When I purchased my 2008 Saturn Vue, it came with a free year subscription to OnStar https://www.onstar.com/us/en/home.html. I understand now that new GM vehicles come with 6 months of free OnStar. I loved OnStar. I loved receiving a monthly diagnostic of my car's operating system, and oil life history. I renewed it at the almost $200 or a bit more a year cost because I really appreciate the peace of mind it offers. I have continued, over the years to renew the OnStar coverage, and over the years, I have used it increasingly. There have been times when my car did not run as I thought it should, and I have requested an on demand diagnostic which helped me to know what to do. Sometimes, my car is just acting strange, and I can call OnStar and talk to them about it and they can walk me through what is happening. If I had a mate or spouse who knew my vehicle, they might be able to do this. But the neat thing about OnStar is that while they walk me through what is happening, I am able to talk to somebody, real time, and actually work it through in my mind. And, if a warning light appears on my dashboard, they can run an on demand diagnostic, and tell me what is happening, and how urgently I need to tend to the problem.
I like the idea that if I have an accident, OnStar will detect it and call help for me, but I hope that I never need to use that feature. It also offers free remote service if you lock yourself out of your vehicle.
My insurance company, State Farm https://www.statefarm.com/ has coupled with OnStar. OnStar provides my insurance company with my driving record, and State Farm adjusts my insurance, accordingly. The first six month I used this, OnStar saved me more in auto insurance in six months than what I paid for OnStar for a year!
I use the one step above the basic plan, called "Protection." The services include Advanced Diagnostics (monthly reports on car health, and on demand reports); Smart Driver (drive smarter and save money, including on insurance); Remote Access; Automatic Crash Response (talk about peace of mind knowing help will be on its way); Emergency Services; Crisis Assist (severe weather); and Roadside Assistance.
The last 3 years, when I renew my OnStar coverage, I have receive a "promotional discount" which amounts to a considerable savings on OnStar. Not sure why I receive the promotional discount, but will not argue with it.
It was a gray May day. The early weather forecast called for severe weather in our area after midnight tonight. But that changed. A thick black cloud moved through about mid-afternoon. The storm moved fast, but dumped lots of rain, and hail up to golf ball size. A skylight at work was broken. My vehicle did not suffer any window damage. It did have dents on the hood. I suspect there are dents on the roof. The dents on the hood do not feel like the paint was chipped.
I will not do anything about it now. It probably is not worth doing anything. But, as the season progresses, if there are more storms I cannot avoid, I may have to make a claim on the collective damage.
I did not sleep well the night of March 17th. I am not sure what that is about. It is what it is. And this has been going on since last Wednesday, March 11, 205.
I woke up very early the morning of March 18th, and could not go back to sleep, so I showered and dressed for work, then sat on the sofa. Haiku and Sake joined me, and I slept for quite a while, before I fed cats and finished getting ready for work.
I had a busy day at work, but for the most part, it was an easy day. I did two training presentations, and I felt like they were well received, which always makes me feel well.
But, by the end of my work day, I was pretty well wiped out. Although I would have liked to call it a day, Wednesday night is a good night to get to the Lifestyle Center http://www.covenanthealth.org/Our-Services/LifeStyle-Centre.aspx , as open swim starts at 5:30 PM. Well, as I worked late, and fed the cats before going to the Center, I did not get there until after 6:30. The pool room was warm, but the water felt colder than I like. However, as I did my routine, I could feel the relief from the discomfort and pressure on my right hip/side/buttock/leg. I am not sure where the pain is. I just know it hurts.
I think it is true that if you do not feel like doing some self care activity, it is probably a most needed activity, and you should force yourself to do it. So, I usually try to force myself. Tonight, that was good for me.
I am blessed to have insurance that covers health care modalities that can help me, even if they do not cure me. I am so thankful that my physical therapist trusts me enough to acknowledge that I can do exercises on my own to help myself, at home, or at the Lifestyle Center.
Some days, it is very difficult to be suffering from pain, disability, injury. I think, as a society, we do not acknowledge enough what people suffer and how it affects their life. I know for me, on days I have extreme pain, it affects my energy level, my frustration tolerance, my decision making, and even my thinking. It affects my decisions about physical movement. I hope I do not diminish myself as a person because of my pain. I am in hopes that if I do diminish myself because of my pain, if I do not recognize it, my colleagues will have the courage and humanity to inform me of this, so I can gracefully withdraw from my professional life as a social worker.
It is my hope that my pain and therapy experiences make me more aware and tolerant of the situations my clients experience. Therapy of any kind is not easy. As human beings, we do not make changes easily. We are resistant mentally and physically. We make excuses. We give up. I get that. I also get that we need to keep going, one step at a time. That is what I try.
I really do not like to take medication. There have been times in my life when I have consistently taken medication, but really would rather not. I am now advised to take calcium and vitamin D, and I try to remember to take it. But, I forget. I really try to take the blood pressure medication I am prescribed. It helps, but my blood pressure is all over the place, from too high to too low. I also try to remember to take the medication for high cholesterol.
Last year, I sprained my ankle, and when I went to the doctor, I did not ask for pain medication. I can effectively use over the counter medication for that kind of problem. I did ask for assistance in treatment, and confirmation it was not broken, although, I knew it was not. Confirmation was what I got.
I did go back to the doctor for my lower back pain and sciatica. I was given an anti-inflammatory, which made a major difference, and I was sent to physical therapy, but had little results. I gained some strength back, and range of movement, but no pain relief beyond what the non-steroidal anti-inflammatory drug (NSAID) provided.
Eventually, I went for pain management, and was sent for an epidural-steroidal-injection. The first one helped some. But a few weeks later, the pain returned. The second injection resulted in my being in horrible pain after the injection, and then not being able to tell there was any benefit after that.
I was sent back to physical therapy, and we did water therapy. It was like someone flipped a switch. By the time the insurance was exhausted, I decided, at the advice of a co-worker, to go to an exercise program where I could continue the exercises. The physical therapist thought that was wonderful: he gave me a copy of my regimen, which I had laminated, and started using for my regular routine.
I was on an NSAID, but the insurance company did not want to pay high dollar for it, so, the nurse practitioner that I see prescribed something else that gave me no relief. So, then she suggested something else. It gave me a little tummy problem at first, but as time progressed, the stomach upset became increasingly uncomfortable. I stopped using the medication.
I could call my provider and tell her I cannot take the medication. I have decided not to. I am learning to manage my pain in other ways. I do not want surgery. I am currently at a point where I can manage my activity and stress and keep the pain to a minimum. Also, the various physical exercises from physical therapy can relieve the pain. I will go for that versus surgery. And, I do not want medication if I can avoid it.
Emergent health care in Texas is not good. It has improved some over the years, but not much. The quality of care provided in our emergencies rooms is adequate if not good or better, but access to care is the problem.
For years, if someone was unable to demonstrate proof of payment and they present in an emergency room needing care, they were often turned away. Or, they were shunted to a different emergency room. Well, there are laws against that, especially for emergent, life threatening situations. But even for questionable situations, people are still turned away.
The front line emergency room staff are trained to be sure that payment is available before they welcome patients wholeheartedly. So, someone who needs hospitalization might be given xrays and prescriptions to take at home, instead of admission.
This may sound barbaric. In many respects it is. But, it is true. Part of the problem are the emergency room users themselves. Many do not have a primary care provider or urgent care clinic they prefer to use, so they use an emergency room for that type of care. Although education and fees have been used to stop this practice, it has not totally ended it.
Much of the problem is the broken health care system in the United States. Insurance companies choose treatment for people, not the health care providers. And there are so many hoops to jump through, no wonder the health care costs are so high. A perfect example is my recent use of insurance for physical therapy. While my health care provider could acknowledge my physical therapy authorizations, they were not done or managed by my health care provider, but by some other contract source. And you know each contract source has its own set of bureaucracy to support and has to justify itself, but really did little if nothing to encourage or support my health care.
I understand private insurance and government programs for health care billing is a night mare. I am sorry that is the case. Instead of insuring people receive timely and efficient care, care is delayed, and billing is so obfuscated that you do not know if your bill is correct or not!
So, who's to blame? I do not know? How do we fix it? I do not know. What I do know is that when insurance companies make health care plans and funding for emergency room treatment is more important than treatment, the American people lose.
I am so mad at my insurance company, United Health Care http://www.uhc.com. I wrote about needing to change prescriptions. Talking to my doctor's office today, they switched me to Arthrotec, http://www.rxlist.com/arthrotec-drug.htm which can be had in generic, DICLOFENAC SODIUM AND MISOPROSTOL. I checked with the insurance, and they said it went through.
So, I picked this up tonight. It cost more for me than the Celebrex cost me. The diclofenac is listed on the Wal-Mart $4 list, but not the combination medication. The misoprostol helps to protect your stomach.
I don't get it. The insurance will have me spend more money for a generic than I would spend with a brand name medication that was working.
I hope this works. It will be worth it if it does.
It was not a particularly bad day, but just a little frustrating. The biggest frustration is that I am in pain. I was not in pain until last Wednesday. Until then, I was taking Celebrex and doing the exercise regimen that I learned in physical therapy, including going to the Lifestyle Center http://www.covenanthealth.org/Our-Services/LifeStyle-Centre.aspx 2-3 times a week to do the pool exercise regimen that I started at physical therapy.
In August, my insurance company, United Health Care http://www.uhc.com notified me I was in the "step therapy" program, and I had to try medications other than Celebrex, as they would not cover the cost of Celebrex. I went to my doctor, got a prescription for meloxicam, which I started last week. The first day I took it, I could tell I was not getting the pain relief I was getting with Celebrex.
I waited a few days, and matters only got worse. I am very frustrated. I had worked hard to do physical therapy and follow up on my own to not lose the strides I had made at pain management. It was thrown into the trash by my insurance company.
I was also frustrated trying to communicate with my doctor's office. Rather than call me back as I requested, so we could discuss this, they just ordered a new prescription. The insurance tells me they did not request a pre-authorization. If I do not follow instructions from my doctor, they get upset, but they do not follow instructions from me. So, I got upset.
This is the kind of stuff, when I am in pain, that can set me to tears. It is manageable. It is fixable, it is not life-threatening. But it takes more time and energy than I think it should. If people did their jobs the way they are supposed to, this would not happen.
I understand the insurance dance. I do not always agree. In fact, I think managed care creates more costs to consumers than it manages costs.
I am a firm believer in "if it is not broke, so don't fix it." But it seems corporate America does not believe in that (Coca Cola http://en.wikipedia.org/wiki/New_Coke.) And, as we have learned, my insurance company is included in this.
Yesterday, a coworker reminded me that my muscle spasms may be due to low potassium. I think she was right: I had been eating bananas, but had not done so for about 10 days, until yesterday. Today, I woke up without the muscle spasms I had been having, but still had some of the other pain.
So, anyway, I went to the Lifestyle Center tonight after work. It was like magic. I got in the water, and it felt like my stressors and pain melted away. And they did. I did my regular routine (actually I have several variations of a regular routine) which takes a little more than an hour.
Although I still have some discomfort, it is greatly diminished tonight.
A colleague who has been going to water groups at the Lifestyle Center for some time told me she felt it was very relaxing and helpful as a de-stressor. I got it tonight. I was really looking forward to my time in the pool, and it was just so soothing and calming. I am hooked!
So, the physical therapist at Spectra http://spectraphysicaltherapy.com/ was surprised when we asked for additional sessions a couple of weeks ago, and were granted two more from my insurance, United Health Care http://www.uhc.com/live/uhc_com/Assets/Documents/landing.html. So, that gave me an additional pool session, and a final "wrap up" session today. As with the last PT series, I had gained remarkable strength and range of motion in my right leg. But unlike last time, I had also gained amazing pain relief. My therapist and I attribute this to the therapy that I was doing in the pool. It was amazing how much it helped me. I could not believe it: It was like the difference between night and day in what I could do.
It may be a combination of PT, and a slower than expected response to the epidural sterocortisone injection I receive in late May. And, an ongoing response to the Celebrex that I take daily. But, I believe it was the pool therapy that helped the most.
Well, sure enough, the insurance company has contacted me and said I need to try another, less expensive medication for pain relief. Of the three they suggested, ibuprophen, meloxicam, and naproxen, I have tried ibuprophen and naproxen over the counter, with no success. While I am not opposed to trying meloxicam, I am a firm believer in "if it's not broke, don't fix it." So, I will negotiate with my provider regarding how best to respond to the insurance.
Additionally, in the same vein of "if it's not broke, don't fix it," I have decided that if water therapy was working at PT, then I can continue doing some of the same on my own. I have explored the possibility of joining the Lifestyle Center at Covenant Hospital http://www.covenanthealth.org/Our-Services/LifeStyle-Centre.aspx. I did a tour, and picked up the application material. I discussed my plan with Robert at Spectra, and he agreed it was a good plan, and suggested I set a goal of two times a week: manageable, and he acknowledged that too much of a goal is self defeating. He was so much in agreement with the plan, that rather letting me rely on my memory of the exercises I did in the pool, he gave me a copy of the regimen I had been following! Wow! What an affirmation for me that this is the right thing to do. Thank you, Robert!
I still need to contact my doctor and get the appropriate documentation from her. I am not usually a procrastinator, but I wanted to discuss this plan with my PT before enacting it. As it turns out, that was not a bad plan, because now I can address the insurance/medication issue and the medical documentation needed for the Lifestyle Center at the same time.
This is one of those situations in life in which I believe things happen for a reason, and in this case, we can see the reason. I am excited about going forward in my life with these options available to help me with my health.
I am amazed about what I have written about physical therapy before. My posts tell me it was an overall positive experience the first time, although it mostly yielded strengthening and range of motion. And, that it wore me out.
I returned to physical therapy after the second pain management treatment (epidural) that did not seem to help much, and in the first few days after the treatment, exacerbated my pain.
When the doctor said I needed to return to physical therapy, I asked to return to Spectra, http://spectraphysicaltherapy.com/services.html for physical therapy, because I knew that the therapist was an excellent, well respected therapist. In addition to reviewing the exercises I had done during my first stint in physical therapy, he added water therapy. The first day I did water therapy, I spent an hour walking in the pool. An hour walking would have meant pain in my back, leg/calf cramping, and tingling/cramping toes. None of that occurred.
And, as I engaged in my regular activities, I had less and less discomfort and problems. To the extent I could stand for an hour without back pain, or leg or toe discomfort or numbing. I continued to do water therapy. It has been great!
I over did it over the 4th of July holiday weekend. I walked too much and too quickly, and did not rest enough when I did house work and yard work. I powered myself through housework and yard work. But, the discomfort that resulted was muscle discomfort, and responded to analgesic patches.
Today, I went to PT before I went to work. After spending time in PT in the pool, and doing some paperwork, I went home, cleaned up and dressed for work, and went into work. I had planned to stay late at work, because I knew what tasks I wanted to do. I completed those tasks in about 8 hours. This did not surprise me. The tasks were what I would have planned for eight hours starting at 8 AM instead of 1020 AM.
However, I am exhausted. I was able to do the foot strengthening exercises I need to do, but I am too tired to do much else.
I am hoping the insurance will authorize many more visits for physical therapy. I like the water therapy.
Oh, but the point of this is that the water therapy wears me out. I was able to complete the tasks I needed to do at work. I stopped at the grocery store on my way home from work, and among other things, bought something off the deli counter because I was too exhausted to do something else to fix dinner.
I will be ready to sleep soon, after my brain winds down.
I am an employee of the State of Texas. Until most recently, the State of Texas contracted with Blue Cross and Blue Shield of Texas to provide health care coverage to its employees. September of 2012, that changed, and we are now covered by United Health Care. So many people say that United Health Care is an inferior health insurance provider. Especially medical providers: they negotiated lower rates of pay than many other insurance providers. But these negotiations were widely although not universally accepted. And the State of Texas changed to this insurance provider for the lowered costs.
There have been some things that for me are good about this new coverage. Wellness prevention checks are covered. For years, my major medical expense was the co-pay for my yearly gynecological exam. Now, there is no co-pay. I have had to have some x-rays this past year, and there has been no co-pay for some of these, as they were preventive, not diagnostic.
I am careful to use my insurance as I am supposed to: My primary care physician is excellent at following up on getting referrals and authorizations. I check that these have been obtained, and I try to make sure I understand what the parameters of these authorizations are.
I needed new glasses and went in for a vision exam. The optometrist discovered some problem with my left eye, and he suspected it was with the optical nerve. My PCP obtained authorization for follow up appointments, and I went to that appointment.
Recently, I received an explanation of benefits from the insurance, which indicated that the optometrist was "out of network." Well, when I checked the list of "network" optometrists, he was still listed, as he had been when I went for that appointment.
So, I called the insurance company to find out what was going on. The wonderfully understanding representative assured me that I had a valid authorization and referral. She quickly ascertained that the problem was that the optometrist billed under an ID number that was not a current provider number with the insurance. She said that if I have to have additional follow up, WE need to find me a new provider who will be covered for this problem. The insurance representative asked me if she could put me on hold, called the optometrist office, and then got back to me. She told me with whom she spoke. She said that the office person said they thought, including the optometrist thought, that he was authorized with the insurance as a provider, and that they would correct that. The insurance representative said that if they did correct that, they could retroactively submit my bill as a courtesy, so I would not have to pay the uninsured bill. She also told me to check back with the provider in a week or so, to make sure that they follow through.
I had dreaded contacting the insurance. I was pleasantly surprised by the customer service that I received. I do not know how this will be resolved. I have little faith that the optometrist and his clerical staff will do the right thing. I am sure I need to find a new optic provider: probably an opthamologist, since I know I have cataracts, and now possibly some other problems.
This was a good lesson regarding health insurance. I know no matter what authorizations there are, there are no guarantees.
I was pleasantly surprised by the help from the insurance company. I hope this can be resolved in my favor, but I am anticipating a protracted negotiation, which I hate, but which I suspect I will have to negotiate.
Well, this is true. There are no guarantees in life So why should I think there are guarantees in insurance.
