Relocation: Where Do We Fit In
Oct 23rd, 2014, 08:03 AM
#21
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I'm wondering if Canada approved the borders with the US that include South Dakota, Wisconsin, and Wyoming touching Canuckland . . .
To the OP:
Your frustrations seem highly political. There isn't a state in the country that doesn't welcome Democrats - even Utah and Wyoming. People are judged more for their character than their political affiliations.
As for practical advice. The first step you will need to take is to determine which states have adopted the medicaid expansion, what the eligibility requirements are for new residents (for example, Idaho hiked its wait-time for certain state services because Californians and Oregonians would move there and that caused strain on the state's resources), and what treatment resources are available (the docs, the RNPs, etc.). All states have medicaid, the question is how much and who participates (both providers and residents).
Second, the deeper query will be what states, and regions therein, will have doctors who treat both the TBI and its attendant manifestations. You know your hubby's GCS rating and how the injury has affected him. You also have more information on the prognosis. So you need to analyze those factors and determine what states (and cities in them) can handle a medicaid patient who will have __ and __ issues stemming from the TBI he suffered in 2004. The cardiac issues should be less difficult to treat (I would think) because that system is much better known and studied in medical circles than the brain (about which discoveries still occur at a Galileo-ish rate every year).
Third, the rent issue will be problematic. Do you qualify for Section 8 subsidies? Can you qualify? That would help minimize your rent burden AND expand the available subset of places where you can live. This is more important than most of the posts above have noted (excepting Trav Gourmet) because small towns and villages will have lower rents, and they'll also have poorer health care coverage due to lack of proximity to top-quality hospitals.
Your dissatisfaction with the treatment he's received in Oklahoma is understandable, but you're in the state capitol and within an hour of the state's flagship university, therefore you may have access to the best care in the state. That may not improve if you go to Cheyenne or Bismarck or Sioux Falls.
I think I've posed more questions than answers, but these considerations are likely important to you and the mister. Good luck.
I'm wondering if Canada approved the borders with the US that include South Dakota, Wisconsin, and Wyoming touching Canuckland . . .
To the OP:
Your frustrations seem highly political. There isn't a state in the country that doesn't welcome Democrats - even Utah and Wyoming. People are judged more for their character than their political affiliations.
As for practical advice. The first step you will need to take is to determine which states have adopted the medicaid expansion, what the eligibility requirements are for new residents (for example, Idaho hiked its wait-time for certain state services because Californians and Oregonians would move there and that caused strain on the state's resources), and what treatment resources are available (the docs, the RNPs, etc.). All states have medicaid, the question is how much and who participates (both providers and residents).
Second, the deeper query will be what states, and regions therein, will have doctors who treat both the TBI and its attendant manifestations. You know your hubby's GCS rating and how the injury has affected him. You also have more information on the prognosis. So you need to analyze those factors and determine what states (and cities in them) can handle a medicaid patient who will have __ and __ issues stemming from the TBI he suffered in 2004. The cardiac issues should be less difficult to treat (I would think) because that system is much better known and studied in medical circles than the brain (about which discoveries still occur at a Galileo-ish rate every year).
Third, the rent issue will be problematic. Do you qualify for Section 8 subsidies? Can you qualify? That would help minimize your rent burden AND expand the available subset of places where you can live. This is more important than most of the posts above have noted (excepting Trav Gourmet) because small towns and villages will have lower rents, and they'll also have poorer health care coverage due to lack of proximity to top-quality hospitals.
Your dissatisfaction with the treatment he's received in Oklahoma is understandable, but you're in the state capitol and within an hour of the state's flagship university, therefore you may have access to the best care in the state. That may not improve if you go to Cheyenne or Bismarck or Sioux Falls.
I think I've posed more questions than answers, but these considerations are likely important to you and the mister. Good luck.
Oct 23rd, 2014, 11:44 AM
#22
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BigRuss - what part of AND/OR don't you understand? I didn't say or imply all the states mentioned bordered Canada but rather that there were both "...northern AND/OR (emphasis added) mountain states that border Canada…"
Oct 23rd, 2014, 01:11 PM
#23
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Um, RA, your original post is linguistically flawed, thus your post calling me out is entirely incorrect.
You could have said "mountain states or states that border Canada" and this would have made your complaint above correct.
You did not.
"Northern states that border Canada" is either a standalone description that excludes northern states that do not border Canada [WI, IA, MA, SD] or is redundant because only northern states CAN border Canada. Therefore the first clause of your and/or interpretation is incorrect.
Your descriptor "northern and/or mountain states that border Canada," by its terms, means northern states that border Canada, mountain states that border Canada, or northern mountain states that border Canada. Northern and mountain both modify the term "states that border Canada." Your comment does not include states that do not border Canada, like Wisconsin, Iowa or Wyoming.
Please reserve being offended for when I'm wrong, which happens quite enough.
You could have said "mountain states or states that border Canada" and this would have made your complaint above correct.
You did not.
"Northern states that border Canada" is either a standalone description that excludes northern states that do not border Canada [WI, IA, MA, SD] or is redundant because only northern states CAN border Canada. Therefore the first clause of your and/or interpretation is incorrect.
Your descriptor "northern and/or mountain states that border Canada," by its terms, means northern states that border Canada, mountain states that border Canada, or northern mountain states that border Canada. Northern and mountain both modify the term "states that border Canada." Your comment does not include states that do not border Canada, like Wisconsin, Iowa or Wyoming.
Please reserve being offended for when I'm wrong, which happens quite enough.
Oct 23rd, 2014, 08:17 PM
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Oct 23rd, 2014, 10:35 PM
#26
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Again, the Op is on SS Disbility, which means that if they have been disabled for more than 24 months, MEDICARE would be their primary medical insurance, regardless of their age. Medicaid maybe involved as secondary, but I amalmost 100% positive they are on Medicare.
Oct 24th, 2014, 01:52 AM
#27
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Yes, the length of their disabilities is a critical fact that we don't know. I assumed it was recent and was triggering this question. If not, perhaps different advice, though the availability, costs, and benefits of Medicare supplementary insurance vary from state to state.
DebitNM makes the entirely valid point that rural areas (cheap rent) often have shortages of health care providers.
I do read of people living near enough to the Mexican border to get dental care in Mexico, but the summers are certainly not cool.
DebitNM makes the entirely valid point that rural areas (cheap rent) often have shortages of health care providers.
I do read of people living near enough to the Mexican border to get dental care in Mexico, but the summers are certainly not cool.
Oct 24th, 2014, 06:45 AM
#28
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You could contact the TBI support groups in different areas, and ask their advice. I know they get these types of questions, and can probably steer you in the right direction.
Denver has a well-respected TBI support group, for instance. You could start there.
Good luck.
Denver has a well-respected TBI support group, for instance. You could start there.
Good luck.
Oct 24th, 2014, 08:40 AM
#30
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There is really no guarantee if you choose another place that your care will be better or more accessible. HOw will you find the right doctors, etc. Do you have a support system of friends where you are? the grass isn't ALWAYS greener.
Oct 24th, 2014, 09:58 AM
#31
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Well Medicare vs Medicaid makes a big difference. Obviously coverage for both differs by state (some states have very minimal coverage and others have additional state sponsored supports to more generous programs - my mom has EPIC in NYC which covers almost all her Rxs once she has paid the small deductible).
Also quite a few MDs (at least here) won;t take Medicaid while many.most will take Medicare. So that is another thing to consider.
I think consulting support groups in areas of interest is a great idea - it can provide a reality check on what one can expect in most places - and help identify the type of tertiary care center which the OP's husband seems to need access to.
Also quite a few MDs (at least here) won;t take Medicaid while many.most will take Medicare. So that is another thing to consider.
I think consulting support groups in areas of interest is a great idea - it can provide a reality check on what one can expect in most places - and help identify the type of tertiary care center which the OP's husband seems to need access to.
Oct 24th, 2014, 10:16 AM
#32
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I do, too. Is there a national support/lobbying organization for the brain injured, like the American Cancer Society for cancer patients? They may be able to clarify the Medicare issues others here have raised.
Oct 24th, 2014, 04:46 PM
#33
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Typically local groups will know more about the benefits in each state which vary tremendously - but a national group will usually have contacts with local chapters.
Look at biausa.org which has a list of state and local orgs.
Or you can easily google the organizations for the states you are interested in.
Look at biausa.org which has a list of state and local orgs.
Or you can easily google the organizations for the states you are interested in.
Oct 25th, 2014, 04:16 AM
#34
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Coverage for Medicare does NOT vary by state. If you decide (your choice) to opt for a private Medicare Advantage plan instead of standard Medicare, yes, of course, the companies who offer it in a particular area are going to be different.
And it seems to me most doctors accept std Medicare. Much more than Medicaid, of course. I know they do where I live, some of my doctors rejected my private insurance plan as they thought it paid too low (PPO), but they would participate in standard Medicare. If you opt for a private Medicare Advantage plan, again, you are going to have a limited set of local doctors who may participate in that plan. This would be true of any PPO you decide to have.
But I agree with the idea of NH/VT. Except NH is pretty conservative. But I have a relative who lives in VT and that is a liberal state and costs aren't that high at all (too far from major cities, I guess). And the medical care is good. If you had to, you aren't far to major medical centers, like Dartmouth or Boston (or Hartford). So I think that's a good idea.
And it seems to me most doctors accept std Medicare. Much more than Medicaid, of course. I know they do where I live, some of my doctors rejected my private insurance plan as they thought it paid too low (PPO), but they would participate in standard Medicare. If you opt for a private Medicare Advantage plan, again, you are going to have a limited set of local doctors who may participate in that plan. This would be true of any PPO you decide to have.
But I agree with the idea of NH/VT. Except NH is pretty conservative. But I have a relative who lives in VT and that is a liberal state and costs aren't that high at all (too far from major cities, I guess). And the medical care is good. If you had to, you aren't far to major medical centers, like Dartmouth or Boston (or Hartford). So I think that's a good idea.
Oct 25th, 2014, 08:25 AM
#37
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Sorry - that is not correct. While basic Medicare is the same and naturally your gap coverage policy cost and benefits depend on which one you buy some states provide other benefits for Medicare patients - often based on income. My mom qualifies for the Epic prescription coverage in Ny state - useful since she is taking 9 different drugs. After she pays a minimal copay (based on income and if its for a single or a couple) the rest of her prescriptions are available at a MUCH reduced rate.
I'm not sure what the income levels are - nor what other Medicare add-on programs there may be in NY or other states - but this is certainly worth investigating.
And if the OP and her DH are covered by Medicare - obviously her care will depend on which MDs in her area take Medicare patients and have openings in their practice (my mom's geriatrician has a closed practice - simply can't take any more patients until some of the current ones depart.)
I'm not sure what the income levels are - nor what other Medicare add-on programs there may be in NY or other states - but this is certainly worth investigating.
And if the OP and her DH are covered by Medicare - obviously her care will depend on which MDs in her area take Medicare patients and have openings in their practice (my mom's geriatrician has a closed practice - simply can't take any more patients until some of the current ones depart.)
Oct 26th, 2014, 03:43 AM
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I think everyone is giving their "rules" for medical insurance in their locales--which is fine. it just points up that the couple needs to be very sure when they move.
Not all doctors will accept Medicare, whether they are full or not.
Not many of us know the SS disability rules so there may be more there--or there may be more access to care.
Their rental amount is low, and will be in parts of large cities (where they think the best medical care will be) that could be less than attractive.
It IS a bad situation. She says they have done nothing to help him--that really also depends on his total picture. She needs to ask for his prognosis for improvement. Can she go to the large university hospital for a referral/consultation.
Not all doctors will accept Medicare, whether they are full or not.
Not many of us know the SS disability rules so there may be more there--or there may be more access to care.
Their rental amount is low, and will be in parts of large cities (where they think the best medical care will be) that could be less than attractive.
It IS a bad situation. She says they have done nothing to help him--that really also depends on his total picture. She needs to ask for his prognosis for improvement. Can she go to the large university hospital for a referral/consultation.
Oct 26th, 2014, 08:18 AM
#39
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My understanding is that Medicare does NOT require referrals (unless they somehow got into one of those faux plans they sell some places) so they should have access to the best MDs in their area at least for a second opinion. The OP isn't clear about what the specific problems are (they may have unrealistic expectations based on the diagnosis/prognosis) but they should certainly have the ability to determine if there is better care out there.
Again - think they should look at the site of the organization referred to and consult a local group who may be able to aim them to the best MD in their area for this specific problem.
And agree that rental limit is a huge issue - I don't know any large cities that have rents at that level in safe neighborhoods - it probably does mean living in a distant suburb and a substantial amount of travel.
Again - think they should look at the site of the organization referred to and consult a local group who may be able to aim them to the best MD in their area for this specific problem.
And agree that rental limit is a huge issue - I don't know any large cities that have rents at that level in safe neighborhoods - it probably does mean living in a distant suburb and a substantial amount of travel.
