Thursday things, running, shopping and fighting with insurance companies.

I ran 6 miles this morning, and yesterday morning, and the day before that, and the day before that.  Our weather has been awesome, cooler, especially in the morning but awesome nonetheless.

running weatherPerfect weather.  MacGyver doesn’t feel that way though.  Yesterday the high never made it past the 60’s and he was in hibernation.  He didn’t leave the sofa until after 3 in the afternoon, Amateur!

I don’t remember if I told you that we finished our river resin table but anyhow, we did.  On Sunday I searched Craigslist and found some chairs that I thought would be perfect for it so we drove out to North Port to get them.  MacGyver isn’t really all that happy with them and constantly mentions it but everyone else has loved them.  We had to touch up the paint on them and I recovered them and I think they’re perfect.

Here is the table that we bought at an estate sale but it didn’t look like this, it was actually in pieces and laying on the ground.

table beforeThe picture came from the lady hosting the estate sale.  She gave it to us so that we could see what it was supposed to look like when put together.

We had no intention of putting it back the same way, instead, we made this:

New tableAnd here’s a better picture of the whole table and a close up of my awesome chairs.

river resin tablechairI’m in love with all of it.

I meant to post the pictures yesterday but instead any extra minutes that I had I was fighting with my health insurance provider.  Why, you ask?  Well, apparently they have decided that they are more skilled at handling my health than my actual doctor so they have decided to use an independent reviewer to determine what tests are medically necessary and so far they have denied all of the recent tests my doctor has ordered and deemed them medically unnecessary.

One of the tests is an echocardiogram and the other is an MRI of my brain.  The doctor is trying to determine if I have new lesions in my brain or if I have any signs of damage to my heart from the sarcoidosis.  The independent doctor reviewer doesn’t feel any of these test are necessary.

So, I called the insurance company to find out how exactly he determined that they aren’t necessary and all they would tell me is that they have a ‘formula’.

whatSo I tried to reason with them and I asked them what I could do since I really need these tests and the nice lady told me to ‘go ahead and have them and pay for them if you’re that worried about it.’  Seriously.  Over 5,000 dollars in tests.  Sure lady, I’ll just pay cash.  So I asked her what exactly my 734 dollar payment to them every single month actually gets me and this bitch tells me, ‘piece of mind that you’ll get the medical care necessary.’

As determined by them apparently.  Anything else, I have to pay for.

So I end the conversation by telling this lady that I will file an appeal and I also tell her that if anything happens to me in the interim, they will be hit with a lawsuit and she tells me that they are protected because I’ve been giving the option of paying for the tests myself.

are you kiddingI don’t think I’ve ever been so mad in my life.  And all the while that I’m fighting with them I was thinking how glad I am that I’m on steroids and have the energy to do this.  Imagine if I was debilitated. It’s ridiculous.  I’m still angry about it but I filed an appeal and we’ll see what happens.

We’ve got less than two weeks to get Christmas shopping done.  Are you finished?  I finally started yesterday.  I’m doing 95% of it online and hope to be finished by the end of the day tomorrow.

overachieverI’m such an overachiever.

How is the weather in your neck of the woods?

Have you ever been denied a test or treatment from your health insurance provider?

Have you finished all your Christmas shopping?

 

 

6 thoughts on “Thursday things, running, shopping and fighting with insurance companies.

  1. I would be SO angry about that doctor deciding that those tests aren’t necessary! It’s very different in Canada, I don’t have any insurance but if tests need to be done, they are done, (usually with a wait time), but they are done for free. I recently had a brain MRI done after I suspected I had suffered a TIA. I hope you get the care that you need <3

  2. 1) That new table is gorgeous! Y’all did an amazing job.

    2) Insurance is a giant poopshow. I’m furious every time I have to deal with my insurance company. Ten years ago I had an amazing policy that covered everything with little tiny copays, and now my policy denies coverage for my son’s medicine and my follow-up mammogram. I barely have any doctors in network and have to drive to questionable neighborhoods for some care. It’s ridiculous.

    • Thank you, we are loving our new table and I’m thinking of making more.

      I hate to hear so many horror stories involving insurance but it seems to be the norm. I talked to a lady this weekend and she told me her coworker had just had a heart attack one week after being denied a stress test. It’s so sad. I hope you are able to get your insurance straightened out. Follow up mammograms and children’s medicine are not options, there basic rights.

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