Monday, March 24, 2014

My insurance story..

One more personal pause before getting back to business here at Hillbilly Quilt Shop.
(I hope!! I have a BUNCH new video subscribers but I cant even talk to make a video!!)

The pneumonia had me up last night all night. It was really rough. I get all bubbly in my chest, like it sounds like I am boiling water or something when I try to breathe. When I went into the ER on Friday and was like this, they could not clear my airways with a breathing treatment and had to give me a couple of shots. (and boy did I feel great after those shots!! I was able to talk and eat!!)
 Last night I just got through, but only slept a couple of hours.

I've been to the ER twice with this and it is quite obvious that had I insurance, I would probably be treated differently, and most likey kept a bit so that I can get the pneumonia under control better.

It's not like I haven't tried to get insurance, so I thought I would write this explaining to my friends why I don't have it. If you are just here for Ahhhhs, well they will be back very soon. But no matter what side of the political fence you are on, you might find this interesting. And to's aggravating!


Three years ago I could not walk. I just woke up one morning and my knee didn't work. I couldnt bend it, couldnt put weight on it, I couldnt walk!! I did some phone calls and found out that to be seen in the clinic for the non insured (in this part of MO) then I have to first go through DSS and try to get Medicaid..or be denied Medicaid. So I went through the process. It takes a few weeks. (I still couldn't walk). I was denied Medicaid because I am not pregnant and I do not have a disability, and because my husband works. They told me if my husband quit work...then I can have Medicaid. Yep, they reward you for being a bum. (their reasoning is I can buy insurance through his place of employment but currently I just cannot afford $350 a month).

So fast forward to now...

I have pneumonia. I do not have the time to go through all the denial process again so that I can be seen by the clinic. My husband attempted to sign me up for Obama Care. Guess what? I qualify for Medicaid under the Obama Care plan. So..they say, I should get insurance. But since it is up to MO..and Mo says I can't get it then..I don't have insurance. At least the plus side is, I cannnot be penalized for not having insurance as I have tried.

So why not just pay the $350 a month? Well last year we made $29,000. That's a lot of money for us to choke up when we have to pay rent and for so many meds for my husband!!! And boys to feed! And my husband misses a lot of work time due to being ill. And...I can't even sign up for it until open enrollment in October. By then I guess I'll have to figure a way to work the fabric shop that much harder, I don't know. I want to scale it back...its wearing me down. I have designs to sew for the book!!

Ugh I dont know. For now...I just will deal with my pneumonia best as I can, and if it gets really bad again, I'll try a new hospital I guess.

And that is my insurance story. Phooey on it!


  1. that's terrible, make sure you have printed proof of this so you don't get taxed next year....

  2. In order to get healthcare reform passed states were given options to implement their own plans. Obama care is not perfect but it is a start. If it was nationwide not state by state it would perhaps have functions o Ned more smoothly. Lots is other programs have state by state differences. Social Security Disability and Medicare are two that vary state to state. I know this was not a political post but I am also sure it is evident I am a Democrat.

    I am so sad that you are caught up in this conundrum. We all know the deleterious affect of stress on the body and you certainly did not deserve to be placed in such an ugly situation.

    I want to thank you for planning up your life story for the world to see. I shall continue to pray for a path to better medical care for you.

  3. That would be putting your life story. Obviously one would networks to be in the mess you find yourself in.

  4. It seems to be a never ending circle of nothing happening in the world of American health insurance. Sorry that you have to go through all this. Hopefully you can sort it all out and get well. Thinking of you. hugs

  5. Seems that good intentions have mucked up the system even more. I hope that you are feeling better soon, my friend. Still praying for your health and strength.

  6. That is crazy. Why are they making people jump through so many hoops to get health care?

  7. Your scenario highlights the fact that, at some point, it is actually beneficial to have an insurance you can lean back on in times of emergency. Yes, there are the regular payments that have to be made that can be a burden, but at the end of the day, your life and health are more important than your money. I think you guys should think things through. There are pros and cons to everything, and you might want to consider weighing them.

    Oliver Duncan

  8. I’m sorry to hear that you had to go through this unfortunate situation. I hope you’re doing fine now, and that you have found a way to deal with those insurance issues soon after. Anyway, Thanks for sharing this with us, Tonya. Stay strong!

    Modesto Culbertson @ D&Z Law Group

  9. Perhaps you shouldn't take pneumonia too lightly. Whether or not the treatment would be covered by insurance, putting yourself at risk and delaying it is no good. Admittedly, I do understand what the cost of the delay was, and hopefully, your insurance company has been more compliant ever since. In any way, thanks for sharing that, Tonya! All the best to you!

    Joshua Duncan @ Focus Insurance