Friday, June 27, 2008

when will it end!

ok, first off, i want to thank those who tried to help with my mom's insurance thing. apparently, she'd been paying for herself AND my dad (who's been gone for 7 years). the insurance company wants us to send in a copy of my dad's death certificate, a letter explaining why we didn't do anything about the insurance, and a letter asking for it to be cancelled. They won't refund her money for herself, but they will refund for my dad. oy vey.

now, for my own insurance woes. Sean is on high doses of medication. as such, the insurance company we now have covering prescriptions requires prior authorization for 2 of his medications. here's where the fun begins. i didn't know about the whole prior authorization need until i took in a prescription, and the insurance refused to give me the whole amount (120 pills). then we got to wrestle around with it for a week and a half, and have the doctor's office talk to the insurance company, and the insurance company take FOREVER to get the prior authorization in place before they would give me the other 30 pills. (the insurance believes he only needs 3 pills a day, as opposed to myself and his doctor thinking he needs 4. needless to say, the thought that an insurance company can dictate how my son is treated, as opposed to me & his doctor? infuriating as hell). fortunately, in this case, we were able to do it without my having to pay a second copay.

fast forward a month. sean also takes adhd medication, which is a controlled substance. for his age, he takes a pretty hefty dose. this medication, as well, needs a prior authorization. when the doctor's office failed to mail this month's prescription to me, i ended up not getting it until i only had pills for a few days (4 to be exact). i took the prescription in on friday afternoon 2 weeks ago, and picked it up after 5. or tried to anyway. the prior authorization had expired. nobody knew why, it shouldn't have, because this insurance company took over april first, and prior authorizations are for 6 or 12 months. this is only mid june, folks. so they refused to fill the prescription. the insurance company refused to talk to the pharmacist about it, because it was after 5 on friday, and their prior authorization department was already closed. so was the doctor's office. so, the pharmacist told me she would fax the necessary info to the doctor's office for the PA, and would work on it monday & tuesday. tuesday night comes, still no PA, and i'm now out of pills.

if you've ever dealt with an ADHD child who really needs medication (not all of them do, but some need it desperately), you know that every parent absolutely quails at the thought of no medication. we don't even scale back in the summer, because he needs it ALL THE TIME. so, i was forced to take the 30 pills that they would give me without PA, so that he would have medication for the next few days while everything got straightened out. the pharmacy, doctor's office AND insurance all told me that i would need to get another 30-pill prescription to make up for the one the pharmacy had to alter in order to get me medication.

once again, the doctor's office fails to mail my prescription, even though i talked to the secretary, and verified that they had the correct address. fast forward to this morning. i dropped off the prescription, and asked them to call me if it didn't go through. at 11, i got the call saying it wasn't going to go through. so i called the insurance. after being on hold for something like 20 minutes while they wrangled all this, they finally got it to go through (apparently, the system was treating it as a new scrip, and i was filling it too soon (i understand trying to keep a tight control on medication like this (people steal them to get high with), but this is driving me nuts!). however, they were going to make me pay another copay, even though it was just finishing filling out the previous prescription, because it had a different scrip # (controlled substances are written out on numbered scrip pads, and monitored by whatever agency takes care of it, to make sure the doctor isn't giving out too many to too many people). the pharmacy did say that i could probably call the insurance and explain the situation, and they'd reimburse me for the $30, as i'm really not supposed to be paying double like that.

i call the insurance company and find out 2 things: 1) the prior authorization had NEVER EXPIRED. she doesn't know why it showed up as such. it's good through october. this crap should never have taken place in the first place. 2) in order to get my $30 back, i have to cancel the 30-pill prescription i just took in this morning, and get a new 60-pill prescription from the doctor. and because mark hasn't logged in to the insurance website since they switched, i don't know passwords or anything to get into it, so they're mailing a form to me, so that i can get my $30 back.

and when i complained back 2 weeks ago? the insurance company said i needed to take it to the insurance holder, i.e. mark's employer. mark didn't want to do it because "i'd waited too long to get the prescription." WTF? i had called the prescription request in to the doctor's office when sean had a 10 day supply. i can't call it in much earlier than that. i did what i'm supposed to do. the doctor's office failed to mail t he scrip when i had asked for it. we are having a serious talk tonight, and if he doesn't go talk to hr or benefits or whomever he needs to speak to about this, there are going to be problems. i should not have to go through this EVERY FUCKING MONTH.

small wonder i have a headache, eh?

Monday, June 23, 2008

a sort of meme

Mark's aunt sent this to me and i thought this would be kinda cool to do as a meme. leave me a comment if you do this (i prefer not to tag people if i can help it, lol)

the premise is you have to come up with ONE word to answer t hese questions. it doesn't have to be the same word, though, lol.

1. Where is your cell phone? charger
2. Your significant other? faithful
3. Your hair? long
4. Your mother? strong
5. Your father? missed
6. Your favorite thing? family
7. Your dream last night? knitting
8. Your favorite drink? starbucks
9. Your dream/goal? enjoy
10. The room you're in? main
11. Your ex? annoying
12. Your fear? loss
13. Where do you want to be in 6 years? happy
14. Where were you last night? Home
15. What you're not? stupid
16. Muffins? YES!
17. One of your wish list items? friendship
18. Where you grew up? Nebraska
19. The last thing you did? nap
20. What are you wearing? shorts
21. Your TV? off
22. Your pets? cats
23. Your computer? loud
24. Your life? happy25. Your mood? satisfied
26. Missing someone? dad
29. Favorite Store? book
30. Your summer? hectic
31. Like someone? smile
32. Your favorite color? blue
33. When is the last time you laughed? today
34. Last time you cried? friday

Thursday, June 19, 2008


My dad died 7 years ago. At that time, we thought we knew about all the policies my dad had. A few years later, we discovered that he'd gotten some insurance, and my mom, not knowing, had paid for the policy for that number of years. We found out that they were unaware that he'd passed away when we got a letter from them asking for a death certificate FOUR YEARS after he was gone.

Today, it happened again. My mom's heart doctor's billing office called, and I found out that the insurance that my mom's been paying for for 7 years is NOT long-term care insurance, but Medicare supplemental insurance. She already has a supplemental insurance policy with a different company. Here's the kicker on that one: it's illegal to have two supplemental policies. You can have a secondary policy, but not two supplementals.

So, now comes the fun part. What the hell do we do? I have to go talk to my mom, and call the second company, and find out what we can do. The billing specialist said she didn't think my mom would get in trouble, because the main name on the policy is my dad's, and it went effective 3 days before he died. In case you don't know the time line, he had a stroke on May 22, 2001. He died June 4, 2001. I think, after my grandmother died on May 2, he decided to change policies, took care of it (and didn't tell my mom, because he took care of the bills), and then got sick and died before he could tell anyone. I'm hoping that maybe, just maybe, if there is no long-term care policy, that we can switch this to that, and there will be no harm, no foul. I don't know at this point.

Anybody out there have any ideas?

Thursday, June 12, 2008

mosaic of me

i've seen this 'round, and decided to do it. i will say picture #1 was NOT my first pic (it was minnie pearl, a woman that ihave admired for many manyyears (and am as loud as!)), but i must say, it fits me ok. the last one onlyhad 4 pics to choose from, though, so i chose the one WITHOUT the funny looking guy.

The rules:
a. Type your answer to each of the questions below into Flickr Search.
b. Using only the first page, pick an image.
c. Copy and paste each of the URLs for the images into the mosaic maker (link below).

1. What is your first name?
2. What is your favorite food?
3. What high school did you go to?
4. What is your favorite color?
5. Who is your celebrity crush?
6. Favorite drink?
7. Dream vacation?
8. Favorite dessert?
9. What you want to be when you grow up?
10. What do you love most in life?
11. One word to describe you.
12. Your flickr name.
i was gonna list the credits, but apparently the code was fubared, so no go. sorry! i enjoyed this.

Tuesday, June 03, 2008

long time, no post

i think a bout blogging. honest, i do. but a lot of my online time is spent doing L&V things, or twitter, or the endless task of catching up on my bloglines, or yahoo, and with the kids out of school, my time is less my own than normal. so posting s uffers.

no pics, although i'll try for some tomorrow. laminaria stopped for a wee bit, cuz i realized i hadn't done much charity crafting last month, and felt the need to do so. hence, the hat/baby sock set, green booties, and 12 squares drying all over the house (they're wool, so no dryer). may's project was for nunavit, in canada, for a birthing center (rankin island, i think?). they asked for wool cuz it never gets truly warm there.

anyway, the real reason why i'm posting.

my mom went in the hospital for a couple of days last week. all in all, it wasn't a big deal, but it scared me to start with. tomorrow is the 7th anniversary of my father's death from a massive stroke. when my mom called me last thursday and told me she was dizzy, i worried. the doctor's office said to take her to the ER, so i drove over there quickly, and hauled ass up to the hospital. she was definitely off balance, because while i was helping her out to the van, i could feel the wobble.

they did a cat scan, and found what they were calling a TIA. a mini-stroke. when the doctor told me that, a large part of me was screaming inside. not again! my grandmother, who also passed away 7 years ago (33 days before my father, it was a WONDERFUL year), had started the downhill slide with a stroke the day after thanksgiving.

she went into AL for the winter, then had another stroke in the spring, which caused her to fall, and break a hip. my mother's cousin was guardian since my mom was so far away, and they had determined the best course of action was to put her in a nursing home. she passed away that night. nurse checked on her at 2 am, and she was sleeping peacefully. checked again at 4 am, and she was gone.

anyway, the dizziness was my mom's ONLY symptom. and it was predominantly light-headedness. this is important. they decided to admit her, so they could do more intensive testing. that afternoon, a neurological med student came up, and got as much info as she could about what happened. the neurologist came thenext morning, and we found out that it wasn't a TIA. apparently, she'd had an incident a long time ago, and that was what they'd found in the cat scan. it's not uncommon in people my mother's age (80) to have those kinds of things. we never knew because she'd never exhibited any symptoms. so, now what? she'd been hanging shower curtains, and had gotten dizzy after looking up and putting her arms up several times. problems with carotids or vertebral arteries? neck ultrasound it is. however, that wasn't it. then, the nurse noticed that when my mom was resting, her heartbeat was normal. when she'd move around, her heartbeat would double. hmmmm. call the cardiologist. they say she'd better stay one more day, and they start discussing meds. they tell me 50 mgs of a medication used to regulate her heartbeat. i'm confused. no, supposed to be 150. so they double check the chart. they called walgreens for the doses, and walgreens told them 50.

it seems there was a mixup between the cardiologist's prescription, and what walgreens interpretted it as, and she'd been short-changed since JANUARY. some days. so they upped it to what it had been before, and things went back to normal. she went home saturday morning, and we even went and wrestled witht he bank about a fuck-up they did.

except. as i age, i see fewer generations ahead of me. it's always felt like the older generations were a barrier between me and time itself. my grandmothers have been gone 7 & 16 years, respectively. my grandfathers died in 67 and 78. in my father's family, the only one left is my aunt frances, and she's 90 and in the nursing home. my mother is an only child, andall her cousins are either aging, or gone themselves. as the youngest granddaughter in my generation, i have several cousins who have retired. the oldest 2 are 78. the barrier is slowly dissolving. the only things standing between me and that vast abyss of time are my mother and aunt. and the aunt is standing on ice with one foot, and a banana peel with the other. my mom is doing alright, but she's got a laundry list of heart-related problems, as well as a laundry list of medications.

today pushed it a little farther along. she called me again this morning, and said she had a cut, and wanted to see the doctor. she's on blood thinners, so this concerned me. she had been folding up a card table last night, andit got away from her, and smacked the back of her right knee, and cut her. she had bandaged it, and gone to bed, not thinking muchof it. she got up this morning to find it bleeding again, and blood on the sheets. i didn't know what was going on, so to the ER again, we went. they removed some torn skin, cauterized the bleeding, bandaged it, and sent us on our way. she's fine. we even went grocery shopping this afternoon (and she's a power shopper, lemme tell you. $105 later, we went on our way).

except. i'm terrified of losing my mother. but i know that i will be the one on the front line when it does finally happen. the brother who truly cares is in georgia, and the other one is too involved in his own life to even bother coming to visit on a regular basis (he goes for months without calling or visiting, and then, visits when it suits him, and he's only 1 1/2 hours away). some day, i will get a call, or find her, or get more bad news. i know it's inevitable.