Insurance Woes

The saga continues. (If you don’t want to read all of this – mom – skip to the last two paragraphs, I am asking for advice there.)

Last summer – July and August – I had a couple of doctors visits that were not covered due to my doctor leaving my insurance and me not wanting to deal with finding a new doctor for two visits,I have out-of-network claims. And as you know, I got married in August. Upon return from our honeymoon I processed my name and address change with HR and filed the out-of-network claim.

Now my insurance says they will cover 70% of reasonable and customary charges. What they actually cover is 37% of what I paid. I really want to know where they are finding this reasonable and customary – because my doctor actually charges a little less than several others that I looked at in Manhattan. This kind of stinks, but I still want my $130 back. It’s not a ton, but when you are unemployed, it’s a godsend. Why then is the insurance making it so hard to claim this smallish amount.

In October I got a call from my doctor saying that the insurance had reimbursed her, not me. Which is wrong. So she sent that check back with a letter explaining to send to me. I heard and waited. Finally November 30 I called about the claim. I felt it should have been issued by now. And I was told the check had been mailed four days earlier to Kasey Powers at MY OLD Brooklyn address. Unfortunately because Kasey Powers never lived in Brooklyn, Kasey Frazier did, the check will not be forwarded. And until 30 days have passed the insurance won’t send a new check. Also they tell me that they can’t correct my address. I have to do that through HR – which I did when I changed my name. I confirm with HR that the name and address were both submitted.

I called on January 13 and was told a new check would be sent to the right address and I should expect it in 7 – 10 days. Because the address has now been fixed.

This brings me to today. I spent 45 minutes on the phone with a very nice customer service agent at the insurance company. Who can find no record of the check that was authorized on the 13th. And says that it looks like the check was cut under a different claim number than originally submitted. I told her I didn’t care how it was submitted as long as I get my check that was authorized for me nearly six months ago. We found that the problem finally. The name change went through on my old address, and my maiden name was attached to the new address. You would think this is an easy fix. But no, I have to fix it through either my company (where I don’t work anymore) or the overall insurance – there are all these sub-divisions in the insurance we have (where I am no longer insured because I don’t work there anymore) So the very nice customer service agent tells me that she will put through the authorization (why couldn’t she do that without all the explanation and my HR department (where I don’t work) already submitted all the information TWICE, because I made them re-do it in December. Anyway, it will take up to 30 days for the name / address issue to be resolved but I should call back in 10. And then, only then will I be allowed to receive my check. Ridiculous I say.

And as the eve of losing all insurance coverage through Rob is upon us, I am trying to weigh the options. I know we can’t afford good insurance, or COBRA, a downfall of the no-job thing. I have been looking into catastrophic coverage, also known as major-medical. But I can’t find anything for under $320 a month. And I’m not sure I can justify spending $4000 a year on the chance that something might happen and we’d still have to pay $10,000 before insurance would start covering most costs, where there would still be co-pays, and most likely physicians fees (which surprisingly are not covered under many of the catastrophic plans)

So what do we do. Insurance companies are a nightmare and expensive. Any advice on how to go when stuck in the place of having to buy your own insurance.

Nothing to Write Home About

The monotony of nothingness has set in. I have no job. (I am freelancing some – those are good days, and sending out resumes from home) It is cold out. And today it is snowing and raining. And overall just not fun to be out walking around. So I bake. And watch Gilmore Girls. But there is really nothing new and exciting. But I want to keep updating this blog. And I wonder – is the nothingness worth writing about, does anyone want to read it. This week I am considering it a good day to shower and get dressed each day.

My week:

Last Thursday and Friday – I had freelance work. Out of the house – it was awesome.

Saturday – I finally got dressed late in the day. I won’t say how late. And we went out to dinner at TJ’s Asian Bistro and had sushi. For those in Woodside I highly recommend the Tokyo Roll.

Sunday – Sunday’s are always good because we have church. And last Sunday Sarah had all the girls over for muffins and coffee. A great way to spend the morning.

Monday – Rob had some of the One Stuck Duck guys over to talk about progress on the music video. When they were done I turned off the Gilmore and did some socializing. Oh yeah, and in the morning Rob took me grocery shopping.

Tuesday – Hmmm, I guess here is where the nothing really set in. I watched Gilmore and made sugar cookie dough. And Rob made chicken parm for lunch. Yum! Then we walked to the mall. Yes, there is a mall in Queens, about 3 miles from here. So we walked to the mall, looked around, and then walked home. We were SOOOOOO tired.

Wednesday – This morning I made the cookies. And was showered and dressed at a decent hour. Today is a good day so far. And as I sit here typeing about nothing, and the play-by-play of my week, it really hasn’t been that uneventful after all.

Still Got It!

The spark in our marriage that is. Yesterday I was sitting on the couch and Rob leaned down to give me a kiss, and he felt a little shock. And started laughing. You see we’ve been wearing a lot of fleece in the cold weather and it really kicks up the static electricity. So Rob rubbed his arm on the back of the couch and kissed me again. A bigger spark! One more time, and yep it happened again! So that’s it, the secret to keeping the spark in your marriage: static electricity.

Funny Kid

So we were at this school Friday with Sesame. And we showed the video and I was asking this kid some questions about the show. The conversation went something like this:

Me: What was the show about?
Kid: Diego.
Me: Yeah, but what was the show we just watched on the tv in there about?
Kid: Dora
Me: (ok let’s go on) (show picture from show) Can you tell me what happened in this part?
Kid: Elmo.

Ok, we are getting somewhere. I ask the rest of the direct questions about the show, and the kid gives correct (or at least Sesame related) answers. Then we have a minute to wait until he’s ready to go back to his classroom.

Me: Did you have fun today?
Kid: Yes. It was awesome! I got to see Diego!

Oy! He was only three, but come on.

Back to Work

This whole working thing – it’s hard work. I’ve grown accustomed to sleeping in ’til around 10, eating a breakfast type snack, checking email and blogs, sending job hunt related emails and searching online for jobs, making lunch, running a few errands, dinner, tv, and more blogging as late as I want. It’s been a nice surreal existence. But I was really happy when Tuesday I was asked to work Thursday and Friday, with a stop by the office on Tuesday afternoon. This has been a crazy week. I worked. And I forgot how exhausting it can be. Wow. And in reality I didn’t even truly work a full week. Two networking events (I was too tired for number 3) and two days of work.
Monday I went to an even on how to network better. It was insightful, and I made it through without too much anxiety in talking to new people. We talked about the biggest setbacks encountered when networking and some techniques to overcome them. Then on Tuesday I was asked to freelance at Sesame Workshop Thursday and Friday. I stopped in for awhile that afternoon to view the tape we were going to be showing the kids. Then onto How to Get York Book Published, part 1. It was interesting and not that I’m planning on writing a book or anything, knowing the process can’t hurt. (Unfortunately I skipped part two – Editors and Publishers because I was just too exhausted.) Wednesday was frigid cold, so luckily all we had was a condo board meeting and then a dinner with Bill and Jess. Of course since these were in the evening – it was frigid cold. The downside to the first three days of this week was I didn’t fully prepare myself for sleep deprivation and an early rise. I spent several hours on Wednesday with this blog, posting and updating the format, and finally told myself I’d fix it later it’s after midnight and I have to be up at 6! This is not so good for a non-morning person who has been sleeping in for a month.

Thursday, I was up at 6:20, showered, I even made lunch, and out of the house at 7. At Sesame by 7:35 and on the way to the school. We hit a little unanticipated snow (unanticipated because I never checked the weather) and when we got to the school the lack of cars in the parking lot was of some concern, but the kids were there and ready to go. We set up, and research was on! We showed a 40 minute (so almost full length, missing short segments) episode of Sesame Street to the kids. Then asked them some questions. Then we did it again. And again. I got to watch three episodes of Sesame Street in a row. Or I should rephrase, I got to listen to the SAME episode of Sesame Street three times in a row. I had almost forgotten how there is a threshold of how many times you can watch something before you never want to look at it again. I did not hit this on Thursday. I did hit the threshold of how many times I can listen to others sing the Elmo’s World theme though, as it wasn’t stuck in my head from watching, but only after the repeated singing. It’s almost gone. When we got back I entered data for awhile, and then headed home. It was 4pm when I got there (just after the plane landed in the Hudson) and I took a nap. When I woke up for dinner at 5:30 I knew there was no way I was going to be heading back out into the cold for the book event. But I did watch a little tv and go to bed at a reasonable hour so that I could get up at 6 on Friday.

Friday I did it all again. When I got home I decided that I really just wanted to hang out on the couch. If it’s not too windy we MIGHT take a walk to get some air, and break up the cabin fever. This working thing is hard stuff, but I am so happy I’m back in the rat race. Let’s hope I can do it again next week.