Author: kathleen

Yeah, my Facebook peeps know what is going on, but I have been out of touch.

Back at the end of February, my husband had to spend some time with a neurosurgeon.  Trust me, this is never a good thing.

My focus since then has been taking care of him.  Not the spoon feed thing, but getting him to appointments etc.  Currently he is recovering, on short term disability and doing physical rehab every day.

Yes, it’s fun.

But it has been okay.  Quick recap – I had been teaching high school at a large urban district, and was driven out a year ago.  I took a job with a mobile app, which was fun, but it got bought out by google and they are in the process of shutting it down.  Right after I took that job, I took a pat time teaching job with Johns Hopkins Center for Talented Youth, and that has been a god send.  I have been doing 28 hours a week with them, teaching and recently added writing courses.

More later, I hope.

Those of you on Facebook know that my husband has been facing a medical crisis.

He had had a headache for several weeks and then had a major change in personality / behavior.  I had been requesting that he contact his doctor before that change because he wasn't getting better.  Of course, I was ignored.

He has United Health Care Choice insurance which we can't figure out exactly what the term Choice  means.  However, Baylor Scott White System is in network.

I've done research and different insurance experts at Baylor Scott White have been helping.  He has a deductible of $2000, which was alarming, I'm used to $1000 deductible.  He also has an out of pocket maximum of $6250, which I'm sure we hit the first day in the emergency room, if not there, in the operating room/recovery room.

So here's what has happened.  He has seen his primary care doctor twice (office visits of $30 copay).  We were sent for a CT scan and have paid co-pays and full price for the scan itself and for the reading.

We were sent to a specific facility and doctor (both in network).  We'll pay copays for emergency room and full price for any of that care until we hit the deductible.  Then we'll pay just copays and 20% of anything.  Once we hit the maximum out of pocket, we don't pay any more.

So far, here's what we got:

2 primary care visits
At least 2 CT Scans
1 emergency room visit
consult by trauma residents
brain surgery and recovery
Surgical ICU for at least 2 days
Regular hospital room for the remainder of the vists
Daily visits by neuro surgeon and by trauma doctor, PT, Speech Therapy, and one visit by Social Worker for plan.
Follow up visits with neurosurgeon, primary care physician
Out patient therapy

It could have been worse.
 

I have an appointment with my endocrinologist next week. In my calendar, I had recorded a lab visit. Apparently, the appointment clerk didn't as I didn't get a reminder call and when I got there,
there was no paper work.

Fortunately a quick recovery but it took extra time. Time I don't want to give up.

I called my contact lens place and told them I wanted a different prescription than what was last prescribed. It is the previous prescription, which I have been wearing. I wanted to know if they wanted to see me first. They scheduled an appointment and told
me they needed call back to update information which I did.

Then another one called to see if she could talk me out of the appointment – she did but it was almost enough to get me to order them from Walgreens and I might yet.

Sent from my Windows Phone

I've been an early adopter of the Fitbit.  I currently have two here around the house.

I have switched to the Microsoft Band, and yeah, I have two.  Here's why (and why I had two fitbits).

I've been known to do one of two things:

• Leave the house without my fitness device.
• Let the battery completely run out.

And yes, you can switch between two devices, though I think the Fitbit is a little harder.  I do know by accident that it is easy to do the Microsoft band, but wasn't the first time.  The first couple of times I had to reset my Microsoft band, I lost my data.  However, now you don't but I'm wonder if it's because I had the other one on the charger.

My favorite thing to do is put it on the charger and then leave the house without it.  I had my first Microsoft band in the truck — it's screen is scratched up.  So I decided to give it a try.  I disconnected the Windows Phone from the band, then I reconnected the new one.  Takes a few minutes, but my data was still there!

I've done it a couple of times now, with no issues.  Even remember what tiles I had set up.  Only problem is that I have to remember to turn on watch mode.

I like it much better than the Fitbit.  I do wish you could go back and put the start and end times of sleep and exercise activity.  You could do that with the fitbit.

Probably the longest I’ve gone without blogging, not sure the site even exists.  New jobs have been sucking all the energy.

For those who don’t know, I’m switched roles, I’m developing software full time and teaching part time.  Both are good gigs, and I took a bit of cut in pay, but I’m happier.

The development gig has been taking up all my writing energy.  I take notes on the stuff I’ve learned, what I’m doing and writing documentation most of the day.  I’ve forgotten that takes away my urge to write.

Blood sugar control isn’t good, but my workout routine is great.  I’ve managed to get to the gym almost every day.  There were a couple of days last week when we hit a hard deadline but there you go.

Hopefully I’ll be back here more often.

I'm on a new plan and I was paying about $230 a month on prescriptions.  Now I am paying $436.  On my old plan, I was paying about $500 a month for the plan, now, about $250.

My co-pay for my insulin pump supplies is double.  It will be interesting to see when I meet my out of pocket expenses.

Of course, the costs don't include pump supplies, doctor's copays, etc., so I am definately paying more for health care.  I almost feel like my whole salary is being eaten up by the health care costs.

UHC claims that their mail order service might save me money but they can't guarantee it.  I really do like Pill Pack so they get to keep my business.

Fun stuff, and I still don't know if my sensors are covered. 

New job is still kicking my butt, but since I have a much younger co-worker that seems to have even less energy at the end of the day, I'm not too worried.  Enjoying it.

So I now have a "normal" insurance policy.  For years, I paid over $500 a month more to get a premium health insurance policy.  Now I am paying half as much through United Health Care.

It seems out of pocket is about twice as much.  Under $500 for pump supplies over a three month period, when I paid until $300 before. 

The most irritating thing is that I keep getting contacted by the insurance companies from my old job. Yes, companies, as they changed insurance companies.  Both think I am still getting coverage.

Of course, there are claims still trickling in and that's fine.

Last week I talked with Medtronics and they said, you were denied coverage because of your diagnosis.  I told them I wanted to see about an override, and they said I would have to talk with the insurance company.

I wasn't up for it, so waited until Monday. 

The reason I was denied?  Medtronics had submitted a 90 day claim and they only do 31 day claims.  I get that.  When I got my CPAP, it was a rental for the first year or so, because there are a lot of people who can't tolerate it. 

So I called Medtronics back and explained it.

Questions?

Why didn't Medtronics look at the claim denial and figure it out on their own?

I'm also wondering if they even processed the claim on the supplies — they sent me a pump once without getting coverage.

<sigh>

The only type of work left to you is a stressful, working at a desk job.

Your arthritis means that you cannot do any job involving a lot of standing or walking.

You need the Continuous Glucose sensors because you are hypoglycemic unaware.

Insurance won't cover because you are overweight, thus you have to be Type 2.

You have been pumping insulin because that is the only way you even maintain weight. Multiple daily injections and basal insulin made you roller coaster.

The good news, they will pay for the supplies but Medtronics doesn't want to go for the overide.

You could do the sensors out of pocket but it is somewhere around $500 a month, about a fourth of your take home.

Another option is disability, about 2/3 of your old take home. It would be ironic if that company would cover the sensors.

Of course, I am lucky, I have Dulce. She is back working part time, getting ready to go full time. But that is a lot of work.

Sent from my Windows Phone

I can't use my new insurance benefits until September 1. I have an overlap and the old insurance takes precedence.

So I can't go back to Novolog until September 1

Sent from my Windows Phone