No way! Better than nothing, but what if that had been an alien life form? Or you know, something
The question was if it was some kind of tear or popped thing…I guess it felt like a swollen area, not some harder biomass. I won’t go in to how it felt to have somebody jamming his thumb around an already sore spot in her knee. But she was quite ambulatory, so it in no way was an “emergency” situation, so that option was out.
I know I heard and audible “Pop!” or “Snap!” and lost support at certain angles, so…
David…
The loss of support sounds like some type of -CL tear which is good cause it’s fixable
too much asphalt court league tennis combined with surfing and trying to lift up a collapsed father caused me to have the shredded meniscus in both aged knees removed which bad. I wish I had a standard CL tear instead.
I’m with Kaiser and only see the doctor when I hurt myself bad surfing, but what you just described is HMO SOP.
Your primary care physician should be able to somewhat pin down what’s happening by running your knee and you through some simple knee tests. The MRI will only show how bad the damage is and help them plan for surgery. In any case they’ll ask you to also prep yourself for surgery as well to reduce the atrophy and therapy you’ll need after.
To get by till then try and get a frankenstein plastic exo-skeleton brace they use for CL injuries. Crank it down tight and you’ll have the support to get by till the MRI and surgery. An artificial full leg strap on cast is another option.
HMO’s are designed for folks who need generalized service and rarely see the docter so if you want something else you’ll have to ante up for one of the blue-cross,blue-shield 80/20 type plans where you can choose your provider. When my brother had his major heart attack at 38 and needed emergency surgery he immediately changed from Kaiser to Queens to survive the incident. It eventually cost his as much as a down payment for a house but he’s still around for his family.
Work your way through it as asked or change plans if you don’t feel this is what you want.
You can try and be a pain in the ass squeaky wheel but they’ll eventually ask you to find somewhere else to go if you’re costing them too much to keep on as a customer. They’ll gladly refund you your monthly minimums as well to get rid of you then you’ll be stuck.
I found out we have a PPO option, but it’s over $800 per month. Who can afford that? Not me on a $45,000 per year private school teaching salary.
I’ve been cruising around on the net searching for plans and I’ve notice that both Great Britain and Australia have things like “Surfer’s Network” and other Extreme Sports insurance programs, designed to keep surfers in the water and out of the situation I am in right now. Why don’t we have something like that in the US? It’s absurd to think that I pay a monthly premium for something that does me no good. Land of the free? Nothing’s free in this country. I’m not implying that I don’t like living here, or that I’m not grateful for the freedom I have. I’m very grateful. I’m just amazed that we do so many things that aren’t really for the good of the people… it ends up being for the good of the mega companies instead, and they loose their whole focus of what the company was originally about.
We should get all of the swaylockians of the world together, and should form our own global “Surfer’s Network” so that any time something like this happens, we are assured that we are insured, to go harder and charge harder, with a sense of ease, knowing we’ll get repaired if we push it a little too hard at our favorite break.
“Why don’t we have something like that in the US?”
Because most of us are sheep.
Because most of us don’t see our country is slowly dividing itself into classes (No child left behind…built to fail so the only good education in the future is unaffordable to the masses)
Because most of us worship the tube.
Because most of us, see the military as a good thing (and let recruters into our schools to scoop up the tallented kids that would normally excel in vocational classes…which don’t exist anymore) .
Because most of us use goods from countries that are rapidly destroying the environment.
Because most of us let others (churches, political parties, money) decide who to vote for.
Because most of us don’t know of the drug companies aggressive campaigns tward individual doctors.
Because most of us buy gift cards that expire? or are never used?
Homeland security…The North American Union…The Amero…Dinosaur Bones…Credit Card Companies…Global Warming…JFK
If the thred is going to bend this direction…I have only scratched the surface.
Stay off the leg, try and see a specialist ASAP, and reduce the swelling by applying ice for the first two days then moving to heat.
I used to go to accupuncture to reduce the swelling in my ankles when I would Valet Park on San Diego’s unforgiving Downtown streets.
Even went once to fix a badly twisted ankle so I could continue to valet.
It worked for me…why? I don’t know.
My wife thinks it’s hocus pocas…but they gave me herbs instead of two refils of Vicodin and
I got a free visit because I went to an accupuncture school.
Is it better here?
Will Arnold help if the machines decide to destroy us.
Did you know there is an oganization in the US that is trying to figure out the date that artificial intelligence will exceed the human brain.
Dogs and Cats living together…reading passages from the bible.
Sorry…been couped up inside for the past 2 days…too much smoke outside.
Dude…Swaylocks Anonymus looked awsome! Why the hell did I not go?
Howzit Kawika, Have you checked with Med-Quest. we are lucky to have it since it is medical insurance for self-employed people. If eligable it is very inexpensive and they will sometimes even cover injuries you already have. It’s part of the S.H.I.P. program. The only thing it doesn’t cover is prescriptions. Then there’s Quest that is a medicaid program for low income people and it pays for everything.Aloha,Kokua
I’ve been cruising around on the net searching for plans
Just in case it hadn’t crossed your mind yet, remember that no new plan on God’s green earth will cover your knee again until after it’s been fixed…right now it’s a pre-existing condition. Trying to sneak it by is grounds for cancellation of a policy and will hold up in court. For this event you are stuck with what you have. Hopefully your doctor told you what to do to not further aggravate the injury until more treatment is approved. Good doctors and their offices (read usually “their assigned nurse” with the people I deal with) can and will keep up on the request for an MRI or permission for whatever other treatments they think are warranted. And really, two weeks of waiting is a drop in the bucket compared to the rest of your life.
$800 a month for a PPO sounds about right, maybe even good, $9600 a year… especially if you have a family. You need to factor in deductables and perscriptions etc. My wife and I are looking at what various policies are going to cost us once we pull the plug on what is laughingly called “the good life”, and near as I can tell we can expect to pay about $15,000 a year plus the deductables and various other little dings. Nearly four decades of surfing might signify some sort of cimmittment to health and physical fitness to people like us, but to the actuaries it means payouts waiting to happen. If you thought the fathers of high school girlfriends didn’t like surfers, imagine them on steroids and working for insurance companies.
Howzit Nels, the Quest program I mentioned actually covers pre-existing conditions and also outstading hospital bills from an injury. Hawaii has been one of only 3 states that makes it mandatory to insure employees that work 20 or more hours a week for a very long time. Aloha,Kokua
Well. Um. Tell a friendly doc it just started acting up–maybe ( stranger things have happened) the doc will want to do the op and get paid, so he’ll sell your story about it being new for you? Maybe it will cost $1500 all tolled? Maybe this happened to someone I know very very well…?
(Sickening that Americans’ health and lives are for sale–I shouldn’t have to worry about some actuary deciding if I or anyone in my family lives or dies or stays maimed or disabled or takes natural odds on some disease… )
Howzit janklow, Think $1200 would not even come close to paying for the op,anathesiest (spell) cost $1200 back in 80’ and the whole thing cost my insurance company a little over $5000 for my torn cartiledge. Don’t know if I would trust a doc who would do it for even less today. Best ortho docs are sports related especially in ski areas. Aloha,Kokua
Howzit Nels, the Quest program I mentioned actually covers pre-existing conditions and also outstading hospital bills from an injury. Hawaii has been one of only 3 states that makes it mandatory to insure employees that work 20 or more hours a week for a very long time. Aloha,Kokua
Ah Kokua…maybe benefit of living in a state with a small population, eh? California with 37-42 million residents has no program that I’m aware of that allows people to buy in with pre-existing conditions. If you have no assets or insurance you might get MediCal or whatever they may call the state coverage for indigent care, but a job paying $45,000 a year precludes that for our patient. Places like Oregon and I think Arizona too may be worse, if that’s possible, but I haven’t looked too deep in those waters yet.
If I’m way wrong, somebody guide me in the right direction…
A lot of the insurance industry is outright reprehensible in California. Arnold made waves investigating companies that routinely cancel coverage after potentially serious diagnoses have been made. Sometimes it helps have a politician who doesn’t need their money.
I work at the Army and Navy Academy in Carlsbad. They always opt for the cheap route, no matter what it is dealing with: kids meals, maintenance of the campus, medical insurance, you name it. We used to have PPO for the staff and then they got rid of it and went HMO to save the school money.
I can’t use my wife because she is a stay home mom. I work 8-3PM at the school, then come home and shape boards until dinner time, then go back out and finish my work until it’s done, come in and shower, see my family if they are still awake, and do it again the next day. I try not to work on Sat. and Sun. So I can be with my wife and kids.
My family is on my school’s insurance.
My friend Don Frates had lived on the East Coast, beat cancer, came out here, and was diagnosed again. His HMO doctor told him he had ulcers, which turned out to be a big ball of cancer the size of a soft ball. He played the two week waiting game just like I’m doing, and died before they allowed surgery to remove it. He knew he was going to die and gave me a board he rode as a kid, and told me to use it… I still have it. We would still have him too if he could have had proper Health Coverage.
I guess the green is worth more than a man’s life in this country.
Don’t get me started… I feel a long tangent coming on…
I’ve had that coverage. It got me through 2 major surgeries, an MRI, and a few other odds and ends. You can keep it for 3 years, maybe it was 5. Mine started at $550. / month and went up to $750 at the end. Now, I don’t qualify.
CONSUMERS: MRMIP (MAJOR RISK MEDICAL INSURANCE PROGRAM)
Notice to Enrollees Regarding Coverage
Effective January 1, 2003, in order to make health benefit coverage available to more Californians who cannot obtain health benefits because of medical conditions, Assembly Bill 1401(Thomson) was enacted to limit the length of participation in the Major Risk Medical Insurance Program (MRMIP) to 36 months. At the end of this period, MRMIP enrollees are given a one-time opportunity to purchase guaranteed health coverage through any health insurance company or health care service plan (HMO) currently marketing coverage to individuals in California.
Post-MRMIP Graduate Plan – Guaranteed Coverage
Under a new pilot program, which began September 1, 2003 and which will be in effect at least through September 1, 2007, individuals who will leave the Major Risk Medical Insurance Program (“MRMIP”) following 36 months of coverage under the Program are eligible to purchase individual coverage on a guaranteed basis. If you have been notified by the MRMIB that your coverage under the MRMIP Program will terminate due to the new 36 month time limit for coverage, you may continue to receive coverage on a guaranteed basis with one of the Post-MRMIP Graduate Plans of your choice, regardless of which MRMIP plan provided your health care coverage under the MRMIP Program. Here are some facts:
Affected enrollees are mailed a Notice 90 days prior to the disenrollment effective date. Forty-five days prior to the disenrollment date, they are mailed a Certificate of Program Completion that will enable them to obtain similar coverage in the individual market. This Certificate must be provided to the plan of your choice on application in order to obtain the guaranteed Standard Benefit Plan.
Each health care service plan and insurance carrier currently marketing comprehensive individual medical coverage in California are required to offer a Standard Benefit Plan that is substantially the same as coverage available through MRMIP.
MRMIP participants who receive disenrollment notices from MRMIP have 63 days from the termination effective date to enroll or submit an application for benefits under an individual health care service plan (HMO) or insurance policy from any managed care company or insurance carrier currently marketing individual coverage. The covered person cannot be eligible for Medicare Part A and Part B (unless it is due to end-stage renal disease).
Health plan companies that participate in the individual health care market in California must offer a guaranteed issue product for MRMIP “graduates” at the indexed rate of 110% of the rate for MRMIP coverage.
The plans currently in MRMIP are Blue Cross of California, Blue Shield of California (HMO) (As of 1/1/04, Blue Shield of California PPO Product is no longer offered), Contra Costa Health Plan and Kaiser Foundation Health Plan.
Insurance companies offering individual health insurance policies are regulated by the California Department of Insurance and not the Department of Managed Health Care. These companies must also comply and are included in the Composite Comparative Benefit Matrix for all individual carriers offering Post-MRMIP Graduate Plans.
If you need further assistance, please contact the individual health care service plan (HMO) or insurance company at the number listed in the Matrix.
Howzit Kawika, Just realized you live on the mainland and not in Hawaii. Do the research on possible health insurance in CA and there are a lot of good ortho docs there I’m sure.Aloha,Kokua