Medical Blues – by Fran Lewis

Did you ever try and change your healthcare coverage? Did you ever try to understand the logic behind having to change something when you reach a certain age? Why is it that the government feels that once you reach a certain age that you need a different type of healthcare coverage even though what you have is just fine and by the time you finish making about 20 different phone calls you realize the only basic difference is the color of the card, the new number that you have that you knew before they gave it to you and the fact that they make you feel old even though until you ripped opened that envelope and saw what was inside you still felt the same. Try calling your drug provider to get a straight answer about why you need prior authorization for a medication that you have been taking for a long time every single year. Why is it that you need their approval to take something that you know works because they want you to try everything else, which you already did, again. Welcome to my nightmare except during the day.

At 8 this morning I started making phone calls to GHI and several other medical providers. I even called one agency and waited for them to call me back because I refuse to sit on the phone for 15 minutes on hold. But, first you have to get through their ridiculous automated system that asks you if you know what you want, which department you want to speak with and if you know how old you are. When you finally press the right button and you have the right department the automated system gives up a list of more areas or buttons to press. I tried doing what I do with the Phone Company and that is press zero until they realize that I want to bypass the voice on the phone that I really would rather not listen to. In most cases they have the system programmed to finish their ridiculous speeches and then you can press zero. After calling one agency three times I figured out the shortcut the second time around. But, that is just a minor glitch. After you have answered some the questions on the automated system because they won’t put you through until you speak to the robotic voice that they have created to drive you crazy and get on your nerves, you have the pleasure of answering the same questions again when and if you get a live person. By this time, it is a good thing that I have a great memory or I might have forgotten the real reason for my call.

After answering their questions for the tenth time or so it seems I get the answers to my questions to learn when I called another agency that they did not tell me everything that I needed to know. You need to mail certain information to one agency and of course they forgot to tell me that there is another one that would like the same information even though they are going to process it too. By this time if was after 9 and I was beginning to think I would never be able to start reading some of the books that were staring at me begging to be reviewed and the manuscript that arrived that was unpaged and needed that done before I could even start to read it.

Just when I thought I was done with my phone calls and all of the agencies in question I realized that I had to deal with drug coverage and both providers. That proved to be another hour at which point by the time these representatives got off the phone I made them promise to buy my books on the net just because I felt I deserved some compensation for staying on the phone so many hours. I even managed to give weight loss advice to another one because she was complaining her legs hurt and she was tired. I never laughed so much. I have a great sense of humor but this really got to me today. By the time I finally completed those 20 calls it was after four and all I finished was one book and paging the manuscript leaving four more sad novels feeling sad, unloved and neglected.

The last representative asked me if I was having a great day. She sounded like she just wanted to go home. But, by the time we got off the phone we were hysterical laughing, I had finally gotten the answers I needed and repeated everything that I was supposed to do to get this ridiculous medical coverage change that I did not want to change to start with. Never mind why I had to do this just know when it is your turn: get a glass of wine, a hot water bottle, some ice cubes for your head, black coffee, and take a deep breath and you just might survive it all.

Word of advice that I learned a long time ago: Always record the name of the person you are speaking with at every agency. Record the phone numbers in a book and keep your cards handy for your membership numbers. Keep a portfolio for each person in your family with their information and their forms and anything related to medical coverage or you just might find yourself in your own state of Medical Blues for more than just twenty phone calls.

But, I hate to tell you it just gets worse. So, for those of you out there that are not Medicare Eligible and are retired heed my knowledge: When you are retired and I got this straight from the script that the person read to me your coverage stays the same as long as you are not old, not 65 and not Medicare Eligible. Hope you got that because there is much more that most people do not know about but after dealing with them with my mom and Medicaid too, I am health insurance/care proficient they tell me. When you are Medicare and SS eligible and if your spouse is an actively working employee their medical insurance now becomes your primary insurance carrier and then Medicare is second and whatever you had or think you had before is now third. All of this because someone asked me to find out the answers that they did not think they would understand and because when it comes to health care and the rest I guess I am pretty much a pro. Better yet: stay healthy, eat healthy like I do and never need a pharmacy and then you won’t have to deal with Medical Blues.

Fran Lewis and her sense of humor.


3 thoughts on “Medical Blues – by Fran Lewis”

  1. It’s not just Medicare but the private insurance agencies also can give you a run for your money. I had to deal with Blue Cross after they claimed my mother hadn’t paid her bill. We gave them all the documents they requested first, via email, and then again by postal service. The problem was we couldn’t find anyone knowledgeable, oh they were nice people and all, but they couldn’t seem to find my mother’s files, or anything else.

    To make a long story short, a month later, the affordable healthcare act took effect and they ended up refunding most of that money! It seems they were overcharging and owed her $70 LOL!


    1. I’m glad it got straightened out. What a pain! We have BCBS of Florida and I’m not fond of them at all. We used to have United Health Care and I LOVED them. They were knowledgeable, friendly, helpful and organized. Can’t say the same for BCBS at all.


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