Progress Report and Insurance Woes

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Let's start with the Insurance. Calling it "Insurance woes" isn't exactly right, but it's easier to write than Insurance confusion. Go far enough back in my writing, and you'll discover nearly everything about my annoying preexisting medical conditions (diabetes, sleep apnea and others) You'll also find out about my accident in late July, and all the resulting problems and complications. 2016 wasn't kind, and I'm truly hoping for a better 2017 in spite of how much of the problems from 2016 have followed me into 2017.


Let's go back to that pesky medical insurance. My PT was ordered by the Orthopedic Specialist in hopes that my frozen shoulder (a result of my right humerus being broken in TWO places and a complication related to my diabetes) would improve. Every visit to the Orthopedic Specialist or PT cost us (the Household) $60. I was supposed to go to PT three times a week, and I saw the Orthopedic Specialist around five times last year. You can do the math. Well, when I went to my first PT appointment, my Physical Therapist looked at my copay, and reduced my appointments to once a week. Still, this meant that Shilo had to take on extra shifts at work to fund this. He didn't mind, because my health was always a priority for him, and he walked into our relationship knowing full well about my health at that time. I was actually going into liver failure at the time due to NAFLD. (http://www.liverfoundation.org/abouttheliver/info/nafld/) I hadn't been diagnosed with diabetes yet, that came as a surprise later. Let's just say he knew everything, and he accepted me and all my baggage, including my 5 adult children and Stitch. Anyway, you get the picture. The cost of my 4 prescriptions a month ($180) and CPAP supplies ($600 a year) and that's just me. I went from being self-sufficient to a burden overnight due to my accident. Visits to my GP were another $40, and I went about 4 times last year. Then there were the ambulance and ER charges etc. from the accident (too much to quote here) Fortunately those last charges were billed, so it wasn't straight out of pocket at the moment. We'll be paying that off for years to come.


We've established that even with medical insurance, I'm expensive. I had also become a burden, because I lost my independence. I needed help using the bathroom, eating, dressing, bathing, hair care, Everything. Neither Stitch or Shilo complained, even when things got ugly. They preserved my dignity as much as possible, cleaning me as often as I needed, dressing me up, and Shilo drove me wherever I needed to go. All with minimal complaint. Fortunately, due to the PT, I can now take care of nearly everything independently, except I still need my hair washed, and the occasional help getting dressed and putting on shoes and socks. I can't scrub my back using the brush without help and I have a long way to go. More on that later...


So, in November, in the midst of all this confusion, Stitch was given the opportunity to add me to his new Medical Insurance with no extra cost to him. The best news was that ALL doctor/medical visits would only cost $10 effective January 2017. Even the cost of my medication would go down to just over $20 month for all of them! At one point, my medication was costing us $180 a month. This was a reason to celebrate!


So, Monday morning was my final PT appointment before I see my Orthopedic Specialist on Monday morning next week. I was so excited about having to only pay $10 instead of the usual $60. Well... until I was told my new insurance didn't cover the PT provider because it was out of network. Fortunately, I still have the other coverage for another month, so I was able to pay $60 and get my final appointment and assessment. I need the surgery (DUH!!!) because my Range of Motion is still lacking in many areas. I could originally lift my arm straight up to 90 degrees, and now it's up to 115 degrees, so that's a huge improvement for me, but it means I can't reach above my head with my right arm, and I'm too young to be this limited. Also, my right elbow can't flex outwards at all, and trying makes me cry. Nevermind that any BDSM play is next to impossible if I use my right arm.


Well, after the news about my PT provider being out of network, I realized that there might be further problems, because my Orthopedic Specialist might not be in my network either. I tried the website, but it was increasingly frustrating for me, so I gave in and called and spoke to Customer Service. The first option was to see if I could get Continuity of care. NOPE! Next step was to see if the new insurance had my soon to be ending HMO available. Another NOPE! The final option was to see if they had any HMO available with my PCP and Orthopedic Specialist in the same network. YES!!! All this confusion took only 20 minutes to solve, but I felt like it had taken much longer. I called there on the verge of tears, but the Representative was so polite and patient with me that I soon relaxed, because for the first time in quite a while, I felt like this woman cared about my medical concerns. I was the priority, not the Insurance Provider.


My next step was to call my PCP and tell them about my new Insurance coverage and request an expedited referral to my current Orthopedic Specialist because of my new Insurance. It had to be expedited due to my appointment being in a week. My next step was to call my CPAP company and change to my new Insurance info, and order supplies. I'm not sure how much my coverage is, but my previous insurance didn't cover my supplies. I'll find out how much the coverage is when my supplies arrive.


I know that this isn't kinky in any way, but once I'm all better and healed, I'll be able to do all sorts of kinky things, and there's nothing kinkier than a woman who can do everything for herself.


Things are looking better and even though surgery will be necessary, and many more months of PT, I won't be such a financial burden on my Household, and that's the best I can ask for right now.