I’m gazing out the window, trying to decide what I want to write about, and I’m really looking at just a wall of white. There’s a very thick fog out there. I can’t see the ocean. My dog obviously sees something he keeps barking. I’m not in a happy mood today. I’ve got two things I’m dealing with insurance about, one for me, and one for my daughter and I’m just so fed up with this stuff.
I got a call last week that my insurance didn’t approve the occupational therapy. They’re stating that I get 20 calendar days total for both occupational therapy and physical therapy. Which ironically was my original thought to begin with and why I never did occupational therapy. However, according to my therapist and the business department they verified that I have 20 days of each. So now I did two days of occupational therapy I’m not covered. Now they’re doing some peer to peer review and I don’t know what’s gonna happen. I was excited by occupational therapy, it was the first time I was doing work on my hands that so desperately needed that kind of therapy. Now I’m just waiting to see what will happen. Worst case scenario I do the maintenance for a month and I am Medicare eligible as of July. Just aggravating, I just wish I get the right answer the first time.
Yesterday in the mail comes a denial from my daughter, who has the same insurance I do, for her cochlear implant mapping. Understand it took us weeks to get the referral approved to go to the doctor to begin with. Then we get the referral and then they deny the payment for the office visit. WTF!!!! The kid is been deaf since she’s three years old. She needs a yearly mapping and they are now saying they don’t cover this appointment. It’s just another fight with the insurance. All I do is fight with the insurance.
Now that I’m going to be Medicare primary, I really want to change this insurance. My problem with the changing of the insurance is my aid. I’m not sure if it’s going to be a smooth transition to a another insurance company with my aid or if I will have a block of time that my aid won’t be in effect. That’s on my next list of phone calls I need to take care of. That will be days of phone calls too. It is the secondary insurance that pays for my aid. They also will become secondary to any, insurance co-pay Medicare has. I have to get this all worked out by June 15 so we can go into effect by July 1. Also I don’t want to lose the aid I have, so I have to make sure that I either have my current agency or her other agencies she uses so I can continue to use her. Just more aggravation.
It’s a good thing I don’t have a full-time job, because calling and dealing with my insurance is my full time job. I would say I am fighting with them about something at least once a month. Nothing ever goes smoothly. I should’ve drop this along time ago, and I just didn’t. My mistake.