Health Insurance (part 1)

 

We are going to veer from my previous posts and start writing about something that I hope can help others. 

PLEASE GET EDUCATED ABOUT YOUR HEALTH INSURANCE! If you are lucky enough to have health insurance through your employer, KNOW your benefits. Everyone should know what Insurance company they have, what their deductible and copays are and if you don't, find out. If you have family members covered, make sure they know as well. I have worked with medical insurance for 30 years now. I have seen changes in the industry many times over. For the past 4-6 years I have said that we have finally hit an era that makes it impossible to predict what the next year will hold in terms of coverage. 

Please understand that this blog is in NO way a political statement. I will let you know my viewpoint from someone who BILLS and collects from health insurance companies and works with patients who are and are not covered. 

I offer a unique point of view in that I am not selling any particular insurance and am not skewed by any kickbacks. 

If you work with an insurance agent to get health coverage, have them show you several plans with benefits and premiums listed. Compare apples to apples.  

We should start with some definitions in layman's terms:

Network:     Many insurance companies belong to a 'network' of doctors and facilities so that they can negotiate what they will pay for services. 

Allowable:  This is the amount that an insurance or network has agreed to pay for a particular service. If you are seeing a physician who is in your insurance network, they cannot bill you for any amounts over the Allowable. 

Deductible:  This is the amount you will pay (Usually each calendar year) before your insurance pays anything. 

Copayment: This is the amount you pay when you receive medical services. 

                    *This can be an office visit copay, a facility (hospital or surgery center) copay, radiology                              copay, laboratory copay, etc. 

                    *Some insurance companies require copayments for EACH service. Eg, if you go to a                                 doctors office and have an xray, you may have two copays.

Coinsurance:  This is the amount you are responsible for after your insurance pays their amount. (This is typically a percentage of the allowable amount.)

I am available for questions or assistance with your particular coverage if you need me. Watch for more blogs with general information and hopefully some key insights into health insurance. 

Haven't written in a while. Funny how cathartic it is. When my world was spinning, writing kept me grounded. Gave me a focus if only for a short time. I felt the blank page calling to me this morning. Weird morning. So many random thoughts and people shuffling through my gray matter. I found myself thinking of the people who aren't with us right now...my dad, my Wyndy, my grandma. I miss them so very much. This particular time of self-isolation would have been nearly impossible for my dad. He didn't sit still very well.

And in this time of isolation and quarantine, I worry about the folks who already suffer and struggle with depression and anxiety. I find myself staring down that hole and having to climb out of it at times. I, like so many, am struggling to find some meaning in these crazy times. I have been fortunate to keep my job and go to it daily. But running a doctors office brings me more risk of exposure to the virus. I have friends who have been laid off, both in the hospitality industry and not. I also have friends who are doing all they can for their community, in feeding the masses and/or donating what they can. I have friends who are healthcare workers, police officers, fire rescue, and front liners. I have a few friends who have battled this virus personally and won.

I saw a post recently about how we should stop saying we are all in the same boat. We are all battling the same storm but in very DIFFERENT boats. Some are working, some are not. Some are staying afloat and some are worried about sinking soon. Some are very outspoken about their boat and others are silent.  Stop assuming that because we are in the same storm, your boat is just like mine. It isn't. Check on the people you haven't seen or heard from. A quick message may be just what they need to keep their boat afloat.

I am so thankful that my family has, thus far, stayed healthy and safe. I am worried about our world. I worry about the information we are fed and wonder if the information I find is true and accurate. I am tech-savvy enough to know where to look but still wonder....

Do not assume I write for attention or sympathy. I write because it helps me process.

If you are still reading, you are probably a very important person in my life and please know that I love you!

Happy on the inside

I began writing this blog post 2 years ago. I had forgotten this very eye-opening discovery about myself. I haven't stopped being happy, just had forgotten to finish this post.

How do you measure success and failure? I had an epiphany of sorts this morning. Some have commended me on my parenting because I have a child who has graduated college and because I've tried to always put my children first. Perception isn't always reality. Yes, my children have been my world and I've done what I thought was best for them. I've been a single parent for nearly 14 years. Yes, I've done homework with them, I've pushed them to succeed in school, I've allowed and encouraged extra curricular activities, I've practiced and played with them and cheered them. But it occurred to me this morning that I've lived on the brink of failing them for years. I had given up...I stopped allowing myself to be happy outside of them. Now that I have opened myself to happiness and love, I have realized what I had stopped doing. I stopped caring about me and our home. Only a select few had been in my home in the past 8 or 9 years. I told myself I was lazy but it occurred to me this morning that it was far deeper than  that. I just didn't care. Allowing myself to love and be loved has created in me a desire to take care of the things I was neglecting for years.  And if this isn't abundantly clear, I am cooking and cleaning...willingly. I have been teased by family and friends as not being able to cook but truth is that I just stopped wanting to. I actually can cook and enjoy doing so.

I am, at heart, a realist and I've always liked to think that I knew my faults as well as anyone else but the truth is, there were some that I hadn't seen, or at least acknowledged. I have always preached to my family and friends to find their "happy".  I just never took my own advice.

I am grateful for the man who cared enough to get me to care again. He's been my knight!

A Tale of Two Dads

I've been one of the lucky ones. I had two fathers. One gave me life and the other gave me a home. The first wasn't ready for a child and the second CHOSE me. (He actually chose my mom, but we were a package deal and at least I wasn't a deal-breaker.) The home he made for us was a good one. We were well-provided for and I got two sisters out of it. I also got a really warped sense of humor. This year, in August,  my biological father passed away unexpectedly but peacefully in his sleep. He set a few things in order for my benefit and I will be forever grateful. He and I hadn't had much of a relationship but we talked occasionally and I was glad to have him in my life.

In November, my dad went to the hospital with shortness of breath and was diagnosed with cirrhosis. He was 'asleep' from the high ammonia levels and encephalopathy that ensued and passed December 17.   This is the man who raised me. He treated me as he did his biological daughters and was both tough and loving. Its his sense of humor that I have and so much of who I am is because of him.

The next week and few months will be the toughest I’ve ever had. My mom is phenomenally strong and i can’t imagine her heartache. Her support system is strong too and I know she’ll be ok. She will because she has to be.  As I was in Virginia  going through my fathers house after his passing and as we make the final arrangements for my dad now, I am reminded just how precarious life truly is. They both let me know in very different ways what I meant to them and I make sure my children, family, and friends know that I love them every chance I get!!

I can't explain the feeling of losing both the same year. I'd like to hibernate for about six months. I spend a lot of time worrying about everyone else....my mom, my sisters, my children, my aunts and uncles from both families, etc. I want to be strong for all of them because that's what I do and who I am. (I get that from my mom) I will be eternally grateful to each of them for the things in my life that each have given to me. I was incredibly blessed and lucky to have two dads!!

For (my) Wyndy

Devastation.  Grief. Heartbreak. Emptiness.
Friends. Support. Love.
How do you cope with the loss of someone so dear? Someone so close to your heart? Someone who left too soon?
So many memories being floated on facebook. So many words of both loss and encouragement and the good things she embodied.

And the special few. The few who knew they were her people...as she referred to us. She was a secret-keeper to many and we were hers. She could light up a room or blend into the background, whichever her mood dictated. She had no idea the enormous impact she had on SO many!! I wish she'd known. I pray she can see now. I can't help but think how lucky we were to have had her in our lives! I am a better person because I knew her!

She had a heart of gold....with a healthy dose of snark woven in. She would text me about something she had seen and how it cracked her up and often it was followed by, "Yes, I have the sense of humor of a 12 year old boy". I always snickered at that. She was ALL girl...from her cooking abilities to her quilt-making to her nurturing and caring nature.

She was my Sugar (and her daddy's) and I was her HB (Honey Badger). My grief and heartbreak cannot touch that of her family's, I am certain. I wish them peace. I offer condolences but know that it can't come close to helping. I hope they lean on and draw on their faith to help them through this. I'm leaning on my friends and vice versa. Friends I haven't seen in 20+ years but whom I will be forever connected to through our love of her.

We all know that grief is different for everyone and I've heard the term "selfish grief" mentioned. My grief is very selfish! I'm grieving for the times I WON'T get to visit with her or text her or have anymore homemade pickles. I'm grieving because of MY loss, not hers. I know her daddy was waiting for her with open arms and she'll still get to be called 'Sugar'! I am thankful she called me a friend. And I am thankful for the friends I can share memories of her with.

As the reality sinks in, I'll still  think about the loss, the heartache, her family's pain....but I'm also beginning to feel the peace of HER. The love that she would so much want for us to feel FROM her, for her, and for each other.

Hell

A.....Angst/Arbitrary thoughts/Awful feeling

N.....Nuisance/Not for the weak/Nerve wracking

X....eXpectations/eXcrutiating/eXcuses

I.....Intimidating/Illness/Inconvenience

E....Encumbrance/Exasperation/Exaggerated

T.....Tension/Terror/Trouble

Y....Y me/Yearn for end/Yay its over

The bad one

I have a confession....and it's about Online dating. I am THAT girl...the one who guffaws at people when they talk about the 'dangers' of online dating. My response has always been, "it isn't any worse than meeting a guy in a bar.  At least you have the chance to get to know them before meeting them."  My confession is that I've never played it safe. I've never made sure someone knew where I was going when I met these guys or who I was meeting.  But I'll preach to do so all day long. Well, I've learned my lesson...and thank goodness it wasn't any worse than it was. I received contact from a guy on a dating site...profile seemed decent...said he wasn't continuing his membership so could we text  and sent his number. I texted and he immediately called. I didnt answer because it wasn't a convenient time to talk so he left a voice mail and texted too. I called back a little while later and we chatted for a bit. He was funny and flirty and asked if we could meet later. I agreed. Later came, we talked and picked a place and time. I was early, as usual. When he showed, he was cute but completely wasted.  Sat next to me and wouldn't stop groping me. He tried several times to put my hand on his crotch, to no avail. Instincts said to get up and leave but I'm not one to be mean so I stayed and finished the beer I had. In doing so, it turns out he didn't drive (lucky for other motorists). Asked if I'd drive him home. I politely refused but, again, I relented and told him I would if he promised to keep his hands off me in the car. I dropped him near his home and was able to leave without incident. The scene at the restaurant, however, had already rattled me to my core.  I've met guys only looking for one thing before...and I've generally known that's all it would be. This one caught me off-guard. I cannot adequately explain, in words, what the situation was truly like. As I over-analyze and lose sleep over it, I think the best explanation is not being in control. I, in essence, allowed him to be in control of the situation. And that may just be the root of my problem. I was cornered into a booth by a guy making very unwanted advances and I didn't stop him. I kept removing his hands from me and turning my head when he tried to kiss me but that just lead to him biting my neck, which I'm certain has bruises today. I am ashamed of myself for letting him continue as long as he did. I am ashamed of myself for putting myself in a situation like that. I got home okay and am none the worse for wear...but I believe my online dating days are over. I've deactivated my profiles and am sad to say that this may stay with me for some time. I feel like he dimmed my spirit just a tad. This all sounds so overly dramatic but I was the victim of date rape when I was 18 and didn't admit or realize it until just a few years ago. Back then, it wasn't a thing so coming to terms with it hasn't been easy. The lack of control of the situation is what the worst part is and that is what made tonight similar. He didn't rape me and we didnt have sex....but he sure did molest me right there in that booth in a restaurant...with people all around. I've always bragged that I'd never be a victim. "I'm stronger and more aware" "I'd never put myself in a situation to BE a victim"  I don't get rattled easily...and I'm rattled.