Saturday, June 11, 2011

Insurance Annoyances

I have had my share of insurance annoyances over the years, but ever since joining government service, I've tried to minimize the headaches by carefully researching plans and making realistic choices for my health needs.  So I'm unimpressed by the insurance headaches I've encountered since being home.

My previous insurance, a modified consumer-driven health plan, worked very well for me.  Preventative care was paid for without deducting from my fund, dental care up to a certain amount was covered each year, and I had ancillary vision benefits.  I also have elected to get additional vision benefits each year so I could get glasses/contacts fairly often.

However, when I moved overseas, I decided that the tailored FS plan (most of you know which one I mean) would be the better choice.  People said it worked well even in the US, and my PCP was in-network.  The price was comparable, the estimated out-of-pocket expenses would be comparable, and if anything catastrophic were to happen overseas, it seemed the easiest to deal with.  (Having had my fair share of overseas medical concerns, I wanted something easy to work with.)

This has not panned out in reality, sadly. 

The new plan only covers a few dollars for dental, so the x-rays I needed this week and the small cavity I had to have filled are all out of pocket.  They would have been covered except for a few dollars overage under my old plan.

The worst, though, is that all of a sudden my PCP is no longer in-network.  I know I checked before switching plans, but when I went in for my annual exam the other day, they didn't seem familiar with the company.  A bit of digging revealed that they are not, in fact, an in-network provider.  And I'm not willing to pay out-of-network costs.  Plus, I am not home long enough to research providers and establish myself as a new patient with someone else.  And I like my PCP.  So, I am going to see if I can do my annual in KSA just to make sure I have continuity of care. 

I am considering switching back next open season to my old plan; the $750 deductible after primary benefit funds are exhausted and before 90% coverage kicks in seems a small price to pay.  Especially because in 16 months of care I never came close to exhausting the primary coverage fund.  The only downside is that I lost the initial fund I'd built up and will have to start from scratch again.  With this current plan I have a $300 deductible that starts immediately and no primary coverage fund.  Plus prescriptions are out of pocket instead of coming from the fund. 

The kicker, though, is that my vision plan is fairly limited for in-network providers at home in NH.  It was great in DC, but there's less choice here, unless I want to go to a big box store super retailer.  Which I don't.  I thought today I'd found a great small practice in southern NH, where I am going this week for shopping anyway.  They said they took my insurance on the website.  But when I called, they said they stopped taking this plan.  The receptionist was slightly unsure because the plans she quoted weren't mine exactly, so the office manager will check Monday.  But I can't find another good place right now.  I don't really need an exam - I mostly want new glasses and prescription sunglasses.  My foray into the world of contact lenses lasted about two days last summer before it became painfully clear that I am inept at inserting said lenses.  Even when I was sitting in the optometrist's office and demonstrating the technique they couldn't figure out why they wouldn't go in.  They wouldn't go in for them, either, so I felt a bit justified.  But it's still frustrating.  I really only need glasses for distance and driving and watching movies, few of which I do in KSA, but the prescription is light enough that I can wear the glasses all day without eye strain, which I often do when I'm going in and out of meetings where I need to read presentations.  And in KSA, having prescription sunglasses would be ideal. 

Still, these headaches are minor compared to the ones I used to have with some of the more annoying companies I used to have to deal with.  I'd spend hours on the phone convincing the insurance company that, yes, I did need an MRI on my knee or that, no, the knee surgery necessitated by the tear shown by said MRI was not, in fact, elective.  I am still paying off that surgery, as it cost far more than the insurance company allowed.  Or electing not to go to the ER when I first injured my knee since I, at that time, didn't have an extra $250 to spend just to walk in the door before insurance kicked in.  My personal favorite, though, was convincing the same insurance company to pay for 6 months of malaria meds instead of 3 months, back before I lived in a place where I could get meds shipped by mail.  I itemized the cost of medevacing me when I developed cerebral malaria versus paying an extra three months of prescription costs up front.  I finally got my meds. 

Thoughts?  Have any of you had concerns Stateside with the FS plan?  Run into difficulties with serious illness with a consumer-driven health plan(CDHP)? 

Thursday, June 9, 2011

Why... It's Astonishing!

It's raining - and the streets aren't flooding!

Women are wearing t-shirts in public!  And driving!

There's pork and alcohol being sold at this store!  There's pork and alcohol being consumed at this party!  There's a party with men and women! 

It's 12:30pm, and the stores aren't closing for prayer!  (Or 3:40pm, or 7:00 pm, or 8:30pm - choose your prayer time!)

Wait, you mean there's only one entrance to this restaurant?  And I can go in it?  And sit wherever I want?

Whoa!  Look at those cars stopping for the red light!  And using their turn signals!  And turning left only from the left-most turning lane!

There's no air conditioning inside any of these houses!  (Wait, this one I don't like...)

That pretty much sums up my experience at home so far.  Lots of exclamation points (mostly in my head) and shocked disbelief at the blatant displays of heavenly vice.  And mostly lawful displays of driving, including by a large number of women. 

I've also been taking advantage of fast internet and downloading copious amounts of music and books and watching lots of Netflix and Hulu.  I forgot that it doesn't have to take an hour to watch a 20 minute show on Netflix...  I really miss fast internet.  I have gotten my fill of real commercials but still don't miss the AFN PSAs.  I love watching the Red Sox and Bruins win often and then watching the Heat lose.  May those streaks continue tonight as well.  I never thought I'd be cheering for the Mavericks, but I am doing so with fervor now!

Last weekend the whole family drove down to Newport, Rhode Island to watch my cousin marry his college sweetheart.  It was a gorgeous wedding and a perfect weekend for a perfect couple, and we had a wonderful time.  I don't ever want to go to a wedding without a 'lobster display' again!  Lobster claw tempura may be the best food ever.  My nephew was the ring bearer, and, despite not having a lot of context or experience for his role, he performed admirably.  (And stood still and quiet through the entire ceremony!)  He was a little miffed that he didn't actually get to carry the rings, but the pillow was pretty sweet.  And he looked so gosh darn adorable in his suit!  He fell head over heels in love with the bride last summer when he met her, so being in the wedding was perfect.  And he got plenty of hugs from his "girlfriend", as he calls her.  Which is a step up from "my older lady friend", which was last summer's term of endearment.  Keep in mind the child is only 4. 

It's been doctor and dentist visits and lots of reading and napping since then.  I don't get Blackberry service at home or even in the vicinity, so I haven't been even tempted to check email.  When I did send a colleague a quick email about how one of our contacts factors into a current US news story, she sent back a much-needed "thanks, we know, now enjoy R&R," email.  A good reminder to just relax.  Which is slightly hard to do as I watch the news coming out of Yemen and the saga of women driving in the Kingdom, but I'm trying. 

I am going to see one of my childhood best friends and her family this weekend after too many years, about which I am thrilled.  More on that next week.  Then, next weekend, a long weekend in Miami for another cousin's wedding!  My mom and I are going to stay in Key West for a night so I can eat conch fritters and stock up on key lime juice.  Yummmm.  Among other touristy pursuits, of course. 

The first tranche bid list came out today.  I of course won't see it until I get back, which is fine with me.  Second tranche comes out soon enough (when I'll be bidding), and too much of a glimpse into what's NOT on my bid list will be anxiety-inducing.  I have my top five or six dream posts, and several of them are probably not anyone else's dream posts (or at least I get really weird looks from people, including the Ambassador, when I mention what they are), but odds are at least half or more of them won't be on my bid list.  So not knowing what might be on there is making me a bit crazy.  Let's just say I don't plan to use my equity to bid Europe, as so many others coming out of KSA do.  To each their own! 

Happy bidding to many of my friends and colleagues!  I'll be asking for advice and recommendations soon enough...

Can you please just email me a copy?

Ah, home sweet home.  It has been a great week, and I've meant to blog, but you know how it gets.

First, I want to congratulate Sara from Wife-Mommy-Woman and her family on their newest baby boy!  I'll let her announce his arrival on her own blog, but I just wanted to say how excited I am for her and the whole family, having gotten to 'watch' the pregnancy on FB and blog.  Congratulations!

Becky at Small Bits is hosting this week's Round Up on a very important FS topic - paperwork!  This is one I could write volumes on, but I'm thankfully not surrounded by the mountains of paperwork I need to go through in my apartment (just the mini-mountains of catalogs and junk mail here), so I am less than inspired.  However, the title of this post pretty much sums up every encounter I have with anyone these days.  When someone helpfully offers to mail/fax/print me a hard copy of something, I cringe and ask if they can do it digitally. 

It's true that paperwork tends to pile up on you in the FS, especially the first year.  A-100 must surely stand for "A 100 inch-high pile of paperwork will be the most tangible result of the next five weeks."  Add to this the need to go through all the paperwork you've accumulated thus far in your life, and it's a daunting amount to deal with.  I am trying desperately to cut down on hard copies of things and had several quite ruthless bouts with a shredder last year.  I bought a scanner/copier/printer combo, which has made life much easier - especially being able to scan hundreds of pages of medical records and the like.  Then I can put the originals in safe storage and keep a couple secure digital copies spread around. 

I am really bad in that I don't deal with paperwork as it piles up.  Instead I pile and pile and pile until it a) falls over or b) attacks me in some way.  Then I put on the television, cozy up on the floor with my X feet-high pile, and start sorting.  It's amazing what you find.  Expired coupons, cards and letters, important insurance documents, papers you've been looking for forever, etc.

The greatest find ever was an un-cashed paycheck for $1,000.  I was so incredibly excited and over the moon but confused over how I'd missed it before.  It was a day or so before I found the matching re-issued check; the first one had gotten lost in the mail, so I'd had my employer re-issue the check.  I never remembered to open/void the first one when it finally came.  Oops.  (This was from a time when I was working about five jobs and traveling a lot, so some things fell by the wayside.)

Right now I have about four or five rubbermaid totes full of paperwork dating back to high school, college, and grad school that I need to go through.  I shipped them with my HHE with the hopes of having an entire room for sorting and shredding.  Of course I ended up with a smaller-than-Oakwood apartment, and they're stacked high in my box room (the tiny second bedroom that is unusable because it's stacked floor-to-ceiling with HHE boxes or piles that won't fit elsewhere because I was under the impression I'd have a human-sized apartment and shipped a generous amount of HHE hoping to sort and shred and give away).  Okay, rant over.  The good news is, once I finally do go through them (which ought to be lots of fun with the kittens!), it'll cut down significantly on my HHE weight to my next post!

I don't have a lot of advice to offer in the FS paperwork genre, but it definitely consumes a lot of time and energy for all of us.  I look forward to reading some other posts to get creative ideas.  Looking through some of Becky's recent pack-out-preparation posts has already been really helpful!

All right, that's a fairly boring post, but it is topical.  Be glad there are no pictures.  I am going to write a quick catch-up post now about the last week.