#insurance is a mess

[larjb3]

So for anyone who believes the medical system is relatively simple to navigate, here is how my afternoon has gone so far:

Called my insurance for help answering 5 questions. The first question took about maybe 50ish minutes to only sort of get an answer? And that was after the agent repeated back to me, several times, saying "As I previously explained" followed by an explanation that did not answer my current question. So that took a while. Then I went on to my next questions. Two of them apparently did not make sense to the agent either (in addition to me), based on the claims, and so they had to go talk to another department while also transferring me to another different department. They also were confused by another one of my previously appealed claims, and so they had to do their own digging as to what was going on. This entire call lasted just over 1 hour 40 minutes.

THEN I got to call ANOTHER number for a different hospital service because my account online wasn't showing a balance, but the letters I have received said I do have a balance. The agent who answered the phone for this call also didn't know why my balance was not showing online. This question got squared away pretty quickly, running just over 11 minutes in call time.

So now think of this: I am a (reasonably) well-educated person, with a PsyD in Clinical Psychology, and have been closely intertwined with the medical system since 2017 when I finally got one of my diagnoses. I have, in recent years, been even more intertwined with the medical system, with applying for Medicaid at one point, managing which doctors I see due to them actually being in-network with my various insurance providers through the years (not sure any of you notice, but finding an in-network provider, ESPECIALLY when on Medicaid, is extremely difficult), managing various prescription costs, talking to insurance as to why certain medications are suddenly no longer covered, advocating for myself when meeting with different providers (which they absolutely do not like but it 100% is necessary), calling insurance when something doesn't make sense on a claim (e.g., why a service, that was not specified, is suddenly not covered under an in-network provider), finding the right department to contact for insurance, trying to send messages with insurance and getting answers that pretty much say nothing with regard to answering my actual question (which then results in having to call insurance, which is not really all that fun), and there's probably more that I'm missing.

I'm also a relatively privileged individual, with a (mostly) stable wi-fi connection, a phone that can be easily charged and is currently connected, and a way to jot down notes both before and after calls (before: what questions I have; after: what the agent(s) said regarding my questions).

Now think about those in poverty. Do I have the most money? No, but I have a stable place to live, food, and water, and I have support from others (including you all!) who have helped me tremendously through financial support. But do those in poverty often have those things? Not always. Then put on top of trying to fend for basic survival necessities (which should probably be a pretty high priority) the medical system. This includes insurance (or lack thereof) and, if someone has it, paying consistently for it. This includes paying out-of-pocket costs with probably minimal money. This includes somehow getting to appointments on time with methods of transportation that may not be the most reliable, or they may cost a lot of money. This includes picking up and paying for prescriptions on time. This includes (if at all possible) communicating with one's insurance regarding claims that may not make sense. THEN we add on possible kids and have all the same barriers previously mentioned. THEN we have the possibility of someone having a job (if they're lucky enough to hold one), while managing medical things for both themselves, and if they have them, their kids. If they don't have a job, then we're looking at figuring out how to get on disability or SSI (both of which are TREMENDOUSLY difficult and tedious to get on and takes months to years to actually successfully do it). Now we're looking at if this person even has an advocate or case worker to help them. If they don't, or don't know how to get set up with one (because actually knowing what services you're entitled to, especially with different insurances, is exceedingly confusing), then they're on their own trying to navigate this vast landscape of things to manage. Oh, and we also have to consider that if someone IS on Medicaid or disability, they can only work a certain amount and take in a certain amount or else they lose their coverage. I'm not entirely sure the number of hours one is allowed to work on disability, but I want to say maybe around 15/week? (If someone actually knows this number please reach out to me and let me know!)

So we have all this mess. And think, I spent just under 2 hours on the phone with various insurance and medical providers today, but someone who is super struggling and under-privileged likely doesn't have the 2 hours needed to whatever questions they may have. Which can unfortunately result in frustration, hang-ups, and not getting an answer that can be understood in layman's terms which can result in more frustration and potentially just giving up on advocating for oneself.

It's a mess, and there are so many layers that are not discussed or even thought about by so many different people. I feel as though this needs to be said and at least somewhat recognized by others, potentially to help provide compassion to those so closely intertwined in the medical system.

[blu-ish]

✨Late Night Flight🌙

[asexualbookbird]

Hm. Okay. So I didn't read a lot this last month. I've been fighting chronic illness and the brain fog that comes with it so really it's a miracle I read what I did. Didn't do any drawing challenge this year, but I DID knit a half dozen cool little things I can't yet share but am very excited about! I also had fun with the Tricking Treats this year. Yall really came through for that game this year, thanks! Acquired a nice new monitor for computer and it's been wonderful. Next step is speakers so I can watch things!

I feel like I made a pretty decent dent in my yearly reading list and while I don't think I'll finish it (waitlist for Jasmine Throne audio is still about sixteen weeks long), I'm happy with where I am. Three (3!!) books I read this month were from the list and I think that's very cool and executive functioning of me.

In Other Lands by Sarah Rees Brennan ⭐⭐⭐½ - A friend has been trying to get me to read this since it came out and I've always put it off because our tastes are SO different, but I didn't hate this! I mostly enjoyed it! It missed a few marks for me and I wouldn't really want to read it again, but I'm glad I experienced it. Love a good gremlin of a main character.

Red Sister by Mark Lawrence ⭐ - Yawn. Snore. Boring. Read for book club, but I wasn't exactly not interested in it on my own. IT just. Didn't hit right. Mark Lawrence needs to stop being afraid of aging up his characters because there is no way a nine year old is doing all that. Was this scifi? Where those space ships?? Is the moon haunted??? Who knows. Who cares. Not I.

Strange the Dreamer by Laini Taylor ⭐⭐⭐⭐ - I am forever a Daughter of Smoke and Bone girlie (gender neutral) so I've been avoiding this because what if I don't like it?? Spoiler! I did like it! It somehow scratched the hole left in my heart after DoSaB, but still felt distinct and unique. Did not like the insta love going on, yall have known each other for like twelve hours what do you mean you're In Love. Visuals were great and world building stunning as always. I wish Laini Taylor published more books, I love the worlds she creates.

Once & Future by AR Capetta and Cory McCarthy ⭐ - I'm never reading another book with Jimmy Pees name on it ever again. I meant to do a full review on this one, but time slipped away. I think this could be SO GOOD if it was reworked to two books where book one stopped at the time skip and book two took more time to overthrow the Evil Capitalist. It was too on the nose. It felt like middle grade, it dealt with older young adult topics. Merlin fucking sucked. I find it icky that everyone was paired off except for the ace character who EVERYONE HATED. Sure they came around to her, but ONLY AFTER IT WAS MADE CLEAR SHE WASN'T INTO GWEN. Ick. Full of potential, and yet.

Not a great reading month. Maybe November will be kinder. I'm slowly getting through Sunbringer, and am enjoying what I'm read so far so things are looking up. Going to see Nerd Squad soon. Still making knitted things I can't share until after the holidays. Tricking Treats also made me excited to do art again and because there were so many I ended up learning a lot about how CSP works which is fun! So hey! November is looking good! November is looking fun! I WILL MAKE IT FUN!

[venstm]

so, for anyone who saw my previous post tonight one of our pipes burst which has caused a great deal of damage to a lot of our house. we're doing all we can to try and clean up on our own but if anyone can help by donating that would be immensely appreciated. i spent the last few hours alternating between wanting to cry and scooping water into our bath to try and minimalize the damage.

i'll add the link here and some photos under the cut so people can see what has happened.

[moghedien]

My face when the mom who just backed into my car with her mini van said that her back sensors didn’t tell her I was there and she doesn’t know what happened: 😐

[ayamari-no-goshi]

Actual photo of a raccoon taken on my back porch that got made into a meme (I want to say it was @stealingyourbones who made it? Edit: my apologizes, it was @gilbirda )

@spite-sapphic-starlight asked me about it, and I guess I never told the story behind it to people.

I have an extreme dislike of raccoons after one got into my crawl space and did a lot of damage. The bastard also liked chewing on electrical wires above where I slept.

So, one summer, I was trying to catch some stray kittens so the cat food was too much for them to ignore. Was in the process of scaring this one off the porch from the storm door when it stood up. And I opened my back door so I could punt it. Yes, my hatred runs that deep.

Thankfully, for the both of us, it realized I was serious and ran off before mistakes were made. But yes, I was going to fist fight a raccoon

[who-is-page]

Life is hard! Consider buying my stuff!

My life isn't quite falling apart, but things have gotten really tricky lately. One housemate (and their super destructive, permanent houseguest) is refusing to pay their share of rent or utilities for the next three months, and another is refusing to pay their full share of rent for that same amount of time and is making us cover around $75 every month, and I'm having to double-up my hours at work while still being a full-time student (and also one of my professors, who we're 99% sure is using ChatGPT to generate her citations because none of them exist and we pointed this out, hates my guts and has been grading me really harshly and forcing me to go full-sail on every assignment to ridiculous degrees in order to pass this required class).

My spouse is working on getting full-time at their job, but it looks like they won't be able to until December, and we also have no idea how much rent is going to increase this year-- my guess is it's going to go up another $500, same as last year, to a total of $3,000, so things are gonna get really fucking bumpy until around January, probably.

So basically, if you like the work I've done, consider throwing me a tip on Ko-Fi or buying my stuff on Itch.io:

(Also I promise we have more stuff lined up that we want to polish and publish, life has just been super-duper fucking busy! There is so much more going on right now than what I've mentioned here, especially in terms of surprise medical bills and other horrible surprises. And we haven't forgotten about Inky Paws issue 2, either, which we're still hoping to have done by December and which will STILL always be entirely 100% free to download, no matter what our living or money situation looks like. That will never ever change, so please don't worry!)

[void-of-unparalled-chaos]

I'm going to throw myself off a bridge

[starlightazriel]

all are started, not sure when each will be complete but i'm updating my works in this order

• bee 11

• necessities 5

• glass heart 2 tied in with an anon request

• another request lol

see hash tags for unhinged explanations cus i've literally been so inactive i miss yall

[iero]

My landlord broke the news to me that he might have a potential buyer on the property I, and my neighbors, live in and that I have a YEAR to find a new place or my rent is gonna increase dramatically (again)…

[over-fen-and-field]

Screaming nauseously into the void

So, for the past ten months I've had a Mystery Problem Syndrome (MPS) -- unpredictable hours to months of nausea, headaches, dizziness, brain fog, weird muscle things, a dangerous amount of weight loss, all that fun stuff. The working hypothesis from my GI is that it's an autoimmune thing triggered by a viral infection in my intestines that may or may not be temporary on the scale of a year or two, but we haven't been able to totally confirm that's what it is or whether it's going to be a year-long thing or a many-years thing or a forever thing. It's not always clear what's triggering the big flare-ups, but stress is a contributing factor. This is a problem firstly because I'm a PhD student who has always run a little anxious in the way that some ovens run a little hot and secondly because my body cannot tell the difference between stress and excitement.

In practical terms, this means that I've zombied my way through work for about five total months since January, have barely left my town all year even for just little day trips, paused a lot of my big plans like getting more intensive therapy to deal with my driving anxiety, and have had lots of little "fun" moments like barely being able to present my work at a big conference, running out of my roommate's big opera performance to throw up in a trash can in the hall, and spending about two months being unable to even take consistent notes during D&D and not really being able to enjoy it or any of my other hobbies. This was all no good, obviously, but to really add insult to injury, I might have triggered a full-on flare-up by... (drumroll, please)...

Buying groceries for my Halloween party!

Not even throwing the party. Not even drinking too much or eating forbidden foods at the party.

Buying groceries for the party. At the same grocery store I always buy groceries at.

I got too excited while passively noodling about desserts and decorations and how I wanted to arrange the cheeseboard and whether blackberries would be good in sangria.

And have been unable to keep food down since.

I hope I'm miraculously cured by the party itself because I'm going to have a hard time convincing anyone to eat my food (I'm definitely not contagious anymore! I cleared the actual infection in January!) if I'm this noticeably sick during it.

Also I was looking forward to it a lot and a good dozen of my friends are gonna be there and :(

Apparently, I can't look forward to things anymore! I should just sit in a quiet room and contemplate the grass as it grows, careful to maintain complete emotional neutrality.

[kickedin17]

Girl (Tyler Robert Joseph) if I don't get this job this week AND the Paladin MV still isn't out, I'm gonna **** **** * ******* ****** *** * **** ***** ****** ****

[floral-hex]

woke up at 4am feeling the weight of my life crushing me, so I’ve been sitting out in my car for the last couple of hours because I just need. to. be. somewhere else.

[terezicaptor]

they should make it so my brain does not function how it does

[kenobihater]

i picked up too many local spoofed spam calls due to fear of missing a callback or a call from someone's personal, now i'm dealing with 15 calls at the least per day, and i'm going fucking insane. while i'm looking into setting up a filter, if i'm pissed off enough i've started picking up the phone and just lying. if it's not a robot i tell them i'm NOT who they're calling after, i'm tired of getting phone calls and want off their list, my mother just died, and i need to plan her funeral, all in a pathetic ass tearful voice. i then hang up while they're awkwardly apologizing. it's not nice but it is satisfying

[altruistic-meme]

help someone please make me be an adult cus i really just don't want to.