Then we got the phone call...the insurance company refused to authorize payment for his surgery because they deemed his torn meniscus being repaired "not medically neccesary". 😡 Seriously, th fact that he is in pain and that the injury is just going to get worse and require a more invasive surgery as time goes on does not matter to them. UGH! Jeff was so angry and quite frankly, so was I.
Our surgeon is going to call the insurance company on Monday and try to get things authorized. I also have a friend that works for another health insurnace company who said she would help us out with exactly what paperwork and "phrases" along with coding, that will help his case. She shared that insurance company claims people are trained to find any way they can to turn you down and not have to pay out. Yeah, she is not a fan of that either.
Jeff's surgery was cancelled for this coming Tuesday and they are booked up Thursday, then the surgeon is on vacation for a week. He only does surgery every other week so we are looking at another month or more before he could even get in if it is approved.
OK, so now we wait...but there is more that could delay it even further. Jeff has applied for a different job and passed the first interview. We are waiting to hear on the second one (hopefully we will hear this week). If he gets this new job, with the same company Jaysn works for, we will have a cut in income, but we will have much better health insurance with a savings of about $500 a month in premiums costs for me alone. His will be fully covered. We will also be able to access the clinic at the work place and not have to pay for each office visit. They have a partial pharmacy right there and the medication costs are super low. The other benifits are amazing and we are really praying he gets it. He will have to give 2 weeks notice at his current job though, so that could stretch things out even further.
Oh yes, there is one more little thing, and you may think I am crazy for even thinking about this but here it goes. This Wuhan virus that is making it's way around the world, is scaring me. I don't want to be at a hospital if it makes it's way to our area. I'd much rather hole up at home and limit our contact with other people. I don't get viruses that often anymore since I have quit teaching, but when I do, they hit me really hard and it takes me about 3 times as long as "healthy" people to recover from the virus itself. It also sends me into a bad flare that takes months to recover from. We do live in an area that has many international students and business people coming in and out with the colleges and companies that do business with the world.
I've been adding to our pantry and HBA supplies to make sure that we do NOT have to go out and shop for up to 2 months if needed. I did this for two reasons...the cut in income and in case either Jeff or I get ill. It is a given that with my health limitations as it is, having a stocked pantry is a very needed thing. It saves time, money and stress for both Jeff and I. I'm also trying out Imperfect Foods home delivery service. I got my first order and overall, I am happy with it. I did have a problem with one piece of fruit and them messing up on one of the items, but was quite pleased with the quick response I got from the company when I contacted them. They are crediting my order for the lemon and for the item they forgot to include (they put a different item in by mistake and told me to just keep that one also) and gave me another credit on top of that. I love that they deliver right to my door and I can customize my order to fit our needs. I really do think they are good value for the money since I can get produce, snack items, cheese, meats, etc, from them. I can also schedule my deliveries for every week, every other week, or suspend my account at any time. I love that flexibilty. If you are interested in checking them out, my link is Imperfect Foods
By using my link (if you want to order anything) I do get a $10 credit once you place your first order and you also get a $10 credit.
Anyway, I am going to try and get back on track here once more. The stress of the on and off again surgery, plus waiting to hear about the other job interview and dealing with a few more things here lately really did take a toll on me. Praying for smoother "sailing" ahead.
I hope everything goes well and Jeff can have his surgery. Having a well stocked pantry makes a lot of sense to me, no matter what your reasons for it are. My daughter tried Imperfect Foods for awhile and then, stopped. She didn't find it cost effective for her. I hope it works out well for you.ReplyDelete
I hope it all gets worked out for the surgery. If he gets the new job, will they be OK with his having to take off work so soon? That would be my concern.ReplyDelete
That would be a big savings on insurance - and I would consider that as income as well.
Good luck with all.
I'm so sorry for the hassle with insurance over his surgery. But what a blessing that he may be getting this new job.ReplyDelete
I've been on my new prescription three weeks and really do see an improvement in energy. I still need to be careful but am quite hopeful with the change.
Do what you need to do to stay healthy. If that means gowning up and putting on mask and gloves to be in the hospital during his procedure, do it. It's your health.
Sending prayers and hugs,
SJ in Vancouver BC
This is such a sad thing when companies can decide how much pain someone can be in.ReplyDelete
I hope and pray things are quickly settled for the surgery.
Good tips for being prepared with food, too!
Have a cozy day. : )
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