Health Care

Unless I find myself near a computer and needing a writing fix, this will be my final entry until late July. Ireland, here we come!

Before we go, however, please indulge me with one last whine. After all, you will be whine free for 20 days.

I am completely disillusioned with our governments carelessness with health care. Rather than write a dissertation on my disappointments, let me just list a few of the frustrations that I have dealt with over the past few years.

• Once declared disabled, a person must wait for 6 months to receive benefits. Remember, our government is the one who determines if a person is disabled. If they are not able to work, then they are not receiving health insurance. If the are not working, they cannot afford health insurance.
• I had a drug induced stent put in after my heart attack, which means I must have certain drugs to keep it from closing up and letting plaque build up again. These drugs, naturally, are not ones the insurance companies care to pay for. My co-pay, monthly, on these drugs is $400. The government allowing drug companies to advertise has to be at least part of the problem of the high cost of drugs.
• COBRA, the law that says companies with 20 or more employees must allow employees 18 months of coverage, after a person voluntarily or involuntarily leave a position, is a great idea. The employee must pay the full cost of this benefit. This is, on paper,terrific, but for a disabled person, the wait for medicare is 24 months. So now Dennis must enroll in a high risk health insurance company for 6 months.
• The government outsources many of the positions of information gathering to companies that do not have the information. Today, for example, I talked to a gentleman with a decidedly foreign accent, from medicare. He actually read to me the very article I was looking at, online, when I called him. Like I have hours and hours to have someone tell me something I already know. Please, someone, just pick up the phone and answer the question.
• It is more cost effective, for individuals, to go to an emergency room and be admitted to the hospital than it is to see a doctor. Every time Dennis has gone to the hospital, every bill has been paid in full, no questions asked. But when we have asked for an out-patient procedure, we have to ask, appeal, re-appeal and then pay the co-payment. Where is preventative care in our current plan?
• It seems that the sicker you are, the older you are, the poorer you are, the more difficult it is to get good care and be treated with respect. How is this situation okay?
• Dennis cannot be home alone. I cannot afford to retire. We pay, out of our own pocket to have someone come to the house and take care of Dennis. Insurance does not help with this. The government does not help with this. No one helps with this.
  

Oh, lucky you, I am tired of whining. Obama, get your butt in gear and begin to fix this. Be careful not to be influenced by the money machines. Listen to your constituency. You could become the most popular, if not the most powerful, president ever.

Until late July,
Ann and Dennis

Taking A Turn?

I talked with Cigna, sigh, once again, today. The lady was nice, and tried to clear up several of the unpaid bills Dennis has accrued over the past year. She was trying to figure out why he needed a primary physician while receiving care at an HMO in Wisconsin. I didn't have the energy to confuse the poor gal. Just get the bills paid and move on, is my latest thinking.

I know the people who help me the most are not paid very well. I know the people that stand in the way of happiness are overpaid, and bonused to boot. I don't understand history well enough to know if this is precisely what our founding fathers wanted for our country. I hope not.

Dennis' PT was here, again, today. She helped us understand getting in and out of bed, and it seems we have been doing the right thing. She worked him for 60 minutes, weights, exercises and walking the halls. I like what I am seeing, and Dennis seems happy with what he is receiving from the RN and PT.

Maybe life is slowing down right now. Maybe solutions are in abundance and problems are in reduction.

Getting Attention

Last night, after cleaning up the latest insurance fiasco, I went online to see what blogs were out there regarding ADP (Automated Data Processing). There were quite a few blogs relating to the stock market and ADP. I took the opportunity to leave a comment on several, regarding the inefficiency of the company.

I also found a site where ADP was recruiting new clients. I filled out a form, with the company name, Ann Is Not Happy, asking for help. I was hoping to capture some one's attention.

Voila! This morning a woman from ADP called me, letting me know she would be my personal contact at ADP. She took all of the latest information, and did one tiny thing that showed me promise. She did NOT point a finger at anyone but ADP.

Tonight, I shall do the same for Cigna.

No Wonder I Am a Cynic

Yesterday, Dennis went to visit his family doctor. Dr. Keifer is the one who Cigna denied as a family practitioner, and held up a few of the insurance claims. I asked him about his credentials, and he told me he has been, always and only, a general practitioner. He has no ENT interest, let alone specialty. Should I call Cigna and let them know?

No.

Today, I went to the pharmacy to pick up one of Dennis' meds. His insurance refused to pay, because his coverage had been terminated.

I wish I could say nice words, but none come to mind.

So I came home, called Cigna, who told me I had to call Medco (his drug coverage), who told me I had to call ADP (where he sends his Cobra payments). I spent the next hour and a half on the phone, once more, talking pleasantly to people who try hard, but aren't able to accomplish much of anything.

I asked the guy, who happened to answer the phone at Cigna, how many calls had been placed on Dennis' behalf since January 1, 2009. Over 75 calls, most of them from one of us, have been generated to fix Dennis' insurance problems. This does not take into consideration the calls to ADP or his drug provider.

No wonder we have been sleeping so much during my spring break.

An Insurance Related Phone Call

You are so lucky if you have never had to make one of these phone calls. Being put on hold is the least of the worries. Here is what I have learned, and maybe someday this information will help you. I hope you never need to do this.

• Dial the number and pray that automated questioning and answering is not the beginning of the sequence.
  
• Skip the above sentence, because you will never again hear an actual person answer a telephone when you call an insurance related company. Sorry to have even put the thought out there.
• As soon as you get a message, push zero. You probably will hear that this is not an appropriate response, but do it anyway. At some point, pushing zero, will get you set up with an actual person. Whether, or not, that person speaks your native language, or not, is a crap shoot.
• When you are required to talk to a phone system, talk slowly and clearly, enunciating every single letter and syllable. Do not, under any circumstances, get cocky and start answering the question before, or while it is being asked. You will only be sent back to Go. Trust me, oh smart alack Ann, I know.
• Push zero once again. At the very least, it may give you a sense of power over technology.
  
• When you do finally get transferred to a holding tank, find something else to occupy your mind for a while, but do not put down the telephone or remove the blue tooth. If you miss the pick-up on the other end, you will be cut off. You will need to start over one more time. By the way, by now they have taken up at least 30 minutes of your life.
• Someone will answer, most likely with a slight Indian accent. This is fine if all you need is the information that shows up on a computer screen. It is not okay if you have an actual question. If you need further assistance, ask to talk to a supervisor in the US. This is the last time that you will talk to someone friendly, by the way. So if it is at all possible to get your problem solved in India, go for it.
• Once you are speaking to someone in the US, always get the full name, the city and state and a call back number before you begin any business.
  
• Write down the following information and read it to the person who answers. I encourage you to to follow this step closely. After you have been asked to repeat these details for the 3rd or 4th time, you will either become frustrated and get snappy (my style) or get flabbergasted and get sloppy.

1. name
2. social security number
3. account number and group number
   
4. birth date
5. address, complete with zip

• If you are calling on someone else's behalf, be prepared to hand the phone to that person to repeat all of the "security measure" questions. Evidently, these phone call bank people can tell one person from another by simply answering these questions. Often I simply disguise my voice and repeat the above information. Sometimes they don't believe me, but usually, if I am being nice, they will let it go. If I am snippy, even one tiny iota, they will however refuse to talk with me.
  

That's enough for today. I have so much more, however, and am willing, able and ready to share it all with you, oh lucky readers.

Ann and Dennis