Wednesday, February 26, 2014

Warning: I Need to Vent

Dear John,
I'm frustrated. I need to vent. So strap yourself in to listen.
It's been a busy day off - I need to go back to work to get some rest. I spent most of the day taking care of financial things. Most of it was good - just paying bills and planning ahead for the next round. I called Panera Benefits and cancelled the COBRA. That was an easy financial decision, but not so easy emotionally. Panera Benefits was my rock for eighteen months - they slew the date-of-death zombie and sorted out so many problems for me. I could call on them and they would use their clout to help me. They stood between me and all the entities that try to eat new widows. I appreciate them more than I can ever say. But I can't turn down a plan that gives me the same coverage for $350 a month less, with a $2000 lower deductible, especially when I could only COBRA for another year anyway.
The new coverage is good, but it brings frustrations with it. Hospitals and clinics that I've worked with for years have made the decision to not accept any insurance that comes through the Marketplace - they will only accept insurance through an employer or Medicare. It makes no sense to me, since their reimbursement is the same that it was through my COBRA coverage. Either the paperwork is more complicated or they are making a political statement. My cynical streak suspects the latter. No billing department will explain to me why they have made that decision, of course - that's private and confidential.
I can adjust to most of this without any problem. I'll have to have Joe take care of my asthma - there are no asthma specialists within two hours who will take my insurance. But I'd been considering that anyway, so the loss is primarily sentimental. I'll have to go back to driving to South Bend for mammograms. I have hospital options in Fort Wayne and South Bend, so an elective hospital admission would be no problem. But the only ERs that will accept me are an hour away. No hospital that EMS would take me to, would accept me. If I need an ambulance, every place within their range would turn me away. because I don't have private insurance. And that stinks.
If you were still alive, I'd be raising holy hell about that. That's because you mattered. If I need an ambulance, I don't mind just not calling anybody. I don't give the proverbial flying fig about my survival. But not everybody has that luxury. I know this will get worked out - it's one of the early bugs in the system, and it isn't sustainable. We went through a few years that our regular providers couldn't work out a contract with our insurance companies - we made our temporary adjustments, and they eventually realized that not having a contract with a  large insurer was hurting their bottom line. That will happen with the Marketplace, too. No provider can afford to cut off a large portion of their patient population. You can't cut off Anthem for long. I just hope I don't need an ER in the meantime.
Thank you for listening - I feel much better now. Venting to you has always made me feel better about things. I've made the only viable choice. I couldn't keep COBRA and keep the house. The money just isn't there. I had to overestimate my income to qualify for Marketplace insurance and avoid Medicare. It would serve all these providers right if I switch to Medicare - then they'd have to take me, but would make much less off of me. Oh, for the rule of common sense! I get to keep Joe for primary care, and that's what matters most. Everything else can go, including ERs. So there. Aren't you glad you're missing all of this?
Missing you so much,

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