What is the dreaded subject? Health insurance claims. After being so sick last summer and fall, I thought it was all tied up BUT I have been carrying two secondary policies for many years. My dad died of cancer at age 60 and I wasn’t Medicare age so I thought these policies were a good idea.
They probably were ….. until I reached age 65 and Medicare kicked in along with my BCBS. That’s when I should have cancelled both policies but I didn’t know and I’d never had a claim.
I guess it’s a well known fact that after the bills have been paid secondary insurance policies become quite stubborn and the small print is very small.
I went to the hospital insurance office in Mason City today and talked with a most helpful gal – she gave me copies of everything to send in and I’ll just hold my breath. When it’s all said and done, I’m cancelling both policies. I was too sick to realize that all this paperwork would need to be done at some point.
Anybody else faced with insurance issues?
It’s been a hot windy day – all those houseplants outside were dry as a bone already.
I’m kind of in the mood to make a new twined rug – anybody else? Or maybe just a runner.
And then this –
I hung the patriotic quilts in the porch today. The ugly chair is Keeper’s and I would love to burn it but he would be so disappointed.
I’ve had a couple requests recently for Rise and Shine, the full size pattern pieces.
It was in this first copy of Quilt Sampler but you had to redraft all the pieces. Our pattern is full size pieces.
So here’s the deal – this is what the pattern looks like – 6 full pages plus the envelope and postage. Cost is $10 – do not send a SASE but PLEASE INCLUDE AN ADDRESS LABEL. And your order with cash, money order or check only.
Connie is responsible for most of the hand appliqué but you could always fuse it. There are lots of pieces! I loved hanging it up again.
Expecting rain – it’s so nice to be here in the porch.
Oh, for insurance problems. My meds are all generic so no problems, yet. Sometimes just cheaper and easier to die.
If your legs were that short, you would need to jump to see where you are going, too. I don’t think Keeper’s chair looks that bad. Just make a pretty quilt and cover the chair so you can’t see it. It is Keeper’s home, too. Been waiting to see what his heritage is. Some of the European dogs have the very big ears, too? Some of the police dogs?
Everybody delivered their entries to the quilt show this morning. Oh, it is going to be a great week!!!
Take care. Betty in Rapid City
Betty – YES! You were spot on! His ears are the give away – haha! I wish I were there for the quilt show – have a great time! And then tell us about it.
Insurance is so frustrating, I think I get it all worked out and then we hit another bump in coverage. I don’t know why it has to be so convoluted. The air quality here is just awful and it smells of smoke late in the day. I would love to be outside, but it’s not advised with the fires/smoke from Canada. I can’t recall suffering wildfires from Canada as a kid, is this something new? It finally rained last night so hopefully today will be better air quality. Need to get some mending done today for the husband and then I can find a new project to cut out and work on. Hazel is just the cutest romping in the field.
Mary,
I’m late with reading the blog, catching up from several days. This is a wonderful post! The best of everything…happy dogs, patterns and beautiful quilts. And lots of news.
Working long days in the gardens and yard preparing for the wedding. Somehow it’s only 6 weeks from now!
Thanks for posting my iris picture. It really was so beautiful. Take care 🌻
Hazel looks like Winnie the Pooh’s character-Tigger-her legs are made of springs. BOING, BOING, BOING.
Funny funny Hazel.
And don’t you dare throw away Keepers chair in the porch. Even Hank knows to stay off that one. Some things are sacred. 🙂
Hank’s mom – think of how nice the porch could look with a new chair! But no, Keeper will keep his chair and visitors will sit on hard wrought iron chairs – as it should be! Haha! Yes – Hazel bounced through the hayground for an hour – as if she had springs.
Oh the absolute dreaded health insurance! It infuriates me! My husband is a medical billing/coding compliance director, he makes sure physicians are billing correctly and educates them on better billing practices. He argues daily with health insurance companies for things like this: a procedure is done that is 100% covered by them and they deny the claim. He then has to audit the patient’s chart and argue why he’s right and they’re wrong.
Well, he has been fighting with our BCBS because they will not approve Botox injections for the migraine I’ve had since October 2022. They say we haven’t done everything required before Botox can be used. I’ve jumped through all the hoops (some multiple times) and they STILL deny it. I keep telling my husband and I want to go back to the days when doctors were paid with a fresh baked pie and there was no questions when it came to procedures. HA!
I apologize if there are typos…I can’t find my glasses!
Jessica – wow, you have experienced it firsthand! I am so sorry – sounds like you have an expert to figure it out but what about us dummies who don’t understand insurance? Maybe we aren’t meant to understand it. I made Rick read all the insurance comments thinking maybe I’m missing something here. I can’t imagine having a migraine for 3 years! I am so sorry!
It’s absolute H-E-Double Hockey Sticks! The entire left side of my head feels like I’m being repeatedly hit with a baseball bat and the pressure behind my left eye makes me feel like it’s going to explode. There’s just no relief at all EVER! I just pray every day for it to go away as quickly as it appeared.
Jessica – we had an employee with migraines and she finally got relief – but I don’t remember how. I’m going to try to text her.
Jessica – my friend said she thinks her shots were called Imetrix but she said it was a long time ago so it’s probably not current. She said she also had a hysterectomy and that was the answer for her. I hope you find relief for your migraines.
Jessica — as a nurse, your comments are spot on!!!! I get SO frustrated!!
Love my Rise and Shine quilt, too. It hanging at the bottom of my stairwell. I appliqued mine “Tonee White” style with large primitive stitches on pattern pieces that were cut with “pinking shears”. So very doable for anyone! I didn’t go get my magazine, but didn’t Connie have a story about her “purple grandma” or maybe it was you and also about using a little bit of purple in every quilt. Ironically, my purple fabric has faded in the quilt!! Just like me!! I also see myself bent over pulling weeds like that too and wonder what the neighbors think or anyone driving by…quite a site, I’m sure.
Rosemary – I love that you still have your quilt hanging up! Purple Grandma was in one of our books but yes, you’ve got that right. Big Stitch would be a great way to manage this – my fingers won’t let me appliqué much. I’m just curious – what are you working on right now?
before I retired, I was the billing manager for an oral surgery practice. I totally get your insurance frustrations and hope they get resolved. The fine print on some of those policies is ridiculous and those companies should be banned from selling their product. I had patients that swore their surgery would be covered, only to find out with a phone call by me (with some medical codes) that their surgery would not be covered. So many people pay for an insurance plan that is simply worthless. And the issue is – most people will never find this out as they never have to use it. Good luck.
Heavy thunderstorm here with morning. Grandkids are here now for summer. And my jury duty fizzled out for the week. My case was settled yesterday morning while we waited for jury selection. Waste of time going all the way downtown, sitting for 4 hours only to be told to go home. But I get paid $30. Quilt money !!!
Diana – boy, did you explain that well! I’ve never had a claim until now and if this last try doesn’t resolve it, I’m going to just give up and cancel my policies. Think of all the money that I’ve paid in over the past 30-40 years!
I always love your Hazel pictures. She’s always up to something and she’s just adorable. On a different subject—don’t get me started on our healthcare system. Insurance companies are making life and death decisions about people’s healthcare and it makes me furious. My son is a medical resident. He studied for the MCAT for two years . Four years of medical school. The amount of information you have to learn is described as drinking from a firehouse and it’s not an exaggeration. He’s a neurologist, so has a four-year residency. That’s ten years of learning and practicing under supervision. He specializes in stroke and he’s excellent at what he does. If he says someone needs a particular drug or treatment it’s because he knows what he’s seeing—who at the insurance companies is qualified to say a a treatment isn’t necessary?🤬🤬🤬
Sue – like I suspected – what’s insurance for if not to cover what the doctor thinks the patient needs? I can’t imagine that much schooling but think about what he does!!! You have a hardworking and intelligent son, for sure. Yes, who behind a desk at the insurance company has any idea what the patient needs!
Do you have a pattern for the large flag wall hanging? The picture shows it behind Keepers “ugly chair”.
Carolyn – I will find it and post it tonight – it’s not a Country Threads pattern and I did change it some. Isn’t that just the ugliest chair???? But I’d do almost anything for Keeper so it stays.
The flag pattern is Liberty by Villa Rosa. Their pattern cards are $2 and I have a bunch—love them!
Mary, before you cancel anything talk to a SHIIP representative. This is an Iowa resource for how to sort your way through Medicare and Supplementals. Locally, they will be a volunteer in your community or area.
We have been retired for a dozen years and talked to three different representatives as they come and go. All have been very helpful with information and recommendations. They will not make your decision but will tell you what your options are. Copy paste the below or google it if it does not become a live link here.
https://shiip.iowa.gov/find-resources/find-counselor
I love your patriotic porch, wonderful quilts!
Hazel is so cute. Thanks, Mary 🥰
I sure had a lot of ads to close today. Doing my part. These stories about meds are horrible. Our insurance companies in Canada prefer the generic drugs but there are some times they can’t be used. So far as long as our dr says it needs to be that exact drug it is covered. Not sure how long that will go on for. I enjoy the quilts on your porch and cute hazel in her water bucket. lol.
Teresa – THANK YOU FOR CLICKING THE ADS! It helps pay the bills for this blog which, like everything else, keeps going up. Sounds like your health care system is more efficient than ours.
Mary – Love the quilts and the porch! Tomorrow I’m getting a new HVAC system. Gotta do it before tariffs kick in. Next up, new toilets! Just taking care of the basics for now.
I could write a book about supplemental insurance especially after my husband passed. To make a long story short, my supplemental medical insurance was under his name and his ID number, but I had my own ID card in my name. That’s how it was set up. When he passed, I could no longer use the ID number. I had to get a new number. It was a cross-reference issue every time I went to the doctor and got a prescription filled or refilled. I carried both ID cards for over a year. Only Medicare paid and then at some point the supplemental insurance kicked in. It took months to get everything paid. Had I known there was going to be an issue with any of the paperwork, payments, ID numbers, etc., I would have changed everything into my name before my husband passed, but I had no way of knowing when that was going to happen. There are numerous other bits and pieces that have come up but I just take it one step at a time. I’m still working on another issue that I inherited from my husband. Even after going through probate, I’m still trying to get it in my name. It’s been over 2 years.
I doubt that I will get it resolved before I die. 😂
Take care everyone.
Sharon – good grief, now that sounds like a nightmare. Such a simple thing – an ID number! I’m trying to avoid issues when I die by writing a detailed trust which I update periodically. It helps me sleep at night. But when my estate sale takes place, I’d love to be there! Hahaha! So many good things to buy! Your statement “had I known” speaks volumes to me!
That is heartbreaking about the asthma medication. My mother in law is 94 years old and now has been made to pay a steep price for one of her meds. The company said if her dr would prescribe the generic, they would pay for it so we’ll be getting ahold of her dr before she needs a refill. And my brother is a diabetic and has been paying a ridiculous amount for his meds. Over a year ago he was told the price was going to $35 a month. Sounds great but it’s made in China and many months he can’t get it at all. So he has to get a different drug that doesn’t work as well. Our meds need to be made here.
Hazel is so entertaining. If she could only talk! She’s got a mind of her own!
Really muggy and windy today. Had to turn the air conditioner on. Chance of rain tonight and off and on all day tomorrow.
Cindy K – yes, get a hold of her doctor! But there you go – the Dr. prescribed what he thinks is best for her and then the insurance companies intervene. Ugh. When is your mil’s birthday? She could be a birthday girl!
I’d love to do a twined rug! And your flag quilt is beautiful.
I was just telling my Darrell that years ago you had a shop and I had a magazine with you on the cover and never thinking I would ever be able to talk with you and now you show it! Loved your quilt style ❤️! My ex didn’t let me spend much but I had that issue and enjoyed rereading it. Glad I have Darrell now !
I still can’t smell or taste, coughing but no longer dizzy or fever so getting better but not there yet. Better miss sewing tomorrow.
Pamela – yikes! I’ll bet you’re sick of not feeling your best, aren’t you? Yup, you can talk to me anytime you’d like. Haha!! How are the girls?
Penny and Lucy send their kitty hugs for you Aunt Mary😻❤️! I’m glad they don’t catch Covid!
Pamela – hope you’re much better very soon!! But don’t overdo and relapse or you’ll end up in the hospital for sure!
I have a twined placemat about 1/8th done. If you start a twined project, it would inspire me to finish my placemat.
Lynn – I’ll keep that in mind!!
I get aggravated with my Part D provider. They keep changing which drugs they approve. I wish they would let my doctors do their job and prescribe the best medication for my conditions rather than dictate which drugs they will pay for. There was an article on the news tonight about a young fella with asthma. He went to pick up his medication and was told it was $500+. Somewhere along the way, the message that he could get a replacement medication got lost and he left without anything. Five days later, he had an asthma attack and died. His family is suing. I hope they win and effect change. The pharmaceutical industry and insurance brokers are out of control.
Janet – I heard the same news story! His parents were so shocked when he didn’t have his meds – things like that should never happen. I don’t take many meds and the ones I do take are cheap but Rick has heart meds and they’re getting almost too expensive to take. Yes, let the drs do their job!
Your dogs are so cute! How are the chickens? Haven’t seen them in awhile.
Janette – I’ll take pictures of them tomorrow. They like to come up to the house yard and eat the birdseed on the ground under the feeders.