Wednesday, November 16, 2016

How Aetna Failed My Child

So, I have all of these blog posts in the works, but I have to interrupt everything to let you know about something that I just learned about insurance and my college kid.

As you know, my daughter Vega was catastrophically ill this past spring with something that turned out to be vasovagal syncope, complicated by the rupturing of an ovarian cyst and some medication side effects. It took us almost three months to even figure out what she had, during which we saw doctor after doctor and had test after test.

During that time, our abysmal health insurance paid for very little of her treatment. In fact, in the middle of one appointment, with the cardiologist we liked best and who seemed to actually be invested in diagnosing and treating Vega, we were informed that the front desk had made a mistake and the office didn't accept our insurance after all. Appointment over. We were ushered out and referred to another cardiologist and had another wait to try to get into to see THAT doctor.

Those were some good times. Because you know what's SUPER fun? Having your child pass out in a doctor's office and not being able to actually receive medical care there. Seriously, she was in distress, we were both near tears, and I had to load her into a wheelchair, get her to the car and take her home. All those doctors right there in that office, and no help available because they didn't take our insurance.

Our insurance company is Aetna.

Vega's father and I are self-employed and we get our insurance on the open market. In Texas, because of its powerful insurance lobby, the options are awful and more awful. After PPOs (Preferred Provider Organization) were no longer supported or offered in the marketplace, what seemed like the next best option for us was an Aetna EPO (Exclusive Provider Organization.) This way, we could still see the physicians, like our Pediatrician, with whom we had long-standing relationships.

But here's the thing we didn't know: we are only able to see physicians in Texas. The plan has limited coverage for emergencies if you travel outside of Texas, and you can just forget about coverage for ongoing medical conditions or prescription refills if you are, say OFF AT COLLEGE AND NEEDING A LOCAL DOCTOR.

I had no idea.

In fact, we declined the health insurance through USC because we were already paying $1,500 per month ($18,000 per year) for our family to be covered by Aetna.

And because it never even occurred to us that our health insurance wouldn't actually pay for Vega to see a doctor in California. In fact, before she saw the doctor, she got a referrals from the student health center for doctors who took Aetna, and when she saw the physician, his office only charged her the co-pay because they thought she was covered.

Obviously, had I known otherwise, I would have made other arrangements. I never would have sent my medically fragile child off to school without decent health insurance.

Except I did.

I'm writing this at 3:00 AM after having jolted bolt upright with the realization that if something medically catastrophic had occurred, she might not have been able to find a doctor to treat her.  In a way, we got so lucky --we found this out through a routine appointment in order to get her meds refilled. We got so lucky that her health improved so much that this was the only medical care she needed in her first semester at school. And we got lucky because our experience with Aetna is almost over and we will NOT be doing business with them again.

So, as always, learn from my experience. Nowhere, in any of the literature I read about sending a kid off to school (and you KNOW I read a lot!), was there the slightest suggestion that I should make sure she would be covered by my insurance in another state. We submitted our proof of insurance to the University with full confidence that she had adequate protection against something bad happening.

I am so tired of my healthcare, and the healthcare of the people I love, being held hostage by insurance companies. We need a better system. But failing that, we need a system that doesn't operate under shadow rules and fine print.

If you have a kid at college, are you SURE that he or she is covered by your insurance, even if he or she is going to school out of state?

Ask the questions.  Don't be like Barb.

Saturday, November 12, 2016

Wow, What a Week



Anyone else here wondering how to identify the truck that just ran us over?

So, the country has elected a President who does not reflect my value orientation. I think it's safe to say that when the Ku Klux Klan holds a parade to celebrate your election, you and I are NOT on the same page.

But there it is. He's the President-elect, and now we have to figure out what to do about it.

A lot of my friends have been talking about moving to another country. Some of my friends are not even joking about it. Some people are actively making plans. So many people were exploring their options that the Canadian Immigration website crashed. (Me? I thought longingly about New Zealand. It's so beautiful there. Plus: one of my favorite artists ever lives there, Jennie deGroot.)

But here's the thing: I can't abandon the people and populations I love without a fight, because they are going to need me. People of color, people with disabilities (how I wish that when I thought of Donald Trump, I could get the visual of him mocking that person with disabilities out of my mind,) the poor, the elderly, anyone who identifies in the LGBTQIA spectrum, immigrants, refugees, our beloved planet--all of these populations and things NEED US.

Now more than ever.

This country needs our collective heart, our compassion, our energy to work for inclusion and policies that take care of the most vulnerable among us. America needs us. So, we can take our ball and go home, or we can work to change the rules of this new game we're playing so that everybody gets to suit up.

Remember this column, A Warrior for Peace? I feel that same calling right now.  I've grown complacent.  I've been so focused on the upheaval in my own family --illness, divorce, teenagers --that I forgot my larger goal of changing the world through unrelenting kindness, compassion, inclusion, advocacy, and intervention. I'm getting to work right this second on behalf of the causes and populations who need me. I'm raising money for women's health, for refugees, for my people outside of the gender binary, for climate change, for people with disabilities.  I'm volunteering my time, my energy and my talents on behalf of those who do not feel safe or welcome in Trump's America.

Remember this famous poem by Pastor Martin Niemoeller?

First they came for the Socialists, and I did not speak out—
Because I was not a Socialist. 
Then they came for the Trade Unionists, and I did not speak out—
Because I was not a Trade Unionist. 
Then they came for the Jews, and I did not speak out—
Because I was not a Jew. 
Then they came for me—and there was no one left to speak for me.

I will use my voice and my privilege to speak out.

I will not be silent.

If you'd like to join me, please leave your plan of action in the comments--we could all use more ideas! Any organizations of social justice or change that you support?  Tell us why. Every positive action is welcome here --from buying a cup of coffee for a disenfranchised person, to marching on protest, to volunteering at the local food bank, to helping settle refugee families, to writing letters of support --anything that taps into your personal privilege and power for the benefit of those outside of the straight, white, Christian paradigm.

And if you are one of those people who feels afraid because you don't feel welcome in Trump's America, know that this is a safe place to speak of that, and that I will do everything in my power to protect you.

(Just a reminder about the comments: I welcome and encourage civil discourse. But if you comment intolerant or hate-filled sentiments, I will delete your comment. My blog wears a safety pin.)