Insurance Rant

January 7, 2014 at 2:44 PM Leave a comment

While we are lucky to have such good coverage for Eliana, it’s not without it’s headaches. We got a letter last week saying our nursing coverage is under review and we have until January 9 to send the insurance company a list of information for them to consider continuing the number of hours we receive. These hours are based on work hours, both mine and Hank’s, Eliana’s care needs, and the other kid who lives in the house–she needs some care too every now and then.

That’s how I understand how they decide if you qualify for in-home nursing coverage anyway. Nobody seems to know exactly how it works, and we’ve heard so many different opinions, we don’t know what to believe. We do know that it’s tough to sleep at night when we don’t have a nurse and worry that Eliana is going to get tangled up now that she’s starting to roll or pull out her NJ tube, which leaves us going to the ER the next day to have it reinserted.

The consensus on insurance coverage for nursing care is that a mom who works gets more nursing help. This makes sense, except when you consider that it would be nearly impossible for me to work 40 hours a week even if I wanted to. Someone has to clean the house, cook supper, set up and start dialysis and Eliana’s overnight feed, unhook her from the machines in the morning, take her to doctor’s appointments, make endless phone calls, and send emails about her care. Hank does all of these things sometimes, but hey, he does have to work full time, so I am the primary caretaker.

Here’s how I spent one recent morning: I put gas in the car and picked up some groceries after Eliana’s nurse got here and everyone got off to school and work. (Eliana had an early doctor’s appointment the next morning, so the car needed gas to get to the appointment.) I emptied the dishwasher, made Eliana’s food, straightened up the home office, checked email, had a snack, and tested out Word 2013 to see how it will work for editing. Now the IV nurse is on her way to check Eliana’s dressing, followed by early intervention’s physical therapist. After that, I carved out some time to work for two hours or so. Because I hadn’t yet.

I called the medical assistance office for the second time–they’re supposed to cover the Medicare premium but have not and we got the bill. Last time I got through to a real live person who put me through to a random voice mail. Now I can’t seem to ever reach a person, just an automated response that said, “Your call is important to us, but all of our staff is busy right now. Please call back later.” Somehow, I don’t feel that my call is important to them. Let’s hope these hassles are not a sign of what’s to come.

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Does your baby go yang? Lerner…table for 2.

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