Pneumonia

As it happens with these things, Geoff and I were approved for Commonwealth Care.  We picked Neighborhood Health Plan, paid our premiums, and promptly got screwed over in every way imaginable.  Before you click through to read the rest, know this.  This isn’t a screed against Obamacare or Socialized Medicine, I am a fan of those things.  This is a screed against incompetent people, those who don’t want to do their jobs, and corporations that put their bottom line over the health of individuals and, in this case, possibly thousands of people.

To quickly catch up those of you who don’t follow every facet of our fascinating lives at home…  We were approved for Commonwealth Care on 7/19/12.  We both paid our premiums within 3 days, before the 7/25/12 cut off date for August 1 enrollment.  For some reason Geoff’s premium and enrollment were processed.  Mine was held in limbo for 11 days.  Somehow they processed my payment before they processed my enrollment.  In essence I’d paid for something very specific before I’d even picked it out.  How that works I still don’t understand.

Anyway, we got our cards in the mail about 10 days apart in August.  As soon as I got mine I called my friendly pharmacy and tried to get some very important scrips refilled.  In doing so my pharmacist discovered that I didn’t actually have any health insurance.  The coverage for August 1st?  That was mysteriously not happening.

After she made some inquiries and then I made three, count them, THREE days of phone calls, it became clear that despite the fact that I’d paid Commonwealth Care on time, they waited around and processed my payment 11 days later which meant no health insurance until September 1st.

As you may have noticed, today is September 1st.  If it wasn’t for the fact that I desperately needed some maintenance prescriptions that do little things like keep me from having seizures, it wouldn’t have been so much of an issue that somebody at Commonwealth Care not only screwed up my payment and enrollment with Neighborhood Health Plan but that they also didn’t care.  The only way that we ended up being able to afford the medications that I needed is that one of Geoff’s employers stepped up and wrote me a check to cover the cost of the meds that I otherwise couldn’t have been able to afford.  Yes, you read that correctly.  One of Geoff’s employers paid for my very important drugs.

That right there, people?  That is how you treat your employees and their families.  That is how you treat the public.  That is how you treat people who buy, oh, HEALTH INSURANCE  from you.

The upshot is that I was able to get the medications that I needed.  I thought that I was in the clear.  During the process of all of the phone calls and the back and forth I discovered that I was technically covered by something called Health Safety Net.  It was dated to July 20th and it basically meant that if I got hit by a bus I had a $2,234.00 deductible.  After I met the deductible everything was covered.  So, we’d be bankrupt, unable to pay our rent, possibly homeless, but not dead.  Yay?

Thursday, August 23rd, I started to cough and wheeze.  I thought, at first, that it was just a bad asthma day.  My asthma is generally well controlled and I rarely need my inhaler.  I don’t need a daily controller medication, just a rescue inhaler and that’s generally when someone is wearing a perfume that sets me off or I’m sick in one of my twice yearly colds that leads to bronchitis.

This wasn’t just asthma.  It went on and on.  By the beginning of this week I was hacking like a 2 pack a day smoker.  (I’ve never so much as had a drag on a cigarette in my life, for the record.)  By this Wednesday I was hacking up stuff that should never come out of the human body.  But I had to work, I don’t get sick time at any of my jobs, we depend on all income for basic survival, and one of my jobs was heading into what is called “Black Out” time.  (Black Out applies to certain heavy traffic/holiday times of the year and it means that we not only have to sign up for extra shifts but that if we call out we have to have a doctor’s note.)

I have called out from this particular job exactly once.  I went to work yesterday and the day before coughing so hard that one of my supervisors was worried that I had a pulmonary embolism.  I’d have to duck out back to take my inhaler and drink water just so I could talk to the customers.  I deal with hundreds if not thousands of people every day in this job and it was not lost on me that if I had something contagious I was putting them all, as well as my coworkers, at risk.  I was even concerned that due to the nature of my coughing and the lack of any sinus symptons that I might have pertussis, whooping cough, which is making a major comeback right now.  The problem was that I had no choice.  I had to be there, I had no doctor to go to.

If my health insurance was active I could have gone to the doctor or an urgent care clinic.  I could have had someone give me a nebulizer or put me on antibiotics a week ago.  Instead I had to wait until today.  I had to make some phone calls this morning and find out if my insurance was actually active (it was).  Geoff, who thankfully had the day off, drove me to MGH after I called my boss and told him I was on my way to the walk in clinic.  I sat there, mask on, hacking until I was seen.  I was seen remarkably quickly and sent for a chest x-ray and then sent home.

I got the call this afternoon.  Pneumonia.  I’ve been asthmatic for over 20 years.  I’ve been asthmatic while thin, fat, in shape and exercising every day, and out of shape.  In every season and weather and in exposure to every possible allergen and irritant.  And I got pneumonia now, despite being vaccinated against pneumonia 2 years ago.  I got pneumonia because I didn’t have access to proper health care.  I didn’t have proper access to health care because someone or someones couldn’t be bothered to process my payment, my paperwork, my healthcare despite the fact that I paid them and paid them ON TIME to do just that.

I have another chest x-ray in 6 weeks when I go back to see my PCP.  This assumes that my next payment is processed properly and nobody decides to sit on it, too.

During the initial investigation into what happened I contacted Health Care for All and they put me in touch with the nice folks at Health Law Advocates.  As is usual with law, there was the truth and there was what we could prove.  As I hadn’t taken screen shots of my online payments there was only the records of when they’d bothered to process my payments and when the transactions had finally been processed by my bank.  Still, if you’re ever in my position I highly recommend both of the above agencies.  They listen.  They care.

The doctor I saw today said that rest, antibiotics, fluids, and no work until Thursday was the proper prescription for me and I plan to take him at his word.  Lucky for you all, maybe it will give me more time to blog.  Heh.

~Kelly

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