Monday, January 19, 2009

Insurance and a play ground

Charlie and Maryam holding hands down the slide.
Maryam climbing up the slide wall.

Maryam celebrating going down the slide!

So, with the new year comes new insurance problems. As of January 1st Maryam and I are no longer insured. Back in October we received a letter from Kaiser informing us that my Federal COBRA would be expiring on December 31st and that I need to file an extension under the Cal COBRA plan. So, I called Kaiser on October 29th asking for a Cal COBRA kit. They said they'd send one out with the info for the extension as well as the rates for the coming year. I got a packet in the mail, and returned it.
On December 30th I called Kaiser to tell them that I still hadn't received a bill for January and needed to know where to send the check. They told me that they never received my packet! In fact, they said they never even sent one out. The woman in Member Services said that the computer shows that I requested the packet, but it doesn't show that they ever sent one. Well, I know I filled one out and mailed it back, but apparently they never received it. So, she requested another packet be sent out to me. She said it could take 7 to 10 days for me to receive the packet. She said in the mean time, if we have any appointments or procedures that we'll just have to fill out some paper work. If we have any prescriptions to be filled we would just need to pay them up front and get our money back after we get reinstated. Well, when 7 days went by and I still hadn't received the packet I started calling Kaiser again. I called every other day asking if they could send me another packet. I asked if they could fax it, email it or if I could drive somewhere to get it. They always told me no.
One day Brett got tired of all of this and called Kaiser for himself. The lady on the phone told him that she would have it faxed to him. I couldn't believe it! He gave her the number where we receive faxes, got her name and then hung up the phone. The next morning she called back and said, whoops! No, we cannot fax it anywhere, we can only fax it to Member Services Offices. Then she proceeded to tell us that the nearest Member Services Office to us is in Fontana! UGH. So, Thursday we drove to Fontana to see if they would call and have the forms faxed to them. IMAGINE MY DISBELIEF when they had the darn form there in their office!!!!!! The rub is that we've been to that hospital 2 times since we requested the packet!!!!! We could have had this taken care of before the end of the year!!!!! Talk about frustrating.
In the mean time ALL of Maryam's medical equipment has been picked up. Apria came and got it all two Mondays ago because Kaiser is no longer paying for it. So, I can't give Maryam her nebulizer treatments, we can't go on our trip to Big Bear at the end of the month because we don't have any O2 and we're not getting any feeding supplies. We can't order any food, bolus extenders, syringes or Mic-Key buttons until we're reinstated. So far this month has been very stressful as a parent. I keep worrying that Maryam will need O2 and we won't have any. Or her button will tear and we won't have one to replace it. Or all of her feeding tubes will break and we won't be able to feed her. Its a nightmare! Not to mention Pediasure is EXPENSIVE!!! It costs us $20 for 3 days of food. I know that doesn't sound like a lot to some of you, but its a lot for us.
The worst news came at the end of last week. CHOC called our case worker and informed her that they won't see Maryam until our insurance situation is taken care of. Our appointment with the CHOC GI doc is on the 26th. This is the closest we've gotten to getting Maryam in a feeding clinic, I will be so sad if we have to put if off. I've been very good at taking Maryam's feeding problems in stride, but I don't know how I'll deal with this. HOPEFULLY we can get it all figured out before the 26th.

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Preemie Parenting said...

Hi. You don't know me - I read your blog (and we are on the same Yahoo Micro Preemie group). My daughter is very similiar to Maryam (gtube, fundo, oxygen, etc.). Maryam's success really gives me hope for my daughter. Anyway, I'm sorry to hear about the insurance. I have extra bolus syringes and a feeding tube extension if you want them. Just email me at and I can mail them to you. Crossing my fingers for you that it all gets worked out quickly.

knuts2knit said...

OK. . .do those two girls have matching side ponytails??? LOL! Too cute. (I can't believe that fad is coming back in though) :)