It's September!

I know that people are always saying things like, "Where did August go?" when it seems like time is flying. But really, where did August go? It is September 1st today, and the Madison public schools are back in session. I guess August went by so quickly for me because Einar and I spent 1/3 of it on vacation in the Northwest.

We had a great time visiting our brothers and brother-in-law in Seattle and Vancouver. We saw a lot of sights, sampled some local beer and ice cream, and genuinely enjoyed our time. I've posted some pictures below.

Unrelated to our vacation, since Einar and I now have health care coverage (thanks, GHC!), we went in for physicals last week. Nothing too exciting - just wanted to meet our doctor and get a check-up. We both got Tdap boosters (Tetanus, diphtheria, and pertussis), which resulted in each of us having a sore shoulder for a few days. Other than that, we are healthy. I, of course, got a referral for a colonoscopy. Fun times. I'm waiting to hear from the clinic about scheduling that. It feels good to have health insurance!!

View of Seattle from West Seattle (Alki)

It's the Space Needle!


View from the Space Needle.

Snoqualmie Falls

This was taken on the way to Whister, at Shannon Falls.

This was taken near the base of Shannon Falls.


Erik and I are imitating Dad's reaction to cold mountain creeks!

Einar contemplates his next step as he crosses the creek.


Lost Lake at Whistler

Lost Lake again.


By the suspension bridge in North Vancouver.

On the suspension bridge.

Look, it's a tiny door!

Lions Gate Bridge is behind us.


At Queen Elizabeth Park in Vancouver - mountains in background

Health Insurance Update

Einar and I will have "regular" (that is, not limited to major medical issues) health insurance coverage beginning August 1. We are relieved to have found a plan that fits our budget, and we are really happy that coverage will begin before our trip to the Northwest. We applied and were approved for an individual plan with Group Health Cooperative (GHC), a nonprofit health insurance company. We haven't received our packet of full benefit information yet, but we do know that they emphasize preventive care and complementary medicine. I believe I read that they will pay 50% of the first $750 spent on massages, which basically means half-price massages. I need to check into that. I'm also wondering if they offer reimbursements for things like Community Supported Agriculture (CSA) shares, as that's something I'd like to do next summer. All in all, I'm really excited to have health insurance again.

Now, I can call and get my annual exam(s) scheduled. . .

Uninsured

Einar and I no longer have health insurance. We had a short-term, major medical plan that expired on June 30. We figured that was no big deal, as we are eligible to get on Dean Health Care's REALTOR group plan (since Einar works full-time for a realtor). So, we looked up all the information about the options, including coverage, deductibles, and monthly premiums. It looked okay - group coverage, with prescription coverage, for under $500/month for the two of us. Not as good as employer-offered coverage, but better than most individual plans we've found. We applied, confident we'd be approved. And we were approved! The letter of approval also included new rates. The plan we'd wanted - the only one that covers maternity - would cost $731.92/month for the two of us!! That is out of our budget. So now we're back to square one in a lot of ways. We're looking into GHC, and we'll probably forego prescription drug coverage. What a nightmare! I truly hope Congress is able to pass some sort of health care reform bill in the next couple of months.

As part of our investigation into health insurance, I looked into BadgetCarePlus, Wisconsin's health coverage for low income people. We make too much money to qualify for that, and if one of us quits our job or reduces hours, we'll qualify, but we won't be able to cover all of our bills. I'm sure we're not the only people in this situation. I suppose we could just skip health insurance altogether and do what a lot of people do - let the taxpayers pay when we show up at the ER and don't have health insurance and can't pay. Or maybe we should just move to a country with socialized health care, like Canada, England, or France.

Inauguration Day 2009

I watched the Inauguration of Barack Obama today while I was at work. Don't worry; it was boss-authorized. I watched for just over an hour. Long enough to see former Presidents Carter, Bush (the elder), and Clinton arrive as well as out-going President Bush. Some of the women from the office across the hall came in and watched with me, and Einar watched from home. It was a great ceremony! And Obama's inaugural speech was as inspiring and well-written as I'd hoped. Now his real work begins.

I was just reading an article from the Washington Post about health care reform. People who are against this reform, and especially against socialized health care, seem to always say that it will cost too much. I don't understand how taking care of the citizens of the country, emphasizing preventive medicine, and making sure that anyone can receive the care they need will cost more than the current costs of health insurance premiums and lost productivity. As a person who pays for private health insurance, I could use some reform. If it doesn't come soon, I'm not sure I'll be able to continue to afford coverage.

Justice

Yesterday afternoon I got home from a super-fun shopping excursion with Ingrid (thanks, Ingrid!) and checked the mail before heading to work.  There was a letter from Dean Health Plan.  I assumed it was regarding my grievance and called Einar.  I wanted to read what they had decided with him, and I didn't want to wait until after work, so the phone was the best solution.  My eyes scanned down the letter and spotted "I am pleased to inform you due to the circumstances surrounding your case, the Grievance and Appeal Committee has approved coverage for the colonoscopy on September 4, 2008.  DHP will reprocess the claims according to the provisions of your policy."  I was thrilled.  Overwhelmed.  Our efforts were worthwhile!  Maybe health insurance companies aren't all bad. . .

Grievance Committee

This afternoon at 2, Einar and I met with the Grievance Committee of Dean Health Plan.  I reiterated what I'd written in my grievance letter, and Einar elaborated on his exchange with the HR person at his work.  They listened, asked a few questions, and told us that they'd mail a letter with their determination (either uphold or reverse denial of coverage) on or before November 13.  A week from tomorrow.  So the wait begins. . .

Regardless of what they decide, I feel that the grievance committee members were sympathetic to my situation.  I believe I did a good job explaining the situation, and I hope that they decide to reverse the initial denial.  This will especially be good news in light of the impending loss of Einar's job.

Grievance

I got a letter yesterday stating that my grievance letter regarding my denied colonoscopy had been received.  There will be a grievance committee hearing November 5.  I am allowed to be there in person, which I plan to do.  I just need to get a time scheduled with them.  The question is, do I try to schedule it for before or after my 11:00am dentist appointment?

UPDATE: I will go before the grievance committee at 2pm on November 5.  They have to make a decision within 30 days of receiving my letter, so I'll know before Thanksgiving.

Health Insurance

After Einar and I got married, I was able to get on his health insurance through his employer.  I jumped at the chance!  I was shocked, however, when my new health plan, Dean Health, denied my claim for my annual colonoscopy because it was with an out-of-network provider.  This colonoscopy has been scheduled in June, and Einar's HR person had told him it should be covered.  I had even gotten a referral from a Dean doctor for it.

I have filed a grievance with Dean Health, and I am hoping that they will reverse their decision.  The grievance proceedings should be complete within 30 days.