Setbacks

I was doing fairly well last week–I was eating mostly according to my plan, which involved eating a sweet potato for one of my meals, and having an apple for one of my snacks, and I had increased my water consumption, meeting my goal of nearly a gallon two days in a row.

And then the baby had his belated six month checkup. My insurance coverage through the marketplace ended at the end of the year, but this is not open enrollment on my husband’s plan so he had to apply to add me and the baby, which shouldn’t have been a problem. They couldn’t add us until the coverage had actually ended, which was on 12/31. He added us immediately on the first, but when we got to the doctor, they couldn’t confirm the baby’s coverage.

They made us wait for an hour past our appointment time, and then we asked them what the problem was and they let us go back. The nurse said, sorry, they said there was an insurance issue, but since you’re self-paying now, that’s not a problem. We immediately said, no, we’re not self-paying. The insurance is fine, it might be a little delayed but it will work. And she said, I can’t give you the vaccines until we get this resolved.

Remember, this visit was already very delayed, nearly 3 weeks past when he should have gone, because we had to delay it because of the surgery. At this point I’m thinking about vaccination schedules getting screwed up and him having to take more vaccines at a single visit than he should need sometime in the future.

The husband is calling his insurance, talking to the people at the front desk, and I was just sitting in the exam room crying because I didn’t know how it was going to work at all. What if they never let us on the insurance and the baby isn’t covered for this? This is not a great time to be relying on the marketplace.

Finally they agreed to give us the shots even though the insurance situation was not resolved.

The good news is that the baby had gained an entire pound in the 8 days since he had seen his surgeon. The bad news is that he’s still too small. He’s a preemie, but not a severe one–he was born at 36.5 weeks–but he’s sitting at 8 percent on his weight and 13 percent on his height.

The really bad news is that his reluctance to roll is a real problem now. He has to get it together or when we go in at nine months he’s going to be sent for evaluation for developmental delays and baby therapy to teach him to roll.

And by this point I was basically in a tailspin. The insurance concerns, plus his weight and height problems which are definitely because I couldn’t stay pregnant longer, plus his developmental delay on the rolling, also because he was early…it was so bad.

Then I started to get emails from the older kids’ schools about their science fair projects, referencing things I had never heard of which means that the schools are once again not communicating information to me, despite my many many requests that they give me a copy of important information. It also means that once again, my ex is in total violation of the court orders because he has to keep me informed.

It was a bad day. I ate everything. And I spent the entire weekend trying to get myself back in line. I need better strategies for handling these kinds of meltdowns. But until the insurance situation is resolved I can’t go back to therapy, either.

ALSO it’s worth noting that I once again tried to fight the good fight with Humana and am still not making any progress. I have 3 outstanding issues with them:

  1. They double charged me a premium payment legit 2 years ago, January 2015. They acknowledge that they definitely charged me twice, but refuse to refund that second premium payment.
  2. They inexplicably refuse to pay for my c-section. I met my out of pocket maximum, but they won’t pay my OB for the c-section so I have a 500 dollar bill over my head for that procedure and they keep saying that I have to pay for it myself because they SHOULD have processed that payment first but didn’t, so…I don’t know. They want me to get the hospital to refund me what I paid them and give that money to the OB? Does anyone think the hospital will refund me that money? No, no they will not.
  3. They also inexplicably refused to pay for my therapy, just during October. The therapist says they did that to EVERY patient covered by Humana that month but they aren’t fixing it for anyone either. So now I owe my therapist hundreds of dollars.

Can I take Humana to small claims court, do you think? It’s so terrible. It’s like 2k that is wrong here, between what I’m being billed for and what they owe me.

 

 

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