Friday, November 15, 2013

Thankfully Unnecessary Drama

Things have been going relatively "same old same old" up until a couple weeks ago.  I'll share the greatly abbreviated version of the rollercoaster ride.  Just so there's no suspense (where's the fun in that?) things are ok and back to the status quo for the time being.

I knew that COBRA would be expiring at the end of November but I misunderstood the extension process and didn't put in the paperwork at the appropriate time. The appropriate time would have been within 60 days of the SSA saying he was disabled. That was soooo long ago. I talked to the insurance and she said to get her some paperwork and she would submit it anyway. I got her the only paperwork I had but that wasn't right so I had to call social security (not an easy feat) and they said that's the only paperwork they got but they could send me a letter with the additional info. I was shocked when I got the letter the next day, thank heavens for the local SS office, and emailed it to the insurance later that day.  I sent it on a friday afternoon and monday morning when I woke up I had an email saying the extension had been approved.  So fast. GIANT WHEW!

There's still a chance that we'll be changing plans because of the ACA stuff becoming available but we really have to just wait that out. The plan he has now will be changing in January because the company is changing all their plans so we have to wait for paperwork and find out if the cobra premium is changing and if another plan would better suit us.  This ACA stuff, while making it easier for some, is really adding another level of complexity to an already complex situation. We're not really stressed about it because there isn't anything we can do so we're playing it by ear and making backup plans for a variety of situations.

The day we got the good news about the extension the hospice nurse came to visit. She was talking about his re-certification and I asked, "Are you saying you're worried he won't be eligible for hospice?" She said that yes, that's what they were worried about.  When the doctor came out to visit he explained that if David were on Medicare he's not sure if he would qualify under their guidelines because he's not declining fast enough... I... what? Oh and he's not improving so he's not technically not eligible for home health either. Stress. But private insurance has been covering hospice, not medicare. The doctor said as long as insurance was covering it it would be ok. I asked if he was worried about the re-cert this time and he said no.  The next day the nurse and social worker came out to tell us that it looked like he was getting discharged the following thursday because the Dr said he wasn't eligible anymore.  That's not what he said to us... Confusion and stress.  The next day they said they talked to insurance and they said they would likely be covering it but they had to review the case. That was friday. Wednesday (2 days ago, 1 day before he was to be discharged) they called to say that they had written notice from insurance saying they'd cover it. 

This insurance has been such a blessing to us. They saved the day with both issues and how quickly they responded. We honestly don't know what we'd do without them.
So there's our fun temporary drama. Things are back to normal so to speak. I'll fill in more details later and maybe post fun stuff. For now I'm just tired. :)

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