Tag: healthcare

COBRA, And What To Do About It

Before my separation from my previous firm, I had only one experience with COBRA, and I didn’t like it, however, similar to last time, this time I didn’t have other options: I was terminated without any notice and didn’t have any upcoming employment. That being said, the fact that my previous firm was going to pay my COBRA for the first four months was a relief.

Everything looked easy because I just needed to go to the COBRA provider website and enroll. I enrolled, but the website didn’t know anything about my former employer paying for my COBRA, and nothing changed several days later. I emailed my former HR, but nobody replied. A couple of days later, I received a note in the mail saying that because nobody paid the COBRA premium, my coverage couldn’t be reinstated.

I emailed my former HR again, and they said that they just paid, and everything should be fine. I logged in to my COBRA provider website, and it indeed indicated that the payments were made. However, the Blue Cross website was still insisting that my insurance was terminated.

On top of that, I actually needed to go to the doctor because my back/left leg started to hurt, and by September 17, it hurt really badly, so I couldn’t stand or walk without the pain. A strong painkiller I had for situations like that didn’t help, and in general, I felt the pain was more severe than previous relapses.

No appointments were available with my primary, and they suggested I go to another office to see another doctor in the same network. Then the scheduling center couldn’t find my insurance, as expected, and my assurances that COBRA would apply retroactively didn’t work. I told them that I would self-pay, got an appointment, paid $145, got another painkiller prescription, an X-ray referral, and a referral to an ortho specialist. A half-hour later, the scheduling service told me they couldn’t send a referral because my coverage wasn’t reinstated, and they told me to call when it was.

I returned home, took a deep breath, and called PT Solutions, which is a Haven on Earth and where Cori does his magic. I asked whether there could be any time that afternoon Cori could see me, and they found a slot. I came in and explained all about COBRA and being in between, and they were genuinely sorry and asked whether it was OK to charge me $35 (do not ask! I do not understand how they can charge a co-pay without insurance, but I am telling you, it’s a Heaven on Earth right here, in Rogers Park!). And Cori examined me and told me that there is no new injury; it’s all in my back, which reacted to the stress in such a way. He made some manipulations and showed me some exercises, and told me to come back on Monday if it didn’t help.

I have been doing all these exercises at least twice a day every day, and although I am not completely out of it, things have definitely improved.

I spent the next two days calling the COBRA provider (who said everything was OK and that they would notify Blue Cross, and insurance would be retroactively applied) and calling Blue Cross, who said they received nothing. On Wednesday, a Blue Cross representative called me and asked me to call COBRA again because he had already called them multiple times and verified the email address where they should have sent a notification, and it’s still not coming.

Finally, on Thursday morning, I logged into my Blue Cross account and didn’t see the red note on it. I couldn’t believe it was over, so I called them to verify, and they confirmed. However, I still had to ask them to reprocess a dental claim from September 2 (they won’t do it automatically), and I also have to file a claim for my out-of-pocket manually…

Summary:

  • Why there are so many parasites around healthcare?!
  • The rest of the world is normal in comparison to us
  • There are some angels around us, especially in Rogers Park

And almost forgot: after I made sure that my insurance was reinstated, I immediately signed up for COVID and Flu shots, and got both of them today, so now I am ready to travel!

Mom’s Doctor

I had to do it all over again and switch my mom’s doctor one more time. After her doctor made us wait for over an hour, I decided we needed to look for an alternative. I thought that since I needed to take an Uber to get my mom to a doctor anyway, the distance didn’t matter, and I could expand my search to find a Russian-speaking doctor. I thought that since she doesn’t follow advice anyway, it might be important for her to be able to communicate directly with the doctor. Also, I was hoping she could be administered a memory test in Russian.

We switched from one doctor to a Russian-speaking one and scheduled an appointment. My mom didn’t like the new doctor, and if you ask me, she was not wrong. It’s funny that she has been complaining about the doctors not doing the same things as Russian doctors, like not listening to her chest at each visit or not giving her a better prescription for constipation. But now, speaking to a very traditional Russian doctor, she was upset that the doctor didn’t give her a visit summary, didn’t speak directly to her, and sent her to way too many tests. As for me, I didn’t like all these things either, plus the fact that she was saying all the time that she is the only good Russian doctor left in this area, and that only Russian doctors are any good.

Since my mom has already forgotten that she didn’t like her “one before last” doctor (who, I think, was the best she ever had) and told me that she never ever complained about her, I told her that I am going to switch her back, which I did, since we were still in the open enrollment period. I still need to wait before we see that new/old one, and I am not ruling out that my mom will be complaining again, but at least in that case, I have access to the patient portal and can message the doctor!

I am slightly upset because of the time wasted, but at least I tried, and there are no “what-ifs” left.

Biking/Falls/Potholes

On June 2, right before the conference started, I fell off the bike for seemingly no reason. It was very close to home. I was returning from my morning ride, and I was just a couple of blocks away from home when all of a sudden my bike jumped, the front wheel took a sharp turn right, and I fell off really badly, breaking half of my nails and getting a bruise and a scratch on my temple; fortunately, small enough not to be seen unless someone would seat very close to me on my right side. I was telling everyone it was a perfect fall because I still looked presentable, even though I didn’t like how badly I’d been hurt. The scratch healed, and the nails were repaired, but unfortunately, that was not it.

Several times afterward, I felt my bike jump at approximately the same spot, and I still couldn’t figure out what was wrong with the road there. Then, last Tuesday, it happened again – I fell really badly at the same spot. Once again, I could not figure out why – I didn’t see anything dangerous on the road. Once again, the helmet protected my head; however, I landed on my right hand knuckles, and the hand quickly became swollen and painful.

Still, there was nothing for me to do except go to work, because it was too early to get to any doctor’s office, and I still could move my fingers and type. And I had six meetings on that day :). I had high-dose ibuprofen tablets in my bag (I always have them since the times my back pain could appear out of nowhere), so I took one in the morning and one in the evening, and that reduced the inflammation a bit, but it was still painful, and I could not lift anything with my right hand, and couldn’t even open the door, which made my life in the office quite challenging (not like it would be better at home). In the morning, the hand was neither worse nor better. Since my workday starts way earlier than the doctor’s workday, I decided to go to the office and start calling from there. The doctor’s office picked up the phone at 8:15. They said my doctor was not in the office (which I already knew) and that there was nobody to see me that day at the Evanston office, so they suggested going to the Lincolnwood office. I had no other choice because I didn’t want to drag out the uncertainty any longer (and I also suspected that my children would give me a hard time if I didn’t go). After my morning meetings, I got into Uber and went to Lincolnwood. A nurse practitioner saw me and said that “just in case,” I should do an X-ray. Guess what? This facility doesn’t have. X-ray, so they were sending me back to Evanston! I called to check the hours; they were open, and I didn’t need an appointment.

One more Uber ride. Two reception desks. One line after, just to be checked in. Then I finally walked to the lab, which had zero people in line, and got my X-ray done. But if you think that was it, it was not. I was told that a radiologist would take a look “later on that day.” Good thing it was actually “that day,” not in the middle of the night! Turned out, I didn’t have a fracture after all.

You can say all well that ends well, but this whole ordeal cost me three hours of life and $100 total Uber fees, and I still don’t understand why I had to go to Lincolwood to get an “OK” for X-ray!!!

Also, I counted the number of healthcare workers with whom I interacted on this day, including receptionists and information desks – ten!

Wait Time

That’s not about the conference. Today, I took my mom to the doctor’s check-up. It’s difficult to find the time when I can take her to the doctor, because she has become very inflexible and does everything very slow, so I have to navigate to secure appointment at the time when she only minimally alters here schedule. Today, our appointment was at 2 PM, and we were there at 1:40, as they always ask, and the doctor saw her only at 3:10! And he didn’t even apologize!

My mom often critisizes doctors for no good reason, but this time, her critiques were completely justified. I was especially mad that he literally didn’t say sorry he was late! He should know what it takes for a 91- y.o. to sit and wait for 1.5 hours!

It’s not much I can do regarding the doctor change, since she is on Medicaid, but I never had anything like that before, no matter what’s the patient’s status, and I am really upset!

COVID Vaccines Update

For those who are in Illinois and want to follow my example, please hurry up- things might change! See the Sun Times article below.

As doctors anticipate word from the federal government, many expect Illinois will promote vaccination for those left out under new restrictions, Elvia Malagón and Kaitlin Washburn report for the Chicago Sun-Times.

That could mean authorizing pharmacists to administer vaccines off-label, as they do in other states. Doctors already are authorized to give vaccines off-label.

The Food and Drug Administration approved the latest version of the vaccine but only for those 65 and older or people with a high-risk medical condition. The agency did not specify which medical conditions were eligible, but pharmacies offering the vaccine are relying on the Centers for Disease Control and Prevention’s definition of high-risk groups. That includes people who have asthma, are neurodivergent, live with disabilities or certain mental health conditions, smoke or are physically inactive.

It’s unclear, however, whether insurers will cover the costs over the long run for people who fall outside the FDA’s guidelines. For now, Blue Cross and Blue Shield of Illinois, one of the state’s largest private insurance companies, hasn’t changed its coverage policy.

The Illinois Department of Public Health plans to issue its own guidance by the end of the month after reviewing recommendations from medical societies, experts and its own immunization advisory committee, according to Dr. Sameer Vohra, the agency’s director. [Chicago Sun-Times]

Vaccination

First, I was waiting for the updated COVID vaccine to arrive. My only COVID happened at that time of the year, when the previous vaccine was already worn off, and the new one hadn’t arrived yet. Since I also travel extensively at that time of the year, I always try to get a new shot as soon as it becomes available.

So, I was waiting for the updated vaccine. The same day it became available, the new CDC guidelines barred me from getting it. I tried to schedule on both CVS and Walgreens sites, and both times got: Sorry, you are not eligible. Meanwhile, my GP returned from vacation and replied to the message I sent to her earlier: Yes, you should get a shot. I told her that “I am not eligible.” She replied: Maybe we do not have this vaccine yet. Could you try a local pharmacy? And please schedule a virtual visit with me if there are any issues. I replied that it was actually the local pharmacy that didn’t allow me to get an updated shot, and then decided to give it another try.

I started at the CVS site again and selected “I have a condition.” Nobody asked me what condition I have, and I could select an appointment pretty much immediately. I didn’t even have an insurance card with me, but I knew that this pharmacy had me in their system. I downloaded the card from the BCBS website and hurried up to my appointment.

Indeed, they didn’t ask for my insurance card, just verified the date of birth and said that both COVID and Flu were free, and five minutes later, I walked out with two band-aids on my arms.

That happened yesterday, and with all the craziness going on today with the Senate hearing, I am glad I didn’t spare any time!

Eye Surgery

My eye surgery was on Wednesday, and we had to be at Rush by 6-45 AM. If you recall how my first eye surgery was five years ago, it could not have been more different!

Rush Medical Center is something amazing! The top technologies, the high-skilled staff, the overall professionalism, friendliness, and respect for patients. It was great that, unlike five years ago, Boris could be there with me. It turned out that although I was not nervous, I actually was, and I missed a lot of explanations from the surgeon regarding what exactly and why would be done (there were three separate procedures).

Right after the surgery, I couldn’t tell what the result would look like because they told me to keep the patch on. I felt OK but could not really focus on anything, and I was motion-deprived because I couldn’t do any exercises, and it was too cold to walk outside. On Thursday morning, we went for a post-op appointment, where they took my patch off, and although my vision was foggy, I realized it was almost perfect! the surgeon told me that I saw way better than he expected me to see on day one, and I was sent home with a whole bunch of eye drops and instructions “not to move fast.” That’s the most challenging thing for me to do! This “no nothing” will last for a week (two days done, five more to go), and after that, I will be able to gradually return to my normal level of activities with complete healing in a month.

TIME Magazine: How To Negotiate Your Medical Bill

I’ve been saying exactly what this article says to everyone—do not pay any medical bill you receive immediately! Never! This article lists all the steps and how they should be done. By the way, before my mom had Medicaid, I had to negotiate her bills, and I remember that I would receive a 30% discount just when I called the first time, without any negotiations. But to get even more discount, please follow the steps below.

I would also like to mention that I find it completely disgusting that in the US, we have to do it this way, that our healthcare is so screwed up!

Continue reading “TIME Magazine: How To Negotiate Your Medical Bill” →

Mom’s Caregivers

It took almost four months, but my mom finally had all the services she could have. Setting up the homemaker service took five visits from different social workers and coordinators from different organizational levels, but finally, everything is in place, and the woman who comes to her is really nice! She has been there only once to do some cleaning, and it looks like I will need to tell her what she can do to help my mom because my mom can’t realize what she needs help with. I have a long list, however!

On Wednesday, a technician came, and her wearable device was set up, although she is complaining and does not want to wear it. Learning something new, including the simple thing of pushing a button and an overall concept of wearable, is challenging for her, so I am unsure how effective this device will be. I just hope for the best.

Another thing I was planning to do but am unsure about is setting up her paratransit. They need us to show up for an interview where they will determine whether my mom needs paratransit, and that’s a whole project on its own. However, since one of my friends uses paratransit, I know it entails long waits and possible delays, so I am not sure it will be worth using it instead of Uber. Still thinking about it.

Everyone who interacted with my mom through these months was either just nice or exceptionally nice, and I am surprised and happy to see so many dedicated people working in elderly care.

All Updates

A side note: I credit myself for two responsible actions. First, when I got a call that my mom fell and was taken to the hospital, I ate before rushing there. And second, when she was already home on Saturday, I asked Igor to stay with her for an extra hour and went to the beach because I knew it was my last opportunity of the season. I said thank you to the lake, to the warm clean water, and to that amazing summer.

Those were the last two responsible actions on my part. Although the second CT scan didn’t show any negative dynamics, the doctor still didn’t want to let my mom go back home. All the doctors kept telling me about horrible things that could happen if my mom fell one more time and insisted she had to be supervised 24/7 if we wanted to take her home. Mom didn’t want to be supervised, she didn’t want to make any changes in her routine, and she repeatedly said that she better die than like “like that.”

It was great that Anna could come over and stay until Tuesday afternoon. Mom was thrilled to see her, and I could take breaks and even do some work. However, we still struggled to make mom use assistive devices and exercise caution.

Taking a shower using the bench was the hardest, and I almost yelled at her. She kept saying that she was not used to washing herself sitting, and it was inconvenient. But then, I came up with a great strategic idea. Mom often states that I don’t remember how it is to live without a shower at home while she lived like this and had to go to the public baths once a week. In fact, I do remember: I had to go to public baths when I was in summer camps and when we stayed in the countryside in summer. So when she repeated that “she never washed herself in a sitting position, I said: Wait, what about the public baths? Didn’t you sit on a bench then? And this was a trigger. She said yes, and you had to wash the bench before sitting on it!

Then she got into the shower as I instructed her, and then I saw through the door crack that she was washing herself while sitting, and then she got out of the bathtub in a safe way. I said: good job, mom! You learned a new skill! For that she replied: there is nothing new in it!

By some miracle which I am not going to question, he got at-home physical therapy twice a week and the nurse’s visits once a week. She already had one PT session and did the exercises once on her own, so the progress is outstanding.

I am planning to go to the office for tomorrow afternoon.