Showing posts with label Health Insurance. Show all posts
Showing posts with label Health Insurance. Show all posts

Monday, December 08, 2008

An Early Present

Here we are coming to the end of the year, and what have I been doing?

Stressing about money.

Money for our property taxes, money for Joseph's orthodontia, miscellaneous medical bills, our insurance premiums, CHRISTMAS...

Money for a new insulin pump.

That's right, Joseph's current pump will soon be out of warranty-- and given our history, there's no way we can afford to be without a warranty. Thus, we have to choose a new pump and purchase it before the end of this month.

After much discussion -- and a brief look at the competition -- we've decided to stay with Animas.

Initially I had some reservations about this decision, but we have gotten excellent customer service and Joseph does indeed love his current pump.

And we're all very much intrigued by the new OneTouch Ping system.

This latest technology from Animas includes a glucose meter that is able to wirelessly communicate with the pump.

You can actually operate the pump from the meter.

What exactly does this mean?

Well, for us it means that when we check Joseph's blood sugar every two hours overnight and have to give him a correction when he's high or decrease his basal insulin when he's low, we won't have to:

  • Pull back his blankets;
  • Roll him over (if he happens to be lying on his pump case);
  • Remove his pump while untangling his tubing (which always seems to be wrapped around the clip on his case);
  • Give a bolus or change his basals while keeping one eye on the pump, the other on Joseph (because any sudden move can easily rip out his infusion set);
  • Maneuver the pump back into it's case as Joseph flails about in his sleep and then rolls once again on top of said case.
Nope, we won't have to do any of the above.

Rock. On.

Ahhh, but there's more...

No, not about the Ping-- but rather, about paying for the Ping.

While we have insurance and have met our deductible for the year, unfortunately, we're still left with a 10% coinsurance payment.

Something like $660.

Uh huh, this is where the stress part comes in.

Or maybe not.

I got a call last Wednesday afternoon from Animas.

"Sandra, we're still waiting for prior authorization from your insurance company, however, we were able to verify your benefits. It looks like you have a 100% benefit."

"Excuse me?"

"A 100% benefit."

"Really?... Seriously?"

"Yes, you see- "

"But wait-- how can that be? Our insurance covers 90% once our deductible is met. I don't understand."

"Well, it looks like you've also met your family's annual out-of-pocket maximum."

"Holy Cripes! Then you are serious."

And now I'm up out of my chair.

"You've just given us an early Christmas present, you know that? This is AWESOME!!!"

The minute I hang up the phone, I'm punching in another number.

"Ryan? Honey, we're getting the Ping for Joseph-- and it's not gonna cost a thing! Can you believe it?!"

I still can't.

Wednesday, October 22, 2008

A Bittersweet Win

"I can't believe it-- we're actually gonna see the Red Sox play tonight!"

"Mom, we should just get cable," Joseph says with a sly grin, "then we can see them anytime we want."

"No."

That's all I say. Because I don't feel like explaining yet again that if we had cable TV, we'd be a family of lab rats-- spinning endlessly through all of those channels...

Nope, I'm not going there.

We're having dinner in a sports bar on a fine Saturday night, minutes away from watching Game 6 of the American League Championship Series in glorious high definition TV.

In fact, all of the plasma TVs in view will be showing our game.

I am in heaven.

In. Heaven.

And nothing is gonna spoil it.

You see, just two nights ago, I listened to Game 5 on the radio while the rest of my family slept. I heard that amazing comeback.

Now, I was about to see my boys play.

"Uhhh, Mom... " Joseph says, interrupting my reverie, "where's the game?"

"Huh?"

Immediately I peel back a sleeve to look at my watch, and then my eyes return to the giant screen several feet in front of our booth.

Yup, the "TBS" logo is exactly where it should be, in the lower right corner.

But, wait-- a sitcom is on?

"What? What?" I sputter.

Frantically looking around for someone who can do something about this, I spot a young, dark-haired man behind the bar explaining to a white-haired gentleman in a Boston cap that he'll try to figure out what's going on.

When I turn back to the giant screen, words scroll across the bottom telling us that TBS is experiencing "technical difficulties."

WHAT?!

For several long minutes, I stare at the screen in disbelief-- while Ryan works hard to reassure me that I will indeed get to see my game.

And thankfully, he's right-- minutes later, I see Josh Beckett going into his wind up.

Criminy, TBS-- don't scare me like that.

Spirits lifted, I sigh, sit back and watch Beckett throw a perfect strike.

And just as he's about to let go a second pitch, I hear my daughter's voice.

"Mama, I want to go home."

"What? What?"

"I'll take her home," Ryan tells me with a smile. "You and Joseph stay here and enjoy the game-- I can listen to it on the radio."

"Ah ya sure?"

"Yes, I'm sure."

(Have I mentioned lately how much I love this man?)

Soooo, moments after Ryan and Evan leave -- with the Sox down one run -- Joseph and I belly up to the bar so we can sit with the other two Boston fans in the place-- that older gentleman in the Boston cap (Rob) and his wife (Deb).

Turns out, Rob is actually from Massachusetts-- born 66 years ago in my hometown. In the very same hospital where my mother had me.

We laugh at the coincidence and proceed to cheer loudly for our team.

Between innings, Joseph talks baseball stats and pitching calls with Rob, even getting up at one point to demonstrate the throwing motions of his favorite major league pitchers-- Daisuke, Papelbon, Beckett, Sabathia...

And he's spot on.

Over and over, Rob tells me: "If I ever had a son, I would have wanted this one!" and "I just love your boy!"

All the while, I sit back on my bar stool and beam.

Until about halfway through the game, that is-- when Rob asks Joseph who he wants to win the presidential election.

"Obama, of course!" Joseph says.

"What about the other kids at your school?"

"Obama. All the way."

Rob, still smiling, turns to me and his wife.

"What about you?" I ask. "Have you all decided who you're going to support?"

"McCain," he responds with a grin. Deb nods, chiming in--
"Oh yes, McCain."

Usually, when someone tells me they support John McCain I leave it at that, respecting their decision-- as I hope they respect mine. But there's something in the way Rob says it. I can't put my finger on it, but for some reason I can't leave it sit, so I go on.

"What made you decide to support McCain?"

"It's simple, Obama is going to spend and we don't have the money-- we need to do an across-the-board cut." He pauses, takes a sip of his Chardonnay, and then continues, "Don't get me wrong, Bush ran us into the ground running up the debt. But now we need to stop spending. Period."

"You do realize that some programs are necessary-- education, healthcare- "

"Nope. We've got to stop. If I had kids I'd probably feel different, but I don't."

He chuckles, and then adds, "It's not our problem."

Those words -- that laugh -- feel like a blow.

"But what about healthcare?" I ask, struggling to stay calm. "You do know that John McCain's own campaign announced two weeks ago that he was going to pay for his healthcare plan 'with major reductions in medicare and medicaid'-- this didn't come from Obama's campaign or a commercial, this came from John Mc-"

"That won't affect us," Rob says, with an almost serene smile.

"But people, people like my son... he has diabetes- "

And now, Rob and Deb stop smiling.

"Listen," I continue, "John McCain's healthcare plan, if he puts this thing in place... well, my son may not have access to the tools he needs to treat his disease. Insurance companies will be allowed to relocate to those states that don't require coverage of diabetes supplies. This will hurt my son, and millions of others- "

"Yes, yes," Deb cuts me off, "pre-existing conditions, that's right-- people with pre-existing conditions. That will be hard for them."

Hard for them. HARD for them?

I want to scream.

But the game is back on.

For a while I can't say anything. I can't even look at them. But then, the Red Sox score another run, and we're cheering again.

In the end, the Sox win. We all celebrate with hugs and high fives, and then say our goodbyes.

"Thank you," Rob calls out, as we pull on our coats, "you both made this game really special."

As I'm backing out of our parking space, Joseph turns to me and says, "Mom, I really like those people."

"Yes, they were very nice," I say, my voice catching.

And here I am, days later-- still feeling troubled.

Yes, the Sox were eliminated and that really sucks.

But it's that conversation at the bar I can't seem to shake.

Saturday, October 20, 2007

So Here's the Scoop



First- thanks.

To everyone who continues to come here -- even when I don't show up -- and to those of you who've commented or sent emails checking in.

We're all right.

I think.

Remember how, two posts back I mentioned that a ton was happening and that there were some things I couldn't talk about yet?

Well, I can now.

Ryan is changing jobs.

After teaching Java programming for over 10 years, he's burnt out -- has been for a while -- so much so that he wants to stop teaching altogether and return to software development.

As a result, he started looking-- and ended up interviewing for a development position with a very small (but growing) company.

He came home from that meeting more excited about work than I've seen him in a long time.

The people were great, the work sounded interesting-- and he could still ride his bike to the office (when it's not bitterly cold and snowy, that is).

Sounds perfect, right?

Well... almost.

You see, Ryan hasn't done software development for a very long time-- so in order for him to make this change, he has to take a pay cut.

A big pay cut.

And then there's the health insurance.

For a while, we were unsure whether or not Ryan could even consider this job-- the benefits had to cover Joseph's pump and supplies.

We could never afford them otherwise.

Thankfully, after much research -- and much, much hand-wringing -- we discovered that while we'll have a deductible (ouch!), our copay will be less than our current one. And this new provider covers both the Animas and Medtronic pumps (but sadly, not the Cozmo).

So far, the only bad news about this new insurance is that Lifescan is not on their formulary-- thus our fleet of OneTouch meters will be useless to us.

(Any information folks could share about other meters would be much appreciated!)

Oh yes, and I'm still on the edge of my seat wondering if our new insurance will cover our 400 test strips a month.

We won't find this out until Ryan starts the new job in mid-November.

Now, in addition to stressing out about all of this -- and trying not to let the kids see me stressing -- I've been thinking about my own career.

I haven't had a paying job since teaching birthing classes nearly eight years ago.

(Man, I wish this job change were happening next fall-- when Evan will be in kindergarten full days -- right now, she's only in preschool a few days a week for 2 1/2 hours.)

I don't know.

I have a few ideas, but nothing really solid yet.

And nothing -- so far -- that will allow me to work around the kid's schedules.

Soooo... that's the big news.

There's more to talk about-- Evan's recent obsession, Joseph's first middle school dance, the end of the Fall Ball season, those dang Red Sox-- not to mention my non-paying, but really cool recent project.

But, if I'm gonna post something at all, I'd better stop here.