Wednesday, March 8, 2017

Who Knew Health Insurance Was Complicated?

I moved last year. Three things happened next.

First, I was forced to give up my excellent health insurance, because it was not available in Des Moines, Iowa - the insurance capital of the world. I live in a downtown converted loft with an insurance company’s name carved in stone at the entrance, so the irony is not lost on me.

Major invasive surgery without anesthesia is to Open Enrollment as getting kissed is to getting hit in the face with a shovel. In the end I chose a PPO plan based on two criteria: the relatively new non-statin cholesterol drug was on their formulary; and no HMO was available. It seemed like a good idea at the time.

Second, by leaving the coastal elite state where I retired for the bleeding red heartland, I was downgraded to my pension plan’s category of retirees about whom they give zero fucks, and my once excellent health benefits were reduced to a $3,000 health retirement account. And it’s not just worth a shadow of its former coverage; I now had to process my own claims and submit proof I paid for each specific service. I had two dozen appointments in January alone.

I cried when the benefits counselor told me he couldn’t be sure, but it looked like my new drug might be expensive. In my defense, I had finished my first double Manhattan by that point in our call. Is a spoiler alert warning necessary? Do insurance costs increase exponentially annually? Do third party contractors multiply like mold in a warm petri dish? It costs $375 for one month.

Finally, inorder of importance clearly, my always-precarious health was relatively unstable. To cut to the chase, I’ve been better - both in terms of managing my health and in managing my anger. Changing doctors in the middle of managing serious health issues and prescriptions is problematic, and considerably more so when combined with confronting a new PPO after a lifetime of HMO care. It’s also exponentially more difficult to keep things straight when Medicare is thrown in.

So far, I’m spending up to 8 hours a week on health insurance paperwork, including an appeal for approval of that drug that’s already on their formulary, plus another appeal of their denial to pay for a generic prescription I took for 20 years, plus an appeal for reimbursement of a claim to correct their mistaken denial, plus scanning in bills and receipts and filing claims, plus re-filing claims wrongfully denied, and plus navigating purposefully clunky and click-heavy websites that make an afternoon in voicemail hell seem like a walk in the park. I admit that I also take some time to compose masterfully snarky Strongly Worded Letters.

You may not know this, but not only is there an insurance clerk/computer algorithm between doctors and their patients. Those were the good old days. So far, and not counting >3 different online bill paying systems from the single network I have chosen, I have encountered the separate plan administrator hired by the pension system, the plan administrator's third party Open Enrollment system, a separate third-party claims processor responsible for issuing reimbursement payments (but not for approving payments, but you have to figure this out) plus an after-completion survey company. I have delved so deeply into this subcontractor hell that I tripped the survey company’s third-party profanity filter and was politely asked by a robot to clean up my shit and resubmit the survey.

My working theory is that all these people taking a slice of my catastrophically reduced benefits have agreed to make a certain level of ongoing low-grade problems for the patient-slash-customer that, regardless of the issue, the result is denial of payments or services. I am convinced they have tuned their systems to assure a pre-determined profitable ROI in dicking around until the patient gives up and goes away. Or, hopefully, dies.

The insurance industry must also be aware that a certain percentage of patients have nothing better to do than fuck with them. My superpower, both by nature and nurture, is bureaucracy. My Excel spreadsheets are meticulously cross-referenced, color-coded, formula-embedded records of every appointment tracking people, places, purposes, inconsistent reference numbers, costs, payments, claims and reimbursement, both covered by medical insurance and not covered but deductible for tax purposes. My mission is to cost them more than I’m worth, not even counting the fact that my actual health care is more expensive.

So, I knew.

Wednesday, August 24, 2016


“Tis better to employ our Understanding, in bearing the Misfortunes that do befall us, than in foreseeing those that may.”
-       Franciois VI, Du de La Rochefoucauld (1613 – 1680)

Bearing Misfortunes may be better, but foreseeing them is certainly getting easier. 

In either case, I understand.

Wednesday, August 17, 2016

A Portionless Woman Answers Hypothetical Internet Questions

“An heiress may fairly look for a husband at any age. But a portionless woman had better give up all such thoughts when she is thirty, and spare her family the expense of going much into company. For it will all be wasted. Nothing will come of it.”
 - Anna Dean, A Gentleman of Fortune

Internet: What walks on four legs in the morning, two legs in the afternoon, and three legs at night?
PW: A breakfast table, a ladder in the garage, and a cheap stool in a dive bar.

Internet: Does acid cause loss of short term memory? What about attention span?
PW: Ask again later. 

Internet: On the Internet, can people really tell whether you’re a dog?
PW:  Well, people on the Internet do seem to be pretty good at sniffing out assholes.

Can dogs and cats marry?

If everybody walked off a cliff, would you?
PW: No, Your Mom. No I wouldn’t.

If it isn’t broken, should you fix it?
PW: You’d certainly be a fool to try if nobody else does.

Can beggars be choosey?
PW: No. But wrt/acid and short term memory, I do recall that this one time I practically asphyxiated myself trying to clean a marble floor in a poorly venilated area with muriatic acid.

PW: Your attention span is short af.

Is a portionless woman doomed to never marry?
PW: We are all doomed, my friends. Portionless woman do have more options to chose their doom. 

Friday, July 29, 2016

Renter's Insurance

Homer: I’m sorry, Marge, but sometimes I think we’re the worst family in town.

Marge: Maybe we should move to a larger community.

I signed up online for renter's insurance in my new place. But I had to call with a question. I got a really nice agent.

Me: Can I get insurance to cover the interstate move?

Sally: The renter's insurance policy covers you household goods wherever they are, including in a moving van.

Me: So, if the van is swallowed by Montana in an earthquake like Lois Lane in Superman?

Sally: Yep: covered.

Me: What if my stuff is scattered by a tornado across a prairie in Montana? Like that tornado movie, only in Montana.

Sally: Yep: covered.

Me: What if the van driver gets drunk and plunged off a cliff in Wyoming?

WISIMH:  Can't think of a movie reference on that one.

Sally: Nope. 

Me: That was a trick question anyway, because I don't think there are cliffs in Wyoming.

Sally: It doesn't matter. The delivery company is liable if it's their fault.

Me: What about if the driver hits a fuel tanker and they both explode up in flames?

Sally: Apart from the legal question of liability - which I won't answer - moving company pays, not me.

Me: What if Thelma and Louise blow up the van because the driver is a dick?

Sally: Argue with the van company first because they are more likely to get the movie reference.

WISIMH: Ask about an alien space ship hitting the van with a drill intended to implant a black hole inside earth like in Star Trek.

Me: Thank you very much for playing along, Sally.

Wednesday, April 20, 2016

Hippo Gerosto Niparos!

“In his great book Enthusiasm, Father Ronald Knox gives us two examples of ‘speaking with tongues’: ‘Hippo gerosto niparos boorasti farini O fastor sungor boorrinos epoongos menati,’ and ‘Hey amei Hassan alla do hoc alors louvre has heo massan amor ho ti prov hir aso me.’ Of these, he says ‘The philology of another world does not abide our question, but if we are to judge these results merely human standards, we must admit that a child prattles no less convincingly.’”
-       W. H. Auden, A Certain World

As I have become a hermit pending my resurrection later this summer following another life change or two, I no longer have conversations in my head about people in the Actual World who cross my path. My path these days is through the tall grass of my own health problems and visits to medical practitioners differing from each other only in the number of times they ask me why I am here today. They always want to see you again in 3 months so they can ask you again. Why.

Instead, today I managed today to file a ton of my medical and health insurance records, receipts and correspondence into some coherent form that may permit at least me to know what the hell is going on. I cleaned out the medical and insurance files in TSG's large loose leaf book file, thus killing two birds with one set of labeled tabs. My inner bureaucrat is feeling content now that the book has been repurposed to contain records of somebody still inhabiting the Actual World. And plus, the cat now has another sunny spot formerly occupied by an unstable stack of filing to be done.

I have found that I can tolerate about 60 minutes of somebody else’s company before I get this itching beneath my skin that threatens either to erupt into a panic attack or manifest in some form of inappropriate behavior usually involving vulgar language. Since saying “Holy Shit” before walking out on the pharmacy clerk at Rite Aidless who denied me my blood thinner for the fourth time, I have not used profanity in public. Twenty days fuck-free, bitches. Out loud in public, anyway. I have avoided any occasion that might lead to profane outbursts and/or that might take more than one hour of social intercourse with other people.

By merely human standards, I do not prattle - convincingly or not - these days. I tried to this past weekend when I had less than 2 oz. of honey juniper mead at 12% ABV to cheer me and myself up. Hilarity and atrial fibrillation ensued.  It took me more than 24 hours to convert to normal sinus rhythm.  I am adjusting my medications accordingly and will resume prattling when some sort of equilibrium is reached and the pointless appointments are done.

Meanwhile, hippo gerosto niparos, everybody!

Saturday, February 20, 2016

Two Friends, By David Ignatow

I have something to tell you.

I'm listening.

I'm dying.

I'm sorry to hear.

I'm growing old.

It's terrible.

It is, I thought you should know.

Of course and I'm sorry. Keep in touch,

I will and you too.

And let me know what's new.

Certainly, though it can't be much.

And stay well.

And you too.

And go slow.

And you to.

Sunday, January 31, 2016

Weather Report

“Where I am, I don't know, I'll never know, in the silence you don't know, you must go on, I can't go on, I'll go on.”
– Samuel Beckett, The Unnamable

The worst of all deceptions is self-deception.
-       Plato

Your friends won’t see you to the end I’m sure but you love them anyway.
 - Jack White

I've heart a lot of voices in my head lately, including the strange company quoted above. The common thread in these voices is inspired by the weather. It is something akin to fear that has taken root in my heart like the moss the covers everything here. Fear is just a reaction. Like sweat is a reaction to hard work (sometimes), or like guilt is a reaction to sin (sometimes).

While we cannot always control what happens to us, we can control how we react to it. For me, it’s clenching my teeth and wishing I could shoot deadly laser beams from my eyes. And insomnia, and eventually, fear. Emotions apparently evolve over time. Once, fear would make me cry. Once, realizing my own inability to control my reactions would make me want to be a better person. Those trains have sailed.

These days, I’m not so afraid of what happens to me as how I’m losing my ability to control my reactions. To offset this increasing uncontrollable rage and growing fear, I have found it liberating that at least I no longer cry when I am overcome with nameless dread. I certainly no longer want to be a better person. I’m good enough, and I don’t have anybody I want to accept me as I am. The fucks I now give are well into negative numbers. I finally got USAA sorted and they even refunded the $22 my credit union charged me for the check that USAA wrote and promised they'd cash and then returned to the credit union. Rage is the latest evolution of my fear: you don't want to make me angry these days.

Short of having the roof collapse and direct rivers of dirty rain down my bent back, I pretty much don’t give a shit. I do have a few library books to return in a few weeks. I still have to complete tattoo removal and edit “prayer works” into “strongly worded letters work”. I think the snakes slithering through tall grass between the tattooed words can stay. The traces of green on the bare branches of the backyard tree pictured here are not budding leaves - they are moss. They are my mood of unnamed menace - growing in the rain and smothering everything.

For a while it looked like today would be the second day in a row that it hasn’t rained since I moved here last November. There have been a few days without rain - but so far I have not experienced two in a row. For the record, I’m not talking about two consecutive sunny days. That would be too much to hope. I would accept two cloudy days without precipitation. By the end of the day, it turned out not to be rainy for one and half days.  I hate this weather and pretty much everything it falls on, including the leak in my roof.

The roofing contract has been signed and the deposit has been put in the mail. Now, weather permitting, I will have a roof next month. Then, new attic insulation, then new kitchen lights, then a heat pump recommended by the electrician to replace the struggling oil furnace adjacent to the new water heater that replaced the old one that bled out last week on to the garage floor next to the second puddle made by the leak in the pipe the plumber had cleaned out the day before. 

These days it's not so much fear that makes me go on, but a morbid curiosity to see what the fuck the new day has in store for me besides rain and silent creeping moss.