this supposed office was; they didn't even show any roads within a 3-mile radius. 

Stunned and reeling from my lack of medications (I had run out of the hospital-supplied "sample pack" 2 weeks earlier) I was just shutting down my 'puter for the night when my email bell chirped. I checked out my latest arrival and saw that it was from the State, informing me that I had been accepted into Plan "A" and assigned the doctor I had originally chosen for Plan "B".

Are you following all this? I wasn't. 

The upshot is that I ended up with 3 doctors and 2 Plans. This caused no end of merriment when I finally got an appointment with one of them. Well, actually that's not entirely true - I was informed by the receptionist when I called that the first available appointment would not be until August 31st. 

That's when I had to get creative and draw upon my voluminous acting experience. I began breathing heavily, coughing and hacking into the phone and begging the receptionist to find an earlier appointment, for if I had to wait until August 31st I should surely be a cold corpse at that point. I even played an MP3 violin concerto over the phone from my laptop, to add to the general pathos of the situation. Throwing in a bribe of a dozen long-stemmed roses and a party-sized box of Godivas probably helped my efforts as well. 

Turns out that a PA - a Physician's Assistant - was available 3 days from now at 8:30AM and that she could write new prescriptions for all my meds. *Hallelujah! *

Turns out that, because of our local transit authority's superior service, I had to get the first bus of the day - at 5:45AM - in order to catch the first transfer bus at 6:15AM, which would deposit me in front of the medical office at 6:35AM.

For an 8:30AM appointment, you may recall. 

I spent the extra time feeding bits of Slim Jims to the sparrows and squirrels, some of them becoming so trusting of me that they perched on my shoulders and legs as I sat on my butt in the Handicapped Parking spot. 

Then it began to rain. I had neglected to bring an umbrella. 

Roughly two hours later I entered the receptionist / waiting area and there was a gasp followed by a deafening hush. I stood at the receptionist's window dripping with semi-solid squirrel and sparrow waste and smelling like a sausage factory, my ponytail undone and hanging limply over my face as I held up the Glad Bag full of empty prescription bottles with my shaking hand and mumbled "I'm ... I'm here f-f-for my drugs."

It was only after the receptionist finally calmed down and asked for my Plan information, to which I replied "A and B", that she pressed the little red button on her desk. When she courageously asked, as a final gambit for normalcy, whom I had chosen as my doctor and I gave her 3 names, she fled the office shrieking. 



I'll never forget the day I lost my Medical World virginity.


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## Happyflowerlady (Jun 18, 2015)

Sifu, you have my complete sympathy ! Medicaid is good to have; but they can also be extremely frustrating. It should get better though now that you have a PCP and a plan. Mine goes with my Medicaid/Medicare so it might be a little different than just the Medicaid. 
I have an insurance agent, and he works with the supplement plans, and he was able to upgrade my coverage so that I have more options, but it is still covered by Medicaid/Medicare.
 It might be that they can do that for you, but you would need to find an agent to help you because medicaid will never tell you that you can actually have a program that covers more benefits. 
Try looking for an agent that works with Medicare Supplements, even though you are not eligible for medicare; he would know if there is a more comprehensive program suitable for medicaid without having medicare. 

Also, you should apply for SSI benefits. You do not have to be over 65 if you have a disability. However-----even with my a-fib and CHF, I was turned down three times for a disability; so even though you actually qualify for one, that does not mean you will get it without a fight. 
I just eventually got old enough to apply through the retirement SS benefits instead of the disability. Up until that time, i could not afford to see a doctor or be treated for my heart problems. We have a free clinic here that I went to after I moved here, and they had a cardiologist who volunteered there and he was able to help me as much as was allowed from the clinic. 

Your PCP is just a starting point, and they will refer you to any specialists that you need. 
Also, our hospital has a pharmacy and I get my heart meds through there.  They have easy contact with the doctors should the need arise to verify a prescription, plus, they mail my meds to me and I do not have to go and pick them up. 
If you ask for a three-month supply from the doctor, you will pay the same co-pay as if you ask for a one month supply, so you can save money that way, plus do not need to get the meds as often, if it is one that you will be taking regularly. 

Another thing to check out is transportation. Medicaid will also provide transportation for doctor appointments if you need it. I think you have to call and set it up each time.
 Plus, we have a thing here called "handi-ride", and it is just for handicapped people, or people who have no vehicle. It is somewhere between a bus and a taxi. You schedule them like you would a taxi and they take you to the appointment and bring you home again afterwards. It costs; but not a lot. It is very likely that you might have a similar thing where you live. Can't hurt to check. 

Blessings and Prayers......HFL


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## Ken N Tx (Jun 19, 2015)

I am glad that I am still a virgin....


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## Ken N Tx (Jun 19, 2015)

Ken N Tx said:


> I am glad that I am still a virgin....View attachment 18757



The biggest problems that I had (when I turned 65) was selecting Med-Gap Insurance!!!!!!!!!!!


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## SifuPhil (Jun 19, 2015)

Happyflowerlady said:


> Sifu, you have my complete sympathy ! Medicaid is good to have; but they can also be extremely frustrating. It should get better though now that you have a PCP and a plan. Mine goes with my Medicaid/Medicare so it might be a little different than just the Medicaid.
> I have an insurance agent, and he works with the supplement plans, and he was able to upgrade my coverage so that I have more options, but it is still covered by Medicaid/Medicare.
> It might be that they can do that for you, but you would need to find an agent to help you because medicaid will never tell you that you can actually have a program that covers more benefits.
> Try looking for an agent that works with Medicare Supplements, even though you are not eligible for medicare; he would know if there is a more comprehensive program suitable for medicaid without having medicare.



Oh, no - another body in the mix! 

Supposedly I had a Patient Advocate or Social Worker or something like that interview me when I was leaving the hospital. All I remember is signing a paper saying she had visited me and said "You'll have to find a personal doctor."

Yeah, thanks for that. 



> Also, you should apply for SSI benefits. You do not have to be over 65 if you have a disability. However-----even with my a-fib and CHF, I was turned down three times for a disability; so even though you actually qualify for one, that does not mean you will get it without a fight.
> I just eventually got old enough to apply through the retirement SS benefits instead of the disability. Up until that time, i could not afford to see a doctor or be treated for my heart problems. We have a free clinic here that I went to after I moved here, and they had a cardiologist who volunteered there and he was able to help me as much as was allowed from the clinic.



I guess that should be my next step, but I'm still punch-drunk from these docs and plans. I'm not sure I would qualify anyway, but it's certainly worth looking into.



> Your PCP is just a starting point, and they will refer you to any specialists that you need.
> Also, our hospital has a pharmacy and I get my heart meds through there.  They have easy contact with the doctors should the need arise to verify a prescription, plus, they mail my meds to me and I do not have to go and pick them up.
> If you ask for a three-month supply from the doctor, you will pay the same co-pay as if you ask for a one month supply, so you can save money that way, plus do not need to get the meds as often, if it is one that you will be taking regularly.



I actually count myself lucky there. The PA gave me a six-month prescription, and my private T'ai-Chi student is the head pharmacist for one of the local Medicine Shoppe pharmacies. In fact, he was getting me syringes for my insulin at cost when I ran out earlier. I also get delivery from them, usually same day and costing just a few bucks. 



> Another thing to check out is transportation. Medicaid will also provide transportation for doctor appointments if you need it. I think you have to call and set it up each time.
> Plus, we have a thing here called "handi-ride", and it is just for handicapped people, or people who have no vehicle. It is somewhere between a bus and a taxi. You schedule them like you would a taxi and they take you to the appointment and bring you home again afterwards. It costs; but not a lot. It is very likely that you might have a similar thing where you live. Can't hurt to check.



My roommate has taken advantage of the Med Bus (as I call it), but in this area they are prone to being extremely disorganized - they show up either an hour early or late, or not at all - and to help my vanity avoid the stigma of riding the "short bus" I prefer to take public transport as long as I can.

Besides, it's more fun people-watching that way.


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## SifuPhil (Jun 19, 2015)

Ken N Tx said:


> The biggest problems that I had (when I turned 65) was selecting Med-Gap Insurance!!!!!!!!!!! View attachment 18759



Yeah, see, I'm still 100% virginal when it comes to _that_ topic ... layful:


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## oldman (Jun 19, 2015)

You have to pay for syringes? I know a lot of methadone clinics that give them out free, but you have to be registered with the county's substance abuse agency. I am not suggesting that you do this, but was just making an analogy of what people have to do to get medical supplies. Drug addicts can get free syringes and people with diabetes or another ailment that needs daily injections has to jump through hoops to get the same service. It bothers me that we have come so far with getting healthcare to those that did not have any previously, but evidently not far enough. I am not saying that it should be easy to acquire such benefits, but certainly easier than your experience. 

I guess that I am fortunate to have my Medicare and also be able to afford a very good supplemental to my health insurance, a drug program and an eye and dental program as well. I know some veterans that use the VA for these services, but after listening to their stories of getting medical attention when needed, I think I'll pass and stick with what I have and pay for. 

We have come a long way, buy we need to continue going farther. No one in this country should be in need of "good, quality healthcare." If we have billions to spend on wars, I would rather see it spent on education and healthcare. However, the U.S. has taken the position as being the world's police department and doing whatever we can to rescue people living in oppressive countries with corrupt governments. (Don't get me started.) 

Good luck, Phil as you travel down the healthcare highway and next time take an umbrella.


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## SifuPhil (Jun 19, 2015)

oldman said:


> You have to pay for syringes? I know a lot of methadone clinics that give them out free, but you have to be registered with the county's substance abuse agency. I am not suggesting that you do this, but was just making an analogy of what people have to do to get medical supplies. Drug addicts can get free syringes and people with diabetes or another ailment that needs daily injections has to jump through hoops to get the same service. It bothers me that we have come so far with getting healthcare to those that did not have any previously, but evidently not far enough. I am not saying that it should be easy to acquire such benefits, but certainly easier than your experience.



Without the prescription yes, you have to pay. I have no co-pay so the box of 100 I just received cost only $4 for delivery, but they retail for around $1 each. By the way, they're available over-the-counter - no Rx needed. 

I agree that the system could use a good tune-up, as it is not quite user-friendly at this point. I'm not the brightest bulb in the lamp but I'm not an idiot either, but I found the process very confusing and non-linear.



> I guess that I am fortunate to have my Medicare and also be able to afford a very good supplemental to my health insurance, a drug program and an eye and dental program as well. I know some veterans that use the VA for these services, but after listening to their stories of getting medical attention when needed, I think I'll pass and stick with what I have and pay for.



I've heard some of the horror stories of the VA, so that tends to put my own limited experience into perspective.



> We have come a long way, buy we need to continue going farther. No one in this country should be in need of "good, quality healthcare." If we have billions to spend on wars, I would rather see it spent on education and healthcare. However, the U.S. has taken the position as being the world's police department and doing whatever we can to rescue people living in oppressive countries with corrupt governments. (Don't get me started.)



Totally agree, but then I get called an isolationist a lot. 



> Good luck, Phil as you travel down the healthcare highway and next time take an umbrella.



I think maybe one of those big beach ones - there's going to be a hard rain, I'm pretty sure.


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## oakapple (Jun 19, 2015)

Cor, stone the crows Guv, wot a palaver! poor old you Phil, you need to be all there 'with your marbles' to work out all the online stuff to register.Why couldn't all that be sorted out for you at a GP surgery, or won't they help?Are you too proud to ask for help?Yes, of course you are, what am I thinking!glad that you eventually got things worked out though, and it did make a great story. I know you hate the word 'submit' but  I think your story should be sent to a magazine.


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## Denise1952 (Jun 19, 2015)

Phil, I haven't had time to write/post on other's posts, and wished I'd seen yours at least  Hang in there, and I will eventually be in closer contact.  I dislike having to rely on strangers to take care of my body.  No matter how hard we try, seems sooner or later they get their hands on us, Denise


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## SifuPhil (Jun 19, 2015)

oakapple said:


> Cor, stone the crows Guv, wot a palaver! poor old you Phil, you need to be all there 'with your marbles' to work out all the online stuff to register.Why couldn't all that be sorted out for you at a GP surgery, or won't they help?Are you too proud to ask for help?Yes, of course you are, what am I thinking!glad that you eventually got things worked out though, and it did make a great story. I know you hate the word 'submit' but  I think your story should be sent to a magazine.



I AM a proud one - that's just _one_ of those albatross I carry around my neck.  I think they were supposed to give me a little more help before my hospital discharge, or maybe I was too impatient to get out of there, but for whatever reason I came away with nothing.

Now, I have NO problem submitting to magazines - thanks! 



nwlady said:


> Phil, I haven't had time to write/post on other's posts, and wished I'd seen yours at least  Hang in there, and I will eventually be in closer contact.  I dislike having to rely on strangers to take care of my body.  No matter how hard we try, seems sooner or later they get their hands on us, Denise



Hiya, hon - I've had mixed results having strangers take care of my body, but that can wait for our closer contact.


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