Friday, September 16, 2005

Caregiving and Medical Insurance donnybrook Pt I

Time is an ever tightening screw that controls caregiving. Our transitional year and more has been dominated by the demands of Patti’s medical insurance debacle.



Patti’s private medical insurance and pharmacy plan through Long Term Disability (LTD) Benefits from previous employer is absolutely critical for care of Multiple Sclerosis. Many treatments and services and MS medications are not available through Medicare. 


In brief, 14 months ago Patti’s long term disability benefit medical insurance was suddenly cancelled (without warning or notice) . Not only was it cancelled it was ‘retroactively’ canceled for a period of time ranging from at least 5 years to 13 years.


Suddenly, hundreds of thousands of dollars in medical bills were past due and subject to collection. After visiting a couple lawyers the consensus was I was screwed. Bankruptcy was their best advice.


With Patti safely in long term care, my daughter and I faced whatever life bankruptcy left.



Beginning in the late 1980’s we became aware of conspiracy theories of insurance companies and employers doing just such things to families living with a chronic illness or chronic disability. Once you cross a certain cost line you are dumped ‘retroactively’. You can try to file a law suit however your legal bills will bankrupt you before you ever see a courtroom and medical providers will bury you in collections.


Over the years too few people have been noticing that medical expense related bankruptcies in the US are NOT from people without medical insurance but filed by people who HAVE or HAVE HAD medical insurance.



Lawyers explained the problem is basically “billable” hours. It takes staggering time to play ‘paper chase’ and for phone calls, ‘on hold time’, and to compile data to keep pace with the near infinite resources of a corporation. You can file for bankruptcy now or go bankrupt trying. The end result is the same.

Instead I just put my head down and charged ahead, minute by minute, hour by hour, week by week, month by month. Over the year the plot took several twists and turns as it began to straighten out or perhaps snake away. It all depends if you believe in the intrinsic good or evil of the medical insurance industry and corporate America.


After over a year of fighting, I’m supposed to believe it all began with “an unexplained computer glitch while files were being centralized…”. No apologies.


Retroactive cancellations have been corrected, long term disability insurance though modified has been restored, ‘retired’ employee status has been reactivated, and medical payments have been repaid.  


"Billable" hours = 2000 (give or take). That is IF I were a professional anything. <grin>


Last week while sitting at my desk preparing paperwork for court date over collection, the last unpaid provider contacts me that they have received payment from insurance and have cancelled legal action.  


Do I believe it is over? NO more than I believe in the alleged ‘computer glitch’. Patti & I rolled our eyes at conspiracy theories for nearly two decades. I’ve learned the hard way that 'the hammer will fall'. "When?" remains the variable.



Not just time but anxiety, a crises mentality, a constant focus on MS were pulled ever tighter by this battle. There are days I wonder if  I even personally experienced a "transitional year"? This focus has prevented any attempt to detach.


A hundred or more human beings were involved in this past year's conversations, letters, emails, etc. The overall picture was never really confusing as to what was happening and why. What saddens me is that about 10% can really be labeled "human" with a moral compass of right and wrong. For those few,  I am beyond grateful for their compassionate courage. The majority of the computer age workforce in the insurance industry, medical billing, and employee benefits are more infected with viruses of disinterest and plastic values than their computers ever will be. 


Have I won?  Adding up my day planner, what are 2000 hours (80 days & nights) of my life worth? Proving lawyers wrong is always nice. Yet somehow a Pyrrhic victory doesn't feel like a win. Too tired and too wary.


  1. Perhaps your bad experience will make the rest of us wary of what can happen,cf

  2. Wow - - Wish I'd known all of this 13 years ago.


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