goingplaceslivinglife

Travel, Food, and Slices of Life

A Medical Hurdle

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This story is for those of you who really hate the concept of  universal healthcare:

My last job working full time was for a financial adviser.  It was a small business and  did not offer many benefits, including health insurance. But that was okay, because my husband had the state employee’s insurance plan through his job at Marshall University. It was restrictive outside of West Virginia. For example, he needed an eye surgery and the best care was in Kentucky. Living right on the Kentucky line, we chose to pay more than drive further to Morgantown.PEIA

Once he retired, we fully expected my health coverage would end immediately and were pleased I could pay fully for coverage to continue for two years. As expensive as that option was, it would give me some time to find something else once we moved to Oregon.  And I was happy it was coverage by Aetna. I had lived in Hartford for many years and felt that company had good policies and attitudes.Aetnalogo

When the Affordable Healthcare Act was passed into law by Congress and approved by the Supreme Court, I was relieved that I did not need to find another 9-5 job with a large company or the state government to get insurance, as all those jobs were an hour away. I started looking into the Cover Oregon plans and determined I would save $100 a month once enrolled.cover oregon

Meanwhile, using my post-retirement West Virginia insurance, I started establishing relationships with new medical care and filling my prescriptions at the local pharmacy.ritedaid

Until yesterday, when I went to pick up a refilled prescription and a new medicine that my new doc felt was necessary to replace one causing some blood chemistry issue.  The pharmacy told us that our insurance had dropped us. Said they had dropped Graham so they had dropped me. But Graham, being on Medicare now, had never been enrolled. Just me.

We have received no communication from this insurance company. It was past 4:30 eastern time so have to get through the weekend and then we will call on Monday. We paid cash for the medications, thankful they were generics and only double and triple the cost we were used to paying.scrip-shopping-cart-md

This is the way insurance companies act. And now, we will have to fight for the coverage we were told would be offered for two years.fight

Having lived through Dave’s long fight with cancer, I know very well first hand that often people who are ill, or dealing with someone who is very ill, have no spare energy to fight battles like this. But this is the way our current healthcare coverage system has existed for years.  I often had to fight for the promised coverage.

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Author: GoingPlaces Can-Do Zero Waste

I moved to McMinnville a few years ago and was impressed with its friendliness and the beauty of the surrounding countryside. I write several blogs. GoingPlacesLivingLife is my personal blog related to travel, food and just general thoughts. Can-Do Real Food tells about my business processing local produce from small farms and preserving it by canning and dehydrating. The concept of Zero Waste appeals to me because we can truly reduce what gets tossed into the landfill with very small changes in our lifestyle. Join us.

7 thoughts on “A Medical Hurdle

  1. Monday morning update: Ar 6am my time I called the phone number on the insurance card to find out the status of my coverage. I was curtly told it was “fine”. I then explained what happened and was told again it was “fine.” I explained again. I was told I would have to call another number, not listed on the card. I called that number and was #8 in queue. I waited 15 minutes (listening to the same short segment of Beethoven repeat again and again-would not have been bad except the recording was scratchy like over a long distance am radio station) and finally reached a live person. She also told me my coverage was “fine”. Must be the word du jour. I explained the situation and she put me on hold. 18 minutes later she said it was now “fine. That it had been fixed.” I asked her what had happened. She said she had been told it was “fixed now.” She also emailed me a claim form so I could be reimbursed on my medicine I paid out of pocket.

    So, again, this is the current insurance. Not a new Obamacare plan. Does anyone besides me think the insurance companies play games with us?

  2. And then there’s those in Washington (DC) who want to keep that system.

    I am so stoked… yesterday I went to Shiba (an Oregon Senior Health Care Assistance agency). I had been trying for weeks to go through the jumble of plans available for MediCare supplements. In less than half an hour they had me saving around $50 in monthly premiums with a far, far better plan (eliminating deductibles and the 20% not covered previously.) I’m so glad I finally found these guys since the insurance companies intentionally make the process ridiculously complicated.

    Have you tried the state exchange set up to help you through the ACA process? I hear it’s pretty good.

    • I am processing my Cover Oregon application through a person at my financial adviser’s office. It;s great to be working with someone who can easily explain the choices. Meanwhile, Lisa got on California’s website and was done in about 10 minutes.

  3. You said, “… were pleased I could pay fully for coverage to continue for two years.”

    I’m trying to understand this. Did you already pay fully for coverage – then they dropped you after you already paid?

    Do you get your money back?

    • Yes, I believe we have been paying in full for the two months of coverage so far. I will call Monday morning and find out what kind of rationale they will present. The woman at the pharmacy said they “dropped him so they dropped me” but he was never on the plan.

  4. I wish you all the best in this latest battle. May the force be with you. ML

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