Chasing the government

[bill_schubert]

Yesterday and today have been mostly spent trying to unscrew what the combined efforts of the Social Security Administration, the military, Tricare and Humana had done in one check box to Dana's health care.

She turns 65 on the 1st of Dec so we went online and applied for Medicare.  Immediately that triggered, little did we know, a change in her healthcare coverage in Tricare.  As of the 1st of NOVEMBER she was cleared for Medicare but we have not yet received a card and can't register her anywhere.  BUT it killed the insurance she did have.  So she was in a month long hole the upshot of which is that a procedure for which she needs some rather expensive drugs is scheduled for next week and the drugs are not covered because she isn't. 

Humana, the carrier for Tricare, says 'no problem, it will be retroactively applied to all the claims back to 1 November when she does get the card registered.  BUT we can't get the drugs.  So this procedure, which is kind of important, is in the same limbo as her coverage.  The drug people don't accept a promise of retroactive coverage.

THEN, I had to get her Medicare number, card or no card.  We managed to get that on the phone from Medicare late last night.

It took me all day yesterday to figure out the above.  And to find out, this morning, that the fix is to register with a military system called DEERS (basically the ID card section of the military).

BUT, today is Veteran's Day so nearly all Veteran services are closed (ironic, huh?).

Fortunately we have a military base in Austin that happened to be open due to some 'border action' going on.  No idea what that is about but the guy there took our info and put it in the computer and by tomorrow we may have this settled.

What we used to call a soup sandwich.  Really nice guy in on the military base.  Very helpful.  Fingers crossed it works.

Comments

[siglinde99.livejournal.com]

Fingers crossed here, too.

[mollywheezy.livejournal.com]

Hope it all works out QUICKLY.

[anais-pf.livejournal.com]

Oh goodness, I hope you can sort this out. I have found, in my one year of Medicare coverage, that it has some very sucky things about it.

[zoefruitcake.livejournal.com]

aarrgghh :0(

[timbear.livejournal.com]

Hopefully it'll get fixed in time. Stories like this about healthcare elsewhere in the world makes me realise that the NHS is pretty amazing, even though it has it's own faults we never have to worry about cost or payment. We kind of take it for granted.

[taz-39.livejournal.com]

There's no question these systems in the US are designed to be as difficult as possible, and to screw people out of money wherever possible. There are lots of things I like about our government but taxes, applying for unemployment, and health care are three that are just such a rip off on so many levels. Sorry, I shouldn't gripe.

Hope you can get everything sorted. What a pain.

[bill-schubert.livejournal.com]

Not designed with the intent of making life difficult but clearly the effect without intent is still there. Bureaucracies are inefficient for a lot of reasons. This particular one integrates the very high level of ID control that is DEERS (Defense Enrollment Eligibility Reporting System) eventually down to the doctor's office lacky that enters the information into the system so they can get paid for a procedure. There is a LOT of money involved and so DEERS is locked down pretty tight. No money is spent on a road map for users of the complex systems nor is there any kind of Sherpa guide to help find the way.
My method is a combination of either ramming my head into the system and or taking doughnuts to the little old lady who holds the keys. I use both methods at various times. No one who answers the phone is intending to be obstructive. They have their miniscule piece of the pie that is their job and they minister to it and usually try to help. The problem is very few, if any, understand the system outside of their purview even as well as I do. So they can only help pass you onto the next cog in the machine that they know about. They can't see the whole machine and can't see that what you really need is to skip the next three cogs. So it is just blundering along.

Fortunately I have time and am fairly good at doing it. What usually happens is I end up understanding the whole system (I'm close in this one) as well as the people answering the phone. I'm not great at taking notes but have gotten a bit better during tax season and now with this. Not useful to anyone but me which is sadly a waste of good information.

[taz-39.livejournal.com]

Gotcha.

I'm glad you got through, and so quickly. Probably due to the relentless effort that you put in.

Certainly, single mothers with kids and a full time job don't have the privilege of spending hours ramming their heads into the system or offering bribes to whoever they need to get through to get what they are actually entitled to. This is not to downplay your efforts and abilities, but to say that quite a lot of people--especially those who desperately need help with taxes, health insurance, etc.--are the ones who simply cannot afford to be on hold during normal business hours, and do not have the time to be sweet-talking operators while working multiple jobs and bouncing infants on their knees. Maybe the system isn't "intended" to be against those people, but it IS very much against them.

And then there are people like you who DO have the time, but really, time is also money. Should you have to spend hours on the phone about this? I don't think so. I know it's too much of a mess and it's unavoidable for all of us. It's just sad and infuriating.

[bill-schubert.livejournal.com]

Agree with all of what you said.