OT- Helping a family in need

  1. You have chosen to ignore posts from ajuly09. Show ajuly09's posts

    OT- Helping a family in need

    Once again I am TOT (totally off topic!)  but you have really been so much help in so many ways and I know that you may have some ideas on this topic.  I have a co-worker who is an aide in my school.  It is not fair, but they hire aids for only a certain number of hours so that they do not get health coverage.  This aide uses her husband's heath coverage for herself and her daughter.  Her daughter was recently diagnosed with scoliosis and got fitted for a brace.  The husband's heath care won't cover a cent of it.  SHe has had this brace for a year and now needs a new one since she outgrew the one she has.  They have not paid a dime of the first one and can't get a new one till the first one is paid for.  Each brace is 3,000.  She can't afford to pay it and has been looking for help through Shriners and other sources with out luck.  I was thinking of starting a fund here at school, but this really seems like a personal issue and I am sure she would be embarrassed if she knew I did this and others knew about it.  Does anyone know about a place that would help give money to families to pay for this sort of thing?  The daughter needs this brace to prevent a painful and expensive surgery.   Any thoughts on organizations or people to contact would be very helpful.  TIA!!
     
  2. You have chosen to ignore posts from kargiver. Show kargiver's posts

    Re: OT- Helping a family in need

    ajuly, you are a dear.  Your idea of raising the money is actually a very good one, I think.  This family would be filled with humble gratitude if the school banded together and raised the money for her daughter.  Neighbor helping neighbor, what's embarrassing about that?  I understand where you are coming from, but just talk to her about how much people who know and love her would want to do this and see how she feels.  If she belongs to a church that pastor would want in on the effort so the church could get involved.
     
  3. You have chosen to ignore posts from NorthernLghts. Show NorthernLghts's posts

    Re: OT- Helping a family in need

    As someone who wore the brace and ended up having the surgery, i think what you are doing is wonderful. Best of luck and i hope you are able to help them out :-)
     
  4. You have chosen to ignore posts from clc51510. Show clc51510's posts

    Re: OT- Helping a family in need

    I did some quick research and here are a few places that she might want to reach out to

    National Scoliosis Foundation - http://www.scoliosis.org/index.php

    Scoliosis Care Foundation - http://www.scoliosiscare.org/

    I think what you're doing is great.  And I agree with Kar that if you speak to your co-worker first she may be okay with you starting a fund to help her out. 

    Another suggestion, may sound a little weird but any money helps, the gym I attend (Bayshore Athletic Club, Braintree) has done Zumba fundraisers recently.  They hold a special Zumba class on Saturday afternoon for $10 and the money raised goes to the charity/family they are sponsoring.  It sounds a little silly but they get a pretty good turn out at most classes (60-ish people).
     
  5. You have chosen to ignore posts from pinkkittie27. Show pinkkittie27's posts

    Re: OT- Helping a family in need

    you can also reach out to friends and family (for example, over Facebook) and set up a PayPal account for donations. If you can get $5 from 100 people, that's $500 already!
    A friend of mine did this when her dog had complications due to surgery and it all ended up costing $5,000 on top of what she'd already paid for the surgery. She ended up raising a good chunk of the money that way. Most of us only donated $5 or $10, but that's all she asked for.
     
  6. You have chosen to ignore posts from pinkkittie27. Show pinkkittie27's posts

    Re: OT- Helping a family in need

    BTW- That's the type pf pre-existing condition that healthcare refrom will force insurance companies to cover. Don't forget to go out and vote today!
     
  7. You have chosen to ignore posts from jasmine09. Show jasmine09's posts

    Re: OT- Helping a family in need

    First things first: I hope your friend has looked seriously into her insurance situation.  Does her husband's insurance categorically not cover the brace, or has it decided it is "not indicated"?  Some insurance companies kick back (i.e. reject) almost all large claims sort of automatically.  You have to fight with them to get it reimbursed even if it is a totally legitimate medical need and something they should cover.  Make sure that she has gone through the appropriate avenues first to see if her insurance company can be convinced to cover it.  (e.g. get a letter from the doc saying it is medically necessary, sending it certified mail, calling the insurance, document that she called, escalate the case, etc.)

    Second, if the insurance co absolutely won't cover it (i.e. this type of insurance never covers this type of device), then I hope she has tried to negotiate with the hospital/clinic.  Talk to the doctor and the hospital, explain the financial situation, see if they can get the price down.  Hospitals charge different prices to different people and insurance companies. 

    ...Now it's possible that both of those avenues will fail, but I think a people some times give up prematurely on them, so I just wanted to make sure that it had been explored.  
     
  8. You have chosen to ignore posts from ajuly09. Show ajuly09's posts

    Re: OT- Helping a family in need

    THanks for the posts ladies.  I am going to check out the links you gave clc, thanks!  The one thing about raising money at work is that this woman works only in one small part of the school and not many people know her.  I am sure people would donate, but I still feel awkward about it.   I am going to look into the United way as well...don't really know much about them.  
    The Zumba idea is a good one too. We have an exercise class at school, maybe we could work that into raising some money (and work off those holiday pounds).  
     
  9. You have chosen to ignore posts from kargiver. Show kargiver's posts

    Re: OT- Helping a family in need

    ajuly, I love your exercise challenge idea for raising money.  Awkwardness might spring from an expectation that people will harbor unspoken resentment about being asked to help, but I believe that the sense of community and indentification with this family even if not many people actually know her would lead to more joy at the opportunity to help than negativity.  This isn't like a random phone call asking you to donate to some random cause - which I do resent, by the way, especially at dinnertime.  Instead, it's allowing a community to help one of their own deserving members which will inspire joy and a coming together of the whole school for a worthy cause.  Be encouraged!  :)
     
  10. You have chosen to ignore posts from memes98. Show memes98's posts

    Re: OT- Helping a family in need

    They should try the Catastrophic Illness in Children Relief Fund.  From what you have described, it sounds like they would be eligible to receive money.  Here is the website:

    http://www.mass.gov/cicrf/

     
  11. You have chosen to ignore posts from that-guy. Show that-guy's posts

    Re: OT- Helping a family in need

    To clarify something here - this type of condition has NOTHING to do with said healthcare reform bill.  Employer sponsored insurance plans are based off of a menu of coverages.  The husband's employer might have a lesser plan and chose to leave these types of medical devices and/or treatments off the policy.  Simply because a condition is preexisting does not mean that a policy would have to cover it.  Get your facts straight before you attempt to drag politics into any discussion.

    All of this is moot now anyway, since the election outcome will at least put the brakes on a bill that was doomed from the start to do nothing more than bankrupt the country all in the name of liberal progress(otherwise known as redistributing wealth and penalizing success).

     
  12. You have chosen to ignore posts from pinkkittie27. Show pinkkittie27's posts

    Re: OT- Helping a family in need

    it's not liberal progress. the liberals wanted an entirely different type of reform.

    "redistributing the wealth" do you mean assisting those like the family mentioned here, so that they don't have to turn to charity?

    health reform would demand a certain level of covergae be provided by ALL insurers. they wouldn't get to pick and choose what illnesses to cover. it's wrong. this child's family is put in a heartbreaking position because people like you only care about themselves.
    Why don't you go his child's family and tell them why you don't think they desevre affordable, MEANINGFUL health insurance?

    if any of you people who opposed health care reform had to actually talk to the people in need, you'd be singing a different tune. Like if you knew my friend from college who has lyme disease. she can't get insured because it's a PEC. she's gone into debt for her treatment, her family has gone into debt for her treatment, and now, they won't be able to afford her treatment much longer. she's terrified because she could die from an easily treatable disease! all because she can't afford the treatment, and other people don't care. Do you want to tell her why you think it's not your problem?
    How about my friend's cousin who was dropped by her health insurance when she found out she had brain cancer? she and her family went into debt for her treatment, she died, and now they have her medical bills to remember her by. they'll be paying off her treatment for the next 20 years! Do you want to tell them why you don't think their daughter deserved more?

     
  13. You have chosen to ignore posts from wendy98. Show wendy98's posts

    Re: OT- Helping a family in need

    Pink I really think you are mistaken on the 'pre existing conditions' issue, but I think it is wise to keep politics off of this board in general.  No one asked for your opinion on healthcare, insurance or reform. 

    And yes I just made a bit of a comment of my own with the first statement but tried to keep it vague.  And now that is all I will say on the matter.
     
  14. You have chosen to ignore posts from pinkkittie27. Show pinkkittie27's posts

    Re: OT- Helping a family in need

    wendy- whatever reason it is the insurer doesn't cover scoliosis, it's not a good one.
    we were asked our opinion on how to raise funds for a family who has a child with an illness that insurance won't cover. I think healthcare reform is entirely relevent to that.

    and I don't see a previous statement from you on this thread. did you delete it?

    and why pick on me and not thatguy? is it because you don't like my opinion?
     
  15. You have chosen to ignore posts from that-guy. Show that-guy's posts

    Re: OT- Helping a family in need

    You are mixing preexisting conditions with the way employers choose their health plans, what services they cover, which levels of coverage they want to offer.  You are also playing the part of whining about every person you know with a problem, so naturally we should mandate that employers/insurance companies/and the US Taxpayer foot the bill for all their issues.  Where do you think it comes from?  Fine - we go and "make" insurance companies cover everything under the sun.  So for those of us under employer plans, you know what happens - our share of the premiums go up, our copays go up, and if you have them - the deductibles go up.  Your prescriptions will cost more and the overall level of care you'll get at a doctor's office will go down.  Why? Because they now have to squeeze in more patients per hour since they're being forced to accept anyone who wants to get in.  What happens then?  You're back here whining about how your costs have gone up, your taxes have gone up, and you can't get any real help from your doctors.  Oh, then you'll be asking why the government doesn't mandate something else to make those problems go away.
     
  16. You have chosen to ignore posts from that-guy. Show that-guy's posts

    Re: OT- Helping a family in need

    By the way - I think it's great that the poster here wants to help this family.  That's what people should do.  But it's a tricky situation.  Would be best to round up a few supporters at the school and get them on her side before making a large campaign about it.  That way it's got some traction first.  Also, check with the school board/commission/mgt.  You want to make sure you're not violating any rules of conduct concerning solicitation.  Aside from the woman's part time status, the school might offer some sort of program to help, even if it's not considered straight-up benefits.
     
  17. You have chosen to ignore posts from cosmogirl. Show cosmogirl's posts

    Re: OT- Helping a family in need

    ajuly09, this is a little nutty but I have a lot of experience in the field of employee benefits and would be very happy to review the family's medical plan information to see if the brace should be covered or not.  It's sad but true that many plans reject claims on the first submission.

    If interested, please email me at cape cod 38 at g mail dot com.

    I would be happy to donate $25.   I've already donated to Haiti so I'd like to give a little to a Mass. person who could use it, too.
     
  18. You have chosen to ignore posts from whatawagSBNy. Show whatawagSBNy's posts

    Re: OT- Helping a family in need

         You have not mentioned (for obvious reason)  the husband's income level.
         The child may be eligible for Medicaid assistance  at a higher level of family income than you think. 

         Scoliosis has to be of a certain severity before it is something an insurer cannot overlook and refuse coverage for.  Often  this automatic denial of claims which so many insurers follow as matter of policy, cannot be fought  without documentation of severity being part of the claim.

        Also, appliances are a funny thing.  Generally if you have one,  gov't as well as insurers can refuse to give you a replacement in less than (usually) 3 years.
    But where someone is a growing child  if it can be shown that  a now too small brace is causing HARM,  it is a whole new game.

         Also,  big health industry issue -  very often a brace can be altered to fit growth,  without replacing it entirely, for a fraction of the cost.
    Has this been tried?  Companies would rather you throw the old one out and buy a new one.

         In addition to Medicaid providing funds,  going to them may get the parents information.  Anyone on gov't aid is used to making do on very little.  So intake social workers are generally very knowledgeable  about which hospitals,  charitable and fraternal organizations, and teaching hospitals with orthopedic specialties,  will at the very least modify an existing brace  so it is functional for another 6 months to a year, depending on the child's age and growth.

        Appliances, braces, orthotics, wheelchairs-  have a major factor in common with car sales -  if you go to  a new car showroom,  you cannot buy a used car.
    The brace company may only be talking,  buy new.  The insurer may turn out to cover part of costs to extend the life of an existing brace by modifying it.
    As long as you are asking for new, they will deny coverage.
    Parents in the middle spin their wheels seeking new things and money for them,  when there are orthopedic specialists who collect old appliances as spare parts as material for altering braces,  etc.  Adaptive Physical Equipment is a specialty.

         Inquire about this at Shriners,  Boston Children's,  which serve all over the state,  and with any teaching hospital or major provider - Tufts, Lahey, in their area.

         Also - unless Mass has canned a lot of 766 special needs provisions since I last had to do with them,  a child with scoliosis often has a condition that merits consideration as a physical disability.  An evaluating school system PT  often does not recommend any therapy through the school if all that is warranted is medical.
           But because of the consequences of an ill fitting brace, they may have connections to get the child an adaptive equipment connection.   Since  a child with CP cannot learn if their body is flopped over,  766 coverage may tap Medicaid and Federal funds to adapt a wheelchair to keep a child's head upright, body in position -  so they can learn in school.

         A child with an ill fitting scoliosis brace may need refitting (not new)  in order to participate fully and safely in all offered school activities.

         This is a state by state issue,  but very often a school system PT,  College  with PT major -Northeastern's Boston Bouve), through Tufts Medical, BU's Sargent school of Health Sciences-  you can get referral to a clinic, Adaptive Equipment a specialty, which will help.

    Your co-worker and you might find a friendly PT in your school system 766 services who will either know personally,  or give you numbers to call, so you do not wait to go through the system.

    As a colleague,  you might offer more help getting an outpatient or hospital clinic that will alter a brace, if it is possible,  than by engaging in serious fund raising or fighting for a new brace from an insurer.
     
  19. You have chosen to ignore posts from pinkkittie27. Show pinkkittie27's posts

    Re: OT- Helping a family in need

    thatguy- you're solrely mistaken, and I do not wish to hash this entire issue out here. I strongly urge you to either go read the facts at healthcarereform.gov or read the actual healthcare bill. a lot of what politicians and talking heads are saying about it simply isn't true. studies and estimates have shown that premiums for working families would be 59% of what they pay now should healthcare reform pass. plus, there would be a cap on out of pocket expenses.

    and that's all I'm going to say about that.

     
  20. You have chosen to ignore posts from that-guy. Show that-guy's posts

    Re: OT- Helping a family in need

    #1, the website is http://www.healthreform.gov/
    #2, the information and "studies" you reference are being distributed by the very same people trying to ramrod this bill out there.  Hardly an impartial source.
    #3, you obviously have no clue how the real world works, if you think this would not result in extra cost to people who actually work for a living.
    #4, I'm willing to bet a large, large sum of money that you haven't read, understood, and digested a 2000 page document
     
  21. You have chosen to ignore posts from pinkkittie27. Show pinkkittie27's posts

    Re: OT- Helping a family in need

    #4- you lose. pay up. I have read it. Because I wanted to know what it really said. Because I really care. It was an easier read than the olde english lit I had to read in college.
    and if you think letting the sick, uninsured and underinsured spiral into debt saves anyone money besides big insurance, you're kidding yourself.
     
  22. You have chosen to ignore posts from clc51510. Show clc51510's posts

    Re: OT- Helping a family in need

    To get back on topic... AJuly, just as Cosmo said, I would be happy to donate to help out this family.  If you do start an organization please let us know how we can help!

    Another fundraising idea... my company will be having a "Jeans Day" tomorrow in support of a Haiti Relief Fund.  Each employee can wear jeans tomorrow if they donate $5 to our company's Haiti Relief fund.  This works rather effectively in my office because our normal dress code is business casual.  I'm not sure what type of school you work in and if you're allowed to wear jeans everyday this clearly wouldn't work.  But it's something to keep in mind.  I've heard of my cousins' private schools doing the same thing for various foundations.
     
  23. You have chosen to ignore posts from that-guy. Show that-guy's posts

    Re: OT- Helping a family in need

    Well you obviously can regirgutate the buzzwords that the media is throwing at you, well done.  But if you actually read and UNDERSTOOD the bill, then you would not have been mistaking the pre-existing condition clause for a company not covering a certain procedure,device,etc if it was not offered by the plan sponsor. 
    Here, I'll help you out a bit.  The pre-existing clause simply says if you don't have insurance, and you apply for it, you can't be turned down just because you have X,Y,or Z.
    In employer sponsored plans, also called group plans, everyone gets accepted.  This is reflected in the premiums.  But - the employer looks at a list of procedures, devices, etc that it wants to cover.  Each have a cost.  They pick from them just like a menu and build the plan using that as a guideline.

    So, in this specific example, as I've noted before, it might be that the husband's insurance plan doesn't cover these devices because they weren't included on the list of services the company chose to sponsor.  If it were mandated that all group plans had to cover everything under the sun, you can bet that potential increase in plan liability will be passed on to the people subsidizing the plan - you the employee.
     
  24. You have chosen to ignore posts from pinkkittie27. Show pinkkittie27's posts

    Re: OT- Helping a family in need

    I did understand the bill. I did mis-use the term pre-existing condition in this case.
    I refuse to argue healthcare reform and how it would benefit people in situations like the one shared by the OP with you here. If you read the bill, like I did, you will see how leveling the playing feild and giving people (not their employers) a choice about the covergae they receive through a connector (which will not feature a governemnt run option) is a good thing, and certainly will not pass any additional costs onto working families. The family in this case is a working family, they don't seem to be enjoying any savings righjt now.

     
  25. You have chosen to ignore posts from that-guy. Show that-guy's posts

    Re: OT- Helping a family in need

    Wait -  you refuse to argue it?  You brought it up.  So in the case of the public option, how can you not think that it would cost me more paying individually for a procedure that isn't covered under a group policy?  The simple economics don't make sense.
     
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