I wish that companies would just have an option to push 8 when you call in for some help. Like it could say, "For help in English, press 1. For help in Espanol, press 2. If you have no idea what is going on, please press 8." I would push option 8. A lot.
Every time I get ready to call a health insurance company, I take a deep breath and try to psych myself up for it. I tell myself, "I'm good enough...I'm smart enough...and doggone it, people like me." Now that I've built up my self esteem, I place the call. By the time I'm done, I'm telling myself, "I'm not good enough...I'm not smart enough..and doggone it, people do NOT like me." Then I have to spend an afternoon with Stuart Smalley and his positive affirmations to build myself up again.
I know people are always talking about how health care is an issue, but I never really knew what they were talking about. Until recently.
When Chris started this new, new job (two "new"s because there was a job in between), he was hired as a 1099 employee. As in, an independent contractor who is not eligible for benefits, including health insurance. We thought that was okay because we could just get health insurance on our own. Not a problem, right? Unless you can't get health insurance.
I spent hours comparing heath insurance companies and within the companies the 9,000 different plans available. Let me relate these plans to an ice cream sundae--would you like chocolate or butterscotch or caramel or strawberry sauce? Or a combination? Chocolate and strawberry, hold the caramel and butterscotch? Or caramel and butterscotch with just a little bit of strawberry, hold the chocolate? Nuts? Sprinkles? Whipped topping? Cherries? Or a combination? Chocolate ice cream, vanilla ice cream or any combination of the a fore mentioned toppings?
It is mind boggling. Especially when it is not as simple as consulting my taste buds. Hence, where that option to push 8 would have come in handy. Come on. Dumb it down. Give it to me in plain "I'm-stupid-when-it-comes-to-this-stuff" English. We finally settled on a plan and then I spent hours filling out a crazy application about our health history for the last billion years (or so it seemed when I was filling out the application). "Tell us about those stitches Chris got back in 1999. Who was the doctor? What is the doctor's phone number? Address? Did he take any medications? For how long? Did he do two handstands followed by one push up? Or two push ups followed by a handstand?...." Seriously? Who has that information? I don't even know what I wore yesterday, let alone some of the medical stuff that happened 10 years ago.
Anyway. I filled it all out and thought I was done with that. Gave them my deposit and my payment information so they can automatically deduct it every month like they insisted on. I was anxiously awaiting hearing back from them as it was time for Carson's 6-month vaccinations. We were also by this time coming up on our 63 day break in coverage which I was very much trying to avoid. So after several phone calls, once again wishing I could just have the option to press 8 (No talkie da lingo, man! Is there a Joe Schmoe there that could help me out?), I finally reached someone who could give me an answer. We were denied coverage because of Carson's kidneys.
WHAT?!? Little naive me--didn't even know that was possible. I thought they may raise our premium rate. Or they may exclude his kidneys from our coverage. Never did I think they would out right deny coverage to our entire family! Is there a hotline with an option 8 anywhere?!? I'm pretty sure that's what I need.
So we had just enough time to still sign up for the COBRA coverage. Normally it would cost us $1500 a month. Again, really?!? Are there people out there that can really afford to pay that so they don't have a break in coverage that can later cause all kinds of problems? Luckily there was some legislation that was put through in February that allows you to temporarily pay 35% of your premium for up to 9 months. So we signed up for that. Or so I thought.
What do you know! A few weeks later we receive a letter back from the company administering the COBRA insurance. We were denied the ability to pay the 35% because it said we didn't meet the criteria. HUH? I saw the criteria and we fit every one of them. That's why I applied for it. And I sent you the documentation. More phone calls. More beggings for an option 8 on those hotline numbers.
Me: Can you tell me how a decision was made on this?
COBRA: Based on the information "they" had, you do not fit the criteria.
Me: Um, who is "they?"
Never did figure that out. More phone calls. More wantings of an option 8. All I can get out of them is that I should just pay the $1,500 a month, including the back-pay required back to June and then figure it out. Hmmm. I don't think so. Here's the math:
$1,500 times June, July, August and September + a contract job that doesn't actually pay out for virtually three months=not going to be doing that.
They told me my only other option at this point was to fill out an appeal with the Department of Labor. What's that? Yeah. That's sounds like it's going to take a long time and a lot of red tape, right? Good thing you only have 45 days from the day you sign the COBRA paperwork to pay the entire premium or you forfeit your right to sign up for it. MESSY all over the place!
So I spend hours filling out this online appeal and attaching documentation. (Where is that option 8?) I don't know what half the stuff means! I'm attaching the same documentation used the first time around when we were denied. Why is this time going to be different, I wonder. I do it anyway. I go to upload the last document and it tells me it is too big and won't let me go back or forward. I have to close out of it. All is lost. This program does not allow you to save it as you go. Cool. I spend hours again filling it out, this time with the document reduced in file size. Ah. Submitted. Now just hoping and praying it comes back fast with approval so we can pay the reduced premium before our 45 days (which are quickly approaching) expire.
Are you tired? I'm tired just typing this. Sigh. Are we having fun yet?
Now, let's back up to the end of July when we originally thought we signed up for COBRA. I talked with Carson's doctor's office and told them we had just recently signed up for COBRA but that we hadn't heard back officially that we it was activated yet. They told us not to worry about it and to go ahead and bring Carson in for his 6 month appointment and they would just work with us. So I bring him in and that's when the doctor said Carson was too sick to give him immunizations and that in fact he needed to be on two different antibiotics. Just so you know...pharmacies don't work with you the same way. You want your drugs? Your insurance is still saying your coverage ended in May? You pay full price if you want those drugs. Did you know antibiotics cost $100 when you don't have insurance? I didn't. I know now.
We went back to the doctor a week later with a mostly healthy Carson to make him sick again with immunizations. Sorry doctor's office, still no word on the COBRA. I'm sure anytime now.
Two weeks later, they wanted to see him back to make sure he had gained some of that weight back that he had lost when he was sick. I seriously debated about not taking him to this one because--yep, you guessed it, COBRA was still a mess.
Enter a month later. Did you know that immunizations cost $1,000? Received a few nice bills in the mail. Including the other two doctor visits. So glad this doctors office is being patient with us. I've never dealt with a doctor's office that has been this patient. They are awesome!! Such a relief!
Appeal from the Department of Labor comes back. Appeal approved. Sigh of relief. Still no one can tell us why we were denied in the first place. Is there an option 8? Still not understanding. But whatever. It doesn't really matter. We're approved, right? Good.
So yesterday, in the pouring rain, I drag Caleb and Carson to the post office to overnight the last stuff so that we hopefully meet the 45 days that are up at the end of this week. Whew. I called them today to double check everything. Yes...you got it. I needed still another option 8. Throwing all these terms around. No comprendo. But we're good, right?
Do you think that magically this will be all squared away before Monday when Carson is supposed to have an ultrasound at the hospital followed by an appointment with the kidney specialist who takes forever to get in to see? You can be sure I will be calling and giving the insurance guys a little motivational speech (I prefer not to call it nagging) to see if they can finally push it through.
Which brings me to my last wish for an option 8. I would like a hotline to someone who can explain to me why I can't get health insurance. I pay taxes which pay for so many to get free health insurance from the government. They can go to the doctor for free. Heck, they can have a baby for free. Meanwhile, I can't take my kid to the doctor. Don't get me wrong--I am so glad there are programs like this. Some close friends and family have really needed this. But how come when you're at a place where you should be able to afford health insurance there are not any good options. During the last few months I've talked with quite a few hard working people that earn enough that they do not qualify for government assistance and yet cannot afford health insurance and/or cannot get approved. There are just not very good options for contractors and small businesses!!! Something is seriously messed up with this system. I don't know what we would/will do when our 9 months of reduced premiums is up!
Ah. Alas, maybe after all this I will create a hotline number with only an option 8. I will have found my way through the crazy system and I can just say, "Girl! Let me give it to you straight... Here is exactly what you need to say and how you need to say it. Talk to this person, fill out that form...." Thank goodness for the option 8's!
p.s. Dear Mr. Homeowner's Association Man with too much time on his hands:
As you can see from my post above, I've been a bit distracted lately. I've had a lot to try to figure out. And fill out. And fill out some more. And wishing there was an option 8 during the hours spent on the phone trying to figure stuff out and pretend I know what the heck people are talking about. And wishing I didn't have to back pay 4 months worth of insurance so I can have insurance. I hope you understand why I have not (and probably will not for awhile yet) fix that crack in the driveway. And why I somehow missed the minuscule sized amount of grass growing in the cracks of our sidewalks. I had to look so hard to find it. But now that I've located it, I'll get right on that. :) Give me a call and we'll talk about it. Dial my number and then press option 8.
p.p.s. I really don't mean to sound like I'm whining. It's just amazing to me all the craziness that surrounds healthcare and health insurance and I hate feeling so ignorant. It's almost humorous. Doctors and insurance people throw these terms around like you should know what they are talking about. Just nod and smile. Just nod. And smile. All I really want to do is take my little cute man to the doctor!
Can you help me that, Mr. Crazy Lingo?
Really, it always works out when it has to...Always has, always will. I'm just trying to patiently wait for when it has to. And in the end, I'll be so much better off after I strike it rich on the option 8 hotline! As our favorite comedian, Brian Regan says, "Say 8, say 8! Did you get some 8?!"
