Medical Insurance Ploy

My husband’s job switched medical insurance carriers in January 1.  He kept me listed on his insurance through his work (this is the only insurance we have, by the way).  I had to see my Orthopedic surgeon one last time in January, and get a lab test requested by my Internist.  They asked for all insurance cards (before providing care) which I dutifully supplied.  The bills for these were $110.00 for the orthopedic surgeon follow-up, and $51.70 for the lab work for my Internist.  Normally we get an “Explanation of benefits” statement from the insurance company which states how much they paid, and which requires nothing on our part but waiting to see if we receive a bill for co-pay amounts from care providers later.  In other words, I don’t normally look at these statements very carefully before filing them away.  This time, perhaps because we had just switched carriers, something kept nigging at my intuition to check the statement.  So this is what I found:

Under the “See Notes Column” – next to each line of amount billed, showing zero was paid out by the insurance company, was the following;  ”A”.  At the bottom of the form, under the heading “NOTES” was the following:  ”A-CLAIM IS DEFICIENT.  ACCORDING TO OUR RECORDS, ANOTHER GROUP HEALTH INSURANCE PLAN WOULD (my emphasize) BE PRIMARY FOR THESE SERVICES.  WE CANNOT PROCESS THIS CLAIM UNTIL WE RECEIVE THE OTHER INSURANCE PLAN’S DETAILED PAYMENT INFORMATION OR EXPLANATION OF BENEFITS (EOB).  PARTICIPANT SHOULD RETURN THIS INFORMATION TO THE ABOVE ADDRESS.  IF OTHER INSURANCE NO LONGER EXISTS, PLEASE CONTACT OUR MEMBER SERVICES DEPARTMENT OR AT THE ABOVE ADDRESS.”

Now first of all, we never had a secondary or other insurance, so of course I called them.  After three-to-five minutes lost in a computerized taped loop that asked all the wrong questions, a taped voice finally asked me for the option of speaking to an “associate”, which I naturally and readily accepted.  I was informed that the claim was denied automatically because of the possibility that we could have had other insurance (I assume they meant, if I was working in a job that provided insurance as a benefit).  I assured her that we neither have nor had other insurance and she assured me she would unlock payment as the status was currently pending.

So I’m thinking–what if I hadn’t looked over the insurance statement so carefully and then called them?  I would have received a bill from these two providers.  I probably would have paid them, thinking they were co-payment amounts (small as they were), and the insurance company–insurance we pay for with payroll deductibles–would have gotten by with their ploy.

And I’m thinking–crimony!  Don’t you think if I had other insurance I would have turned it all in and let them sort out among themselves who pays what first, second, and so on?  What right does an insurance company have to not pay because of the remote possibility (though hardly likely) a person could have insurance with more than one company?  That’s like your car insurance company saying they won’t pay for an accident because you could have bought car insurance from more than one car insurance company and they want you to prove you are only insured through them before they’ll pay… Yeah, like anyone can afford to buy extra insurance anyway.  Give me a break!

Real American Politics

Did you hear the one about Congress voting themselves ANOTHER RAISE at the same time they raised the monthly amount medicare recipients have to pay for medicare insurance, at the same time they denied a cost-of-living increase for social security and veterans disability and military pension recipients–IN THE MIDDLE OF A RECESSION?  And by the way, Indiana State employees did not get a cost-of-living increase either.  This while the cost of living continues to go up, foreclosure rates are still going up, there’s no appreciable decline in the unemployment rate, and (is anyone surprised) there are not enough homeless facilities or shelters to house homeless women and children.

This comes on the heels of their taking OUR tax money and giving it to irresponsible CEOs and SEOs so they can have even more millions and billions in salaries and bonuses.

Is anyone getting a picture here?  Does anyone besides me feel like our elected “servants” are slapping us in the face with the proverbial glove?

I find it interesting they have no will to fix the healthcare issue in America, when they have the best healthcare plan around, nor do they have the will to resolve the unemployment problem when they have only to put in one term and they retire with full pay for life.   Crimony!  Who thought that one up?  Most of us will work for thirty years or more and if we have any retirement at all, it will only be because we have paid into it ourselves–and only if some unscrupulous CEO or SEO doesn’t steal it all through bad or illegitimate investments which we will then reward him for making by paying him billions of dollars in tax money.

Isn’t there something we can do?  Oh wait, there is!  There is a law that allows us to take back their raise, if we will use it.  And next election, we can vote out of office every single person who voted for their own raise–EVERY ONE, across the board, no exceptions!  Now THAT would send a loud and clear message:  WE  elected YOU.  YOU work for US.  YOU do your job, or WE will fire YOU.

Utilities Police

Over the past several years we made some gradual and necessary improvements to our home.  We had the siding painted with an insulating type of paint that is guaranteed not to peel for twenty years.  We replaced all the old drafty windows with triple pane argon gas (highest insulating rated) and insulated edging.  We added insulation to the attic and some of the walls.  About a year and a half ago we were forced to replace our 30 year old non-efficient gas furnace, central air conditioner, gas dryer, and gas water heater.  We purchased highly efficient replacements.  The other thing we installed was a programmable thermostat.  We consciously began lowering the temperature to 68 degrees (winter) during the day and 66 or 65 degrees at night (winter), and in the summer setting it to 73-75 degrees or even not using air conditioning when open windows will suffice.  Also, we have a humidifier on our furnace, which helps.  In the winter we supplement our area heating with occasional electric heater use.  At about the same time, we began making a conscious effort to turn off all lights when not needed, to shut off the power on power strips to TVs, computers, etc. when they were not in use. We always use cold water when we wash our clothes.  And we turned the temperature on our water heater down to 120 degrees.

Now, to make budgeting easier, I have my gas and electric bills on the budget system.  This means they look at what last years bill was, estimate what this years bill will be, divide by 12, and charge me an equal amount monthly–which they adjust every January and/or June.

Last September the natural gas police came by and demanded to go through my home and quizzed me on what we had installed, done different, etc. because we hadn’t had much of a gas bill for two months and our gas bill had gone down quite a bit the winter before.  He then installed a new meter, claiming that our current one must not be working.  Ha ha.  Who uses a furnace in the summer?  We don’t even cook then, we grill outdoors.  Idiots!  Turns out they were upset because we had over paid so much we didn’t need to pay a gas bill for a whole year!  Now my budget payment has gone from $70.00 less monthly, to $100.00 less monthly, to $123.00 less monthly.  (Although I worry they’re setting me up for a big balance due come June, so I’m keeping an eye on it.)

Two days ago I got a new electric bill and was pleased to see my new budget payment went down $6.00 per month.  Today the electric company sent someone to replace our electric meter because it “probably hasn’t been changed in thirty years”.  In fact, it was replaced in 2001 when we bought the house.  At least the electric company didn’t insist on going through my home and inspecting every appliance I own to see if I was somehow stealing electricity from them.  Or maybe the gas company thought I went to all electric appliances.  What were they going to do?  Sue me?  Crimony!

Give Me A Pet Break!

Okay.  I’ve had it!  I have peeled the last of my three cats and two dogs off me, my desk, and my computer (while attempting to write the great american novel) for today.  I am sick and tired of rescuing books from animals who think I put them on shelves as pet toys, and of separating cat from cat, dog from dog, and dog from cat as they fight over my lap or some other coveted space to lie in or “toy” to play with.  Out!  Out!  Out!  I round them up (no easy matter, as the cats have learned to hide behind furniture to evade capture) and put them out of my home office and shut the door.

FINALLY.  Some peace and quiet.  Now, back to the great american… WHAT is that noise?  Scratch, scratch, scratch.  Whine, whine, whine.  Meow, meow, meow.  Growl, growl, growl.  Hiss, hiss, hiss.  Tromp, tromp, tromp.  Bark, bark, bark.  Crash, bang, slam.

Why can’t there be a place where you can dump your animals for a day when mommy is at the end of her rope and fears for the life of her pets?  You know, like they have for kids?  Why do pets think they have to hang on you every minute of every day?  Or that you have to entertain them constantly?  Crimony!  They’re worse than kids – they never grow up!

How did they go from being sweet, quiet, little things in desperate need of rescuing to demanding, clinging, monsters who run this house (and me) with iron willed paws?  All I can say is, it’s a good thing they’re pretty.

Call To Action On Homeless Issue!

At the risk of repeating myself, let me restate some of the background on Fort Wayne’s homeless issue from last year:

First there was that horrible ice storm that disrupted power and left so many without heat and electricity for a week or two or three during one of the coldest snaps in recent memory.  Within hours what stores were still open for business had sold out of kerosene heaters and emergency supplies.  A state of emergency was declared and the Memorial Coliseum, as well as several other facilities around the city and state, was opened up as an emergency shelter facility for people and even for pets.  Neighbors, friends, and family members hunkered down together to weather the circumstances in general community minded pleasantness and good old fashioned mid-western resiliency.

About a month later, after the debris was cleared away and people were once again tucked warm and safe in their own homes, I was watching the news on TV when a short news statement caught my interest.  The anchor woman said that there were not enough facilities to house homeless women and children, that the city of Fort Wayne said they had not known there was a problem because the homeless shelters had not informed them, and that they were creating a committee to conduct a ten year study and plan to solve the problem, meanwhile there were “unlimited” places available for homeless men.  I searched the TV and newspaper websites immediately and found only one short item on each which essentially reiterated what I had heard.  Over the next few weeks I listened to the TV (I don’t get a newspaper) and heard no more about this issue).

Now again, one year later, I am watching TV and there is a short news item that there are not enough facilities to house homeless women (this time children are not mentioned) during the coldest part of the year, there are “unlimited” spaces for homeless men, the city did not know about the problem because the shelters did not inform them, and the ten year study and plan is still ongoing.

I’m sorry but puhleeze!  Give me a bloody break!  The economy has been going down, down, down.  The jobless rate has been going up, up, up.  The foreclosure rate has been going up, up, up. (Meanwhile notoriously–compared to their corporate colleagues–lower paid state employees take pay cuts or get bumped on cost-of living increases and are asked to put in free days at work WHILE state and federal legislators vote themselves new raises) and NO ONE sees this coming?!

And puhleeze!  A ten-year study?!  Crimony, the whole STATE could freeze to death before they finish THAT one!  It’s 17 degrees (not counting any wind chill factor) outside today, TODAY!  If even ONE person could freeze to death out there today, isn’t that one to many?

Why can’t they use some of that “unlimited” space available to the homeless men?  Move over fellows, INCOMING women and children!  What self-respecting homeless man wouldn’t share.  Okay, so maybe they might want to temporarily hire a security guard to protect the women and children from the non self-respecting homeless men…how much could it possibly cost the city?  Less than a life is worth.

Why can’t they open up any number of buildings that stand empty?  All that is needed in an emergency is heat, a mattress, some bedding, sanitary toilet and shower facilities, and maybe a guard to protect the innocent from the not-so-innocent.  Why can’t they start there?

Why am I not hearing more people scream in outrage?  I don’t get that.  Where are the protesting voices?   Where are the bleeding hearts demanding someone do something, anything, even if it’s inept so long as it’s NOW, before it’s too late?  Is it because no one knows what to do?  Is it because so many are themselves so helpless to help?  Is it because these homeless are women and children?  Because they are poor and destitute?  Because we blame them for creating their own circumstance?  Do we even know who they are?  Do we even care?

Please, someone be outraged with me.  Add your outraged voice to mine.  If it’s happening in Fort Wayne, Indiana it’s happening all over this country.  Let us deluge our Mayors, Governors, Legislators, Congress men and women, President, media representatives…with our outrage:  Do something or we will take back your raises!

SEE ALSO:   http://espottickler.wordpress.com/2010/01/08/bureaucracy-at-its-finest/

Technorati Tags: women, homelessness, cold weather, men, homeless shelters, Fort Wayne, Indiana, bureaucracy, homeless women, homeless men, homeless children, children, pets, ice storm, freezing weather,

It’s a Dog’s World After All!

DOGS!  Can’t live with ‘em.  Can’t live without ‘em.

I just fed my two dogs (Stevie “Nicky” Nicks and Emma Jean)  their dinner.  Normally Emma gets one scoop and Nicky gets two. Tonight I decided to give Emma a few kernels extra in a second scoop because she’s been demanding more late in the evening and I really don’t feel like dealing with her bouncing off me and barking in my ear tonight (you think I’m exaggerating?).

I put the bowls down on opposite sides of the water bowl so they wouldn’t fight over their meals (even though they eat the same food–smells the same, looks the same, you get the idea).  Nicky wouldn’t eat.  She moved a few paces away from her bowl and looked at Emma happily scarffing away, then looked at me–with her head cocked somewhat sidewise, the white of her eye showing so that her expression looks almost human (it’s the guilt tripping look she gives me when she wants to say:  ”you petted another dog, you ate the last bit of your sandwich and didn’t give me any…).  I bent over and moved her bowl in front of her and encouraged her to eat.  She moved away again and repeated her body language.  I sat on the floor, moved the bowl in front of her, pulled out a few kernels and tried to hand feed her (sometimes that works–my groveling).  No, she only repeated her behaviors. FINALLY, I caught on.  Nicky saw me put the extra bit of food in Emma’s bowl.  Uh Oh!  She thinks Emma got something she didn’t, even though she still got more food than Emma (she’s bigger by 9 lbs.).

Now there’s only one thing that works in a case like this.  I took the two kernels from Nicky’s bowl that were in my right hand and put them in Emma’s bowl AFTER I took two kernel’s from Emma’s bowl with my left hand and put them in Nicky’s bowl (while Nicky studiously watched it all).  Sure enough, she began eating.  Crimony!

Some people say we humans are more advanced creatures than dogs, after all look at all the things we create, invent…look what we can do physically, that dogs can’t.  Personally, I imagine dogs smirk over this.  Why would they WANT to do these things when they have us to do it all for them?  Clearly they are the masters and we are the slaves, and they know it.

Bureaucracy At Its Finest

For the second year in a row Fort Wayne, Indiana has made a short news announcement during our coldest winter weather that “there are more homeless women than there are places/beds for them, but  there are unlimited places/beds for homeless men.  They are still working  on the ten-year study (which they began last year) to determine what to do about this situation.”  Gee…I wonder how many women will freeze to death in the interim?

Pardon me for being sarcastic, but it seems a little COLD and callous.  And why has no one thought to take some of the “unlimited” space available for homeless men and use it for the women?

The news didn’t mention if any of these homeless women have homeless children with them (that might actually incite people to do something about the situation) – but I’m betting they do.  The news didn’t mention how many of these homeless women are veterans who have returned from serving our country and are now at the receiving end of our undying gratitude – but given the known statistics, I’m betting several are.

Like last year, other than the short announcement on TV, I have heard no discussion, no public outcries, no questions… just silence.  Like the silence in which I imagine some of these women will breathe out their last frozen breaths, underneath some bridge or on some park bench, uncared for and past caring.  And by the time some men in their warm bureaucratic offices have finally figured out what to do about them, the problem will have disappeared into unnamed paupers graves and it won’t really matter anymore, will it?

LINKS TO ARTICLES ON THIS ISSUE:

http://www.indianasnewscenter.com/news/37601079.html

http://www.indianasnewscenter.com/news/local/79088332.html

http://www.indianasnewscenter.com/news/79004172.html

http://www.indianasnewscenter.com/news/53799992.html

http://www.indianasnewscenter.com/news/43370552.html

http://www.indianasnewscenter.com/news/local/41020042.html

http://www.indianasnewscenter.com/news/40314377.html

http://www.indianasnewscenter.com/news/39206542.html

http://www.indianasnewscenter.com/news/38609152.html

http://www.indianasnewscenter.com/news/37678949.html

http://www.journalgazette.net/apps/pbcs.dll/article?AID=/20091210/LOCAL0201/312109979

http://www.journalgazette.net/apps/pbcs.dll/article?AID=/20091222/LOCAL/312229984

the butterfly and me

i thought  she must have been there for me

that we should share the same closeness of moment

the butterfly and me

in all the immensity of space and time

but what a pretentious thought

-she probably had the same idea of me

and for more reason

for I sat admiring her beauty

A Jehovah’s Witness With a New Technique For Proselytizing: “Coffin Chasing”

If you’ve ever been in an accident, you have experienced your sudden rise in popularity.  Letters pour into your mailbox from Attorneys offering their services for your lawsuit (the one you had no intention of making).  Worse yet, they use all manner of persuasion to get you to call them.  Some Attorneys will call you at home, usually at the most inconvenient times, to solicit your business.  This might explain the apt nickname such Attorneys have garnered, “ambulance chasers.”

COFFIN CHASERS

A few weeks ago a close relative died.  We received several cards, calls, and notes of sympathy and condolences from other family, friends, and acquaintances.  These helped us to feel cared about, even when some clearly mentioned ideology, beliefs, and religious persuasions that differ from our own.  There was no attempt, in these, to proselytize us.  People who know and care about us simply poured out their love and support in whatever ways they were able, and we were grateful.

Two days ago, I received a letter that has taken “ambulance chasing” to heights before unknown.  I call it “coffin chasing.”

It arrived in a hand addressed envelope, written by someone in our town (who used a Post Office box address, and whose name – first initial and last name – I shall not mention).  No one in my family knows this person.  Inside the envelope was a rather prettily designed sheet of stationary and a pamphlet from the Jehovah’s Witnesses.  The letter is computer generated and in a handwriting type of font.  It begins without any salutation to us, nor is our name mentioned anywhere in the letter.  At the bottom of the letter, in smaller block print, is the following:  “For Additional Information:  www.watchtower.org.”

The letter begins:  “I’m writing to express sympathy to you on your loss as reported in the newspaper.”  It doesn’t mention the name of our “loss,” or his relationship to us.  It then continues with three paragraphs outlining the writers beliefs, in a clear effort to proselytize us to convert to his or (most likely, judging from the floral stationary) her religion.  It reads like, and looks like, a “form letter,” the kind most often received from businesses regarding far less sensitive issues.

Sensitive being the key word, I found the letter writer to be highly insensitive, insulting, intolerant of others religious beliefs, and clearly lacking in the social skills necessary to function well in a community of diversity.

I am most incensed by the writer taking advantage of our grief, to push her or his religion on us at a time when we are vulnerable emotionally.  Clearly, we are not the first to be subjected to such egregious tactics.  I worry how this may affect others, who are perhaps less discriminating and more vulnerable – for example, the elderly.

On my front door is posted a sign, “NO SOLICITATING.”  It is designed to keep door-to-door sales persons of all types (commercial and religious) from disturbing me in my haven of peace, which also happens to be my job site (I work from home as a freelance writer and communications consultant).  Do I now need to post one on my mailbox?

I hope the writer of the letter is just one person among the Jehovah’s Witnesses who is acting so unethically and immorally.  Somehow I doubt it.  The letter smacks of company endorsed advertising and marketing tactics.  Having heard their schpiel before, since Jehovah’s Witnesses must earn their salvation through proselytizing every last “heathen” on earth, I want to scream:  “Enough already!  I am beyond your salvation.  You did your best, now go to Hell and leave me alone!”  And I would scream it, if they believed in Hell.

I assume all 144,000 slots in Heaven for Jehovah’s Witnesses (JWs) have by now been spoken for by those JWs audacious enough to self-proclaim themselves by the act of taking their once yearly communion.  (Only JWs certain of their Heavenly calling as one of the 144,000 are allowed to take their communion.)  The rest of the JWs, in good standing as such, will be relegated to living on earth in the JWs version of “paradise.”  This is, of course, after the Earth is purged of “heathens” in what JWs call “Armageddon.”  One wonders how much Earth could possibly be left for paradise after being deluged by fire and brimstone.  JWs have been proclaiming Armageddon as imminent since their beginning as a religion.  In fact, JWs have been setting (and resetting, when the targeted date passes without incidence) the date for their Armageddon as regularly as some people go to the bathroom, thanks to fiber and that new yogurt.

Personally, I couldn’t live with that much drama.  I have known of JWs so devout they quit their jobs and divested themselves of everything they owned in preparation for the upcoming date of Armageddon.  I wonder what they did when the date refused to produce the expected result.  No doubt they filed for the “heathen’s” welfare benefits, until they could rebuild what they gave away.

I have read accounts of JWs who were proud of their assignments as Cappos in concentration camps, because they were chosen for their “honesty and good character” – which they equated with being a JW – (meaning they did whatever the Nazis told them to do, and didn’t try to escape).  I rather doubt the Jews they policed thought so highly of them (I know at least some of them didn’t).  Apparently, neither did the Nazis, since the JWs proudly proclaim that some of their own were also incinerated.

I am also familiar with the technique of taking scriptures out of context to “prove” beliefs held, and of ignoring the interpretations and meanings of those in whose language that scripture was written, and whose religious tradition wrote it.

So you see, I am well versed in their story and have no desire to hear it again, especially from strangers posing as caring friends.

Book Review of “Mrs. Kimble” by Jennifer Haigh

Mrs. Kimble, by Jennifer Haigh

SYNOPSIS:

A chameleon, an enigma, all things to all women — a lifeline to which powerful needs and nameless longings may be attached — Ken Kimble is revealed through the eyes of the women he seduces: Birdie, his first wife, struggling to hold herself together after his desertion; second wife, Joan, a lonely, tragic heiress who sees her unknowable husband as her last chance for happiness; and Dinah, a beautiful but damaged woman half his age.

Haigh is a graduate of Iowa Writers Workshop.

MY REVIEW:

Haigh’s first novel is a good read.  Well written.  It presents four women, really, who all fall for the same guy.  All four women are fooled by him, are used by him, are in some way discarded by him.

We never find out what happens to the teenager he leaves his first wife for, then dumps for his wealthy second wife.  The first wife degenerates into a hopeless alcoholic until late in the book, when she seems to find redemptive love with an old forbidden childhood flame.  The second wife dies of breast cancer.  The third wife actually has the chutzpah to have an affair while married to him.  She gives it up after Kimble has a heart attack.  When Kimble later skips out on her and their son, also leaving behind a financial scandal, her renewal of that “illicit” relationship is redemptive for her.

In the end, which is how the book really begins, Kimble dies alone, the way he has really always lived.  Haigh never tells us why he is the way he is.  She only presents us with the debris he leaves behind as he self-centeredly crashes through lives.

Kimble reminds me of a salesman that sells you new windows for your home.  Top-of-the-line, guaranteed for life, free replacement if ANYthing goes wrong, company’s been around 25 years… Six months after installation he calls to check on you, is everything OK?  Do you need siding?  One year later someone calls, how is everything?  A year and-a-half later one of the windows is having a problem so you call to have it fixed.  Someone says they’ll send someone out that day.  No one shows up.  So you call the next day.  Same routine.  Six months later (and how many calls?) someone finally shows up.  He says he’ll order the window.  Replace it next week.  Next week you call because he never came.  No one knows anything.  Six months later they’re still trying to trace it down.  Six months later the company doesn’t exist.

By now you’re crazy.  But it’s partly your fault for hanging on so long.  For believing.  For not doing something, anything, different.

MY RATING:

3.5 stars