Public Service Announcement for the Swift and Swifter

   It all started out with a friendly visit with my friend's cat...

   The cutie who loves to help with my Bible Study homework. My friend asked me to drop in and check on him while she was away for a day or two. The cat and I get along great and enjoy each other's company, so I readily agreed. Besides, it gave me a change of scenery and a helper for my homework!

   Yesterday's visit was no different than any other, we cuddled, played, cleaned the litter box together (yes, he "helps") and put out fresh food and water. We did some reading and a bit of the homework for class. It was time for me to go, so I wished him goodbye and locked the door behind me. I put my study materials in the back seat of the car and closed the door.

   And this is when things went horribly wrong.  It took me seconds (hours?) for my brain to register that I could only see half my thumb. Perhaps a few more to register that the other half was in the door. The closed door. I grabbed the handle and yanked the door open. The rest of the thumb was there.

This was the point at which the pain sensors caught up with the rest of my brain.

   OW, OW, OW, OW, IT HURTS, IT HURTS, DA## IT HURTS. I grabbed the keys from my purse, closed the door (without my hand in it this time), pressed the lock button on my fob and vaulted the stairs to the door, miraculously pulling out the house key as I did. Smoothly I unlocked the door, yanked it closed and locked it behind me. 

Looking back, I do believe this is the smoothest I have ever entered a building while swearing.

Sometimes I impress even myself.

   I sprinted to the kitchen, dropping my purse in route and swiftly pulled open the freezer drawer. It was stuffed full of frozen food. Go figure, they keep frozen food in the freezer. Since I did not think the frozen chicken would do me much good, I pulled open the top drawer. More frozen food.

   The cat joined me as I rifled frantically though the food looking for ice packs. He delighted in batting around freezer bags that I inadvertently knocked out. At the bottom of the drawer, I found an ice tray... filled not with ice, but green stuff.

For the love of God, who keeps green stuff in their ice trays?

  As I wondered about this mystery, my throbbing finger decided to bleed. I was contemplating the frozen chicken when the cat batted a lumpy baggie under the open drawers. It could have been frozen vodka, but to me it looked like a homemade ice pack. Tossing the baggie on the counter, I turned on the sink and rinsed my bloody hand, wrapped it in tissue and applied ice.

   I then sat on the floor and pet the cat as my injured hand ached from under the ice/vodka pack. After a while, I picked up the frozen goods off the floor, checked to make sure I hadn't bled all over the inside of the freezer, and closed the door. Then I snuck a peek at my hand.

   It still hurt like the devil, but I didn't think it looked all that bad. Not even all that swollen. And I could bend it, so not bad, right? I decided that I should drive home and baby it a little.

   It was on the way out the door once more that I realized it was my right hand. Did I mention that I was right handed? It made the drive home really suck.

   After ibuprofen and lunch, it was still sore, but considerably better, so I went about my day. Sore, but no big deal. I was fine.

   Till the next morning. Perhaps a sheet brushed it. Or maybe it was a light cool breeze from our open

window. Searing pain brought me up in a hurry. And my thumb was not looking better. The nail was now very dark, the underside red and bruised and I could now barely bend it. Crap. I was going to have to see a doctor.

   I took more ibuprofen. I sent my daughter off to school. I tried to nurse the thumb with a real ice pack, but the digit was having nothing to do with anything, cold or otherwise, touching it.

   I called the doctor.

   They referred me to a walk-in clinic for emergency aid where they could do X-rays and stuff.

   I made my husband drive.

   Bumps in the road made it hurt. Thankfully the staff were all kind. They made a hole in the nail using (a medical grade) heat wand and drained the blood from under the nail, which greatly relieved the pressure. The X-rays found what might be a tiny fracture or an anomaly, which means I have to wear a brace until I can see a hand specialist in about a week or so to review.

   Unfortunately the tip of the thumb was too tender for the small brace. So they resorted to the larger brace...

Did I mention that I am right handed?

I also bought my friend an official ice pack. Turns out she keeps ice in the freezer in the garage. Well,

now she keeps an ice pack in the house freezer.

Insurance - The Trilogy?

 Just when I thought my insurance adventures were over...

   The last month has been filled with insurance adventures. First was Insurance Search, a Cautionary Tale, in which I shared my mistakes of my initial search for private insurance.

   In my next post, Insurance: The Sequel, I continued my journey of insurance selection. Fortunately I have advisers and friends who knew what they were doing and could help me ask the right questions and use the correct website Healthcare.gov to search the market place for pricing and options.  If you don't have the fortune of a good friend like mine, the official website offers resources to find people and groups in your area (for free) to help you apply. Which is more than I could say for my state website... my state's official website offered several links for health insurance, but I could not find the one to the  Healthcare Marketplace!

   But there is no such thing as smooth sailing, is there? No sooner than the boat was launched, seas got rough and the sky clouded up! You guessed it, we ran into problems.

       First problem: I am currently on a specialty drug. Before deciding on the policy, I had contacted the insurance company to determine if this medication was covered and, if so, under what pricing tier. I wanted to understand my payment responsibility ahead of time. Most of the medications we currently take we could look up online through the Market Place, but not this one. After much effort (and talking to several individuals) it was determined that the medication was covered by the insurance company. However, the pharmacist could not tell me the tier associated with that drug nor the cost since this drug was outside the tier structure. Further complicating the matter, I was not yet a member of their plan.

   Next, I contacted the drug company to confirm they had payment assistance programs. I was relieved to find that they did and that I was eligible, but without being enrolled in the new insurance program, there was little they could tell me as to what this entailed.

      Having gathered information and read through materials to the best of my ability., I made what I hoped was an educated decision. I was feeling pretty good that we were able to obtain affordable health care and remain insured. I signed up for the policy that seemed best suited to our needs and I sent in a payment right away to prevent any delay in coverage.

I did mention that I spent a lot of time on the phone?

      Within a few short days we received our cards! Now covered under a new plan, I decided to continue to pursue the few questions that could not be answered previously. Was I going to be able to continue my therapy using the specialty drug? Since I now had a card and ID number, I was hoping to get some answers to my questions they would not provide to non-members.

    Easier said than done. Because the medication falls under the category of specialty drug, it is outside the tier structure and turns out is not covered the same as all other medications. (Insert panic attack when I was first told - wrongly - that none of our prescriptions were covered before the deductible was paid.) For the specialty drug in questions, I would need to pay my entire deductible. After that, they were pretty sure it fell in the category where I would pay a whopping 30% of the medication (a hefty sum of money). But they could not tell me what that amount would be until they received a claim. In other words, I would not know my cost until AFTER I had received the medication therapy.

Well, if I couldn't afford it, wouldn't that be a little too late to find out?

   Further discussion determined that in order for the insurance to give me an estimate, I would need to provide them with a diagnostic code, procedure code, provider types, provider number, billing codes and billing amounts for each (just to name a few), all of which I could obtain from the medical group that provided the service. At this point, they had already approved the medication therapy through a doctor request for authorization.

   So now I spoke with the medical group. I sent emails, I made phone calls. I took notes. In the meantime I received feedback on what I could expect the drug company to assist with. I also decided to get set up with the insurance pharmacy. That was when I discovered that we were never fully entered into the insurance system and that for all intents and purposes, we kinda didn't exist.

Guess who made more phone calls!

  At the end of the week, I determined three things: 

1. I take good notes and people find me friendly on the phone.
2. I like chat rooms and email as they provide written documentation to refer to at a later date.
3. I could never hold down a full time job and juggle all the follow up I have had to do on our insurance (all of which had to be done during business hours). 

   Our insurance is being updated as I type. I have decided to take a break and come back to the problem of specialty medication at a future date and have canceled my current therapy. I won't die, but will be living dangerously in the disease management arena. As I have neither time nor wine needed to cope with the issue at the moment, I think I am okay with that...for now.

   Why? Because I have enough stress right now....Did I mention we are having work done on our house that started before our major life changing event and all of the insurance issues that came with it? 

Chair memories.

   Chairs don't have memories. At least I don't think they do - there was a whole episode on Sesame Street with John Cleese about inanimate objects not having feelings, so my theory is, if inanimate objects don't have feelings, they don't have memories either. And what is on Sesamie Street must be true, right?

But I have memories and some of my favorite ones are of chairs!

   My most recent memory (well, it is a borrowed memory) is of Dad's new chair. It is one of those remote control models that heats up, massages the back, lays flat with the foot rest out, and tips up to make getting out of easier. Not that he needs it to tip up to get out, but he does like it to lay back nice and flat for napping. All of this is done with an attached remote control.

It is a fun chair! Here the stuffed animals are enjoying it as a slide.

   The memory is actually Mom's memory, but the story of the chair has made it my own. I guess you could say I sometimes live vicariously though the memories of others.

   As Mom tells the story, she and Dad were sitting in the living room together watching TV. She commented on what they were watching. Since Dad is rather hard of hearing, he leaned forward in his chair to listen to what she was saying. As he did so he accidentally sat on the remote control. He often sits on remote controls, as can be noted by the car doors sometimes opening randomly or the alarm going off. But I digress.
   
   Mom continued her explanation to Dad, and as she did so, the back of the chair began to slowly lay back. Dad listened intently, unaware that the chair he sat on was in motion. Mom seeing the chair moving, struggled to keep from smiling as it lay farther and farther back. Turns out the chair lays really far back - more than just flat - the back can nearly touch the floor!

   Conversation drew to an end, and Dad, satisfied that he had "heard" everything, leaned back. Only now the chair that had been in the sitting position was now more of a bed that tilted toward the floor. Unaware of the change, he was caught off guard. Back he went and up went his feet. Mom, unable to contain herself any longer, burst out into laughter. Dad, his head now near the floor and his feet higher than the rest of his body, struggled to get up and find the remote to the chair (he was now laying on the remote). At first he was going to be mad, but realizing the ridiculousness of his predicament, he too began to laugh.

   Heck, hearing the story the next day caused much laughter. It is amazing how the innocent misfortune of another can be such amusement for others. Well, he wasn't hurt, just rather surprised! Which reminds me of another, older chair story, from my days of working in an office setting...

   At this particular job, I worked in an open office setting, which means there were cubicles, but the walls did not go up more than 12", so you could see everyone an everything going on in the office. Even the president's office had glass walls, so he too could see all that happened in the office, from workers at their desks, to someone using the copier in the filing section of the office. I believe the conference room and the break room had walls, but I am guessing this was just because the designer

didn't like to watch people eat, and those are the places we would eat our lunches.

   As is often the case, furniture eventually wore out or broke, and like many offices, stuff did not always get disposed of in a timely manner... Enter the chair. One of the office chairs had lost one of its wheels. Unable to be repaired, a sign was affixed to the back of the chair that read "Broken, do not use." The chair was then promptly placed in the copier/filing area of the office where there were a few empty cubicles and then completely forgotten about.

   Well nearly forgotten about, anyway. We occasionally had computer consultants that would come into the office to work with staff on the programs that we used for business. It was during one such visit that our consultants (a husband and wife team) set up shop in the empty cubicles in the copier/filing area of the office. Unfortunately the "Broken, do not use" chair was still occupying this space. How it managed to lose its signage is a bit of a mystery.

   The consultants were great. They were quick and intuitive, responsive and hands-on team, amicable and very well liked.  During this particular visit, the husband of the team was setting up shop in the copier/mail area of the office while his wife, a few feet away in the employee cubicle section, was catching up with the staff. Suddenly, her male counterpart made an odd, strangled noise, all of us turned just in time to see him as he tumbled backward, feet flying in the air.

   It was minutes before any of us could stop laughing long enough offer assistance. My friend was the first to recover asking if he was all right between her tears. His wife in the meantime, had to sit down and hold her sides. Fortunately, he was only surprised and laughed along with the rest of us. He really was a good sport. I still giggle when I think of the expression on his face.

 Still don't know what became of the sign.

   What is it about chair misfortune that sparks such mirth?

And it is not just me, I bet you have chair memories too!

 

Insurance Search: The Sequel.

   After my first unsuccessful and rather disastrous foray into The Hunt for the New Insurance, I was a little shy about continuing my journey. But the clock was ticking and I needed to find coverage for my family before the dreaded COBRA kicked in and eradicated any savings we had managed to scavenge over the last few years.

   Quite frankly, I felt like I had walked into a GI-Joe episode and was in imminent danger of stepping on a land mine.

So I switched identities.

   "You can do this." I told myself.

  

              Then I called my best friend. I already saw the results of what I could do.

   My best friend knows what she is doing. I think I mentioned in a previous post that I had trusted advisers... After talking me off a windowsill and getting me to sit down, she fired up the internet and took me to the official government website to shop for insurance policies, Healthcare.gov.

   This was the Market Place site to compare and shop for insurance for individuals and families as well as for small business. Together (okay, she did most of the work) we navigated the site to create an account and answered questions to see if we qualified for any aid, if we could get coverage right away, and what type of insurance we were looking for.

   First there was all the personal information that I had to put in about my family. Stuff like birthdays and social security numbers and addresses and phone numbers. Did I mention that I was a little paranoid about giving up my phone number. I mean I did that once before and what did that get me? A bizillion phone calls, some of which proved to be just pure harassment. Which lead to a great education on call blocker features offered by my phone company and introduction to Nomorobo. Now this education has proved to be a great bonus as I no longer get all those pesky robot calls from the "IRS" and my "credit card," so I guess I really came out ahead. I trusted my friend and we moved forward. Actually I think she moved forward, I believe I was holding my breath.

   There were a LOT of questions. Well, maybe not quite so many questions if you consider that many of the questions asked were repeated two and maybe three times over. A few of these questions made me wonder... like the one asking if my minor child was married. I mean, really? Didn't we put in her birthday two questions ago? Just how many twelve year old children in the United States are married? I Googled it later and was blown away by what I learned. Did you know that in many states allow children as young as 12 to be married?  WHAT?

   But I digress. I was shopping for insurance. Well, I was answering questions anyway. Many, many, many questions. After what seemed an eternity of questions, we were able to submit our information and within moments, we were give many health plans to shop from. Right then, right on the computer. No message about you will be contacted shortly by qualified insurance carriers, no bombardment of phone calls, just a list that I could refine based on my coverage preferences. Moreover, there was premium price information, information on costs to see doctors and specialists as well as access to drug coverage information.

It was as if someone handed me a hot fudge sundae!

   Not to say that there wasn't a catch. My trusty advisers warned me away from two of the insurance companies who were no longer going to cover people on the Market Place at the end of this year. Making this decision once is hard enough, but to go through the process a second time because your carrier has opted out? Not going to happen if I could help it. 

   Now feeling confident, I saved my favorite insurance company policy picks on the site (you can do that!) so I could come back later to finish the process. Then I began the real work of research on the coverage. I have learned from family experience that just because the doctor is on the insurance company's list, doesn't mean that he or she accepts that insurance policy. Sometimes these lists are not updated as they should be. I wanted to review out of pocket costs for visits and medications, verify what pharmacies they require participants to use, and compare the new policy benefits to our previous benefits.

   On the phone once more, I confirmed with the doctor's offices that they were accepting one of the two policies that I was reviewing. I called the insurance company directly and spoke to their customer service to navigate the benefit pages on their website and I talked to their participating pharmacy to verify that the medications we used were covered and what pricing tier they would fall under. It appeared that all the other options for our coverage were about the same. Whatever you do, do NOT skip this step. No matter what the price, insurance will do you no good if it will not provide you with the services you need!

   Then I took a look at pricing. Surprise. We would pay less than we had under the work sponsored insurance plan. Medication co-pay would also be less expensive. Deductible and doctor visits were about the same, but hey, lets not get crazy here! After sitting down and reviewing with my spouse, we logged in under our account and hit the accept button for the choice that seemed the best for our family. I held my breath.

   No phone calls. No explosions outside the house. Just a message asking me to provide one or two documents to complete the process. I could even upload the documents right onto the Healthcare.gov website. I promptly scanned the documents using my handy dandy smartphone app CamScanner, then uploaded it to the website.

   Just like that, we were approved. All we needed to do was to pay for the first month and we were good to go. I wound up in a payment loop when I tried to set up payment on line, but a quick call to the insurance company I had selected (Blue Cross Blue Shield of Illinois) and I was able to square this away on the phone. 

   I can happily say we are insured. No insurance coverage gaps. No hard sell tactics. 

   Now onto my next adventure...

Dental plans!