Health care

So, as expected, the CardioDoc prescribed a blood pressure med. When I pointed out to him that if a drug has a bizarre side effect, I will get it (and no, it doesn’t matter whether I know what the side effects are or not), he came up with something so mild one can even eat grapefruit with it. Besides a little diarrhea, a little belly pain, a little syncope, and kidney failure, it’s fairly benign.

Lovely.

You have to die of something, and between you and me, dropping dead of a heart attack, which occurred to my great-grandmother and my great-aunt when they were in their mid-90s, looks a helluva lot better than dying of cancer while bat-brained doctors stand around hooting that you’re a mental case, as occurred to my mother in her early 60s. It also looks a great deal better than dying of kidney failure, which is a) a possible outcome of high blood pressure and b) a possible outcome of blood-pressure drugs. If one could be sure of the heart attack, possibly one would have a clearer view of the best course of action.

Whenever I’m in a doctor’s office or, God forfend, an ER, my blood pressure obligingly goes into the 150s. Here at home, a battery-operated blood pressure monitor registers in the high 110s and low 120s. But CardioDoc blew those figures off this afternoon — he said home BP monitors are unreliable and don’t measure a real figure: you have to take three readings five minutes apart (consuming FIFTEEN MINUTES of generally miserable time), and then average them to get anything resembling accuracy.

Well. Since every time I repeat a BP reading here at the Funny Farm, it’s invariably lower than the first effort, that would push my readings significantly lower. The guy refused to even look at the record I had. Sooo…. I’m thinking maybe I need to get a second opinion about this before I start gulping prescription drugs.

I don’t know. If the guy is right, I need to get on this stuff ASAP. If he’s wrong, it could do more harm than good; at best, it’s unnecessary.

Tomorrow I’m driving out of town. You’re not supposed to drive after taking the stuff until you see what it will do to you, since it can make you pass out. So the soonest I can start gulping this chemical down will be next Thursday…after I finish the dawn junket to Scottsdale.

Two things I like about this guy are that he seems to be right about the heart palpitations, which are extremely uncomfortable and scary, and that he is manifestly correct about the fact that I’m some 20 pounds overweight. How can one do without reassurances that you’re NOT old and you’re NOT fat?

Yes. Young Dr. Kildare has denied not only  that I’m old (give me a break, kid!) but that I’m fat. When I remarked in passing that I need to go on a diet, he looked at the 158-pound weight I’d logged that morning and allowed as to how I was within the “normal” range for my gender, age, and height. Right. And I look like I’m three months pregnant because…why?

CardioDoc suggested that I might be able to shuck the BP drug if I would get off my fanny and exercise (now there’s a radical idea) and if I would lose 22 pounds. These are things I’ve known for a long time but been too indolent to act on.

He also believes that the uncomfortable chest sensations are a manifestation of a genetic tendency to anxiety, which he describes as something different from stress, per se. It amounts to a pathological over-response to pretty much routine stressors. And I do have to say, I get these “heart palpitations” or whatever they are when a series of stressful events or situations occurs over a long period of time, especially when these happenings kick into “it never stops” mode. Even when on the surface things seem fairly quiet, what goes on day by day can add up, in the same way small savings here and there can add up to big savings, or small expenses here and there can add up to big bills.

Consider, for example, the day-by-day sources of stress I’ve recorded in the blood-pressure and Holter monitor logs since this annoying medical venture began:

4/10

• About 3:30 or 4:45, client called. Long angst-filled talk about her co-editor & the project.

• Racing out the door, late for choir, find notice in mail from IRS billing me for $10,000 in 2011 taxes and accusing me of fraud. Fly out the door to rehearsal. Sing for 2 hours.

• Accountant didn’t get message. Client from Hell persists. Student submits late paper in format I can’t open.

4/11

• Get up after awaking at 4 a.m.

• Return extremely difficult edited essay to anthology editors, with involved cover note. Start calculating billable hours. Not washed, made up or dressed! Now running late for 7:15 meeting.

• Late; fly out the door. Make u-turn, fly back to house, RUN to take out overfilled recycling bin, run back to car, race to Scottsdale thru rush-hour traffic.

• Finish chairing business group meeting; have light breakfast w/ coffee. Haggle with nuisance client. Discuss client’s work and general business issues with designer.

• Correspond with book packager, client. Correspond with accountant. Try to find password for p/w-protected financial statements from manager. E-mail binging nonstop. Client’s co-editor nagging for a bill.

• Trim tree suckers and cut back dead (man-eating!) agaves.

5/22

• Insomnia; meet with difficult client; undergo stress test; worry about health; drive thru awful traffic.

5/23

• Insomnia; take on new client’s challenging project on tight deadline; worry about health.

5/24

• Meet with client starting at 8:30 a.m.; it’s after 12:30 before he leaves. Edit Chinese scholars’ work on 5-day deadline.

5/25

• Just once I’d like to be able to sleep for 6 or 7 hours straight. SO tired!

5/26

• Wrestle with annoying ditzy job; pressure from author to accelerate deadline; many errors in Au’s References; Word as usual puts up a fight.

• Work  like a horse to finish Chinese researchers’ paper. Word crashes. MacBook crashes; looks like its drive is fried but it finally reboots. Terror!

• Carbonize my dinner on the grill; have to throw out expensive cut of lamb that I couldn’t afford in the first place & sure as hell can’t afford to toss in the garbage.

5/27

• Spend day shopping w/ KJG at Arrowhead, which should be fun. Feel terrible most of the time: weary, lightheaded, marginally headachey, tense sensation in chest.

• Return from dog walk to find front door open. No one there. Unsettling, after prior garage invasion episode

5/28

• Land another new client! Yet another Chinese scholar, likely to be difficult and low-paid. Chinese faculty’s salaries make ours look like manna from heaven.

• Getting an ear infection — hurts.

• Drive from pillar to post; hustle a business owner to donate to next fall’s choir fund-raiser.

• Get told I need blood pressure meds.

• Make my way through rush-hour traffic to pick up Rx at Costco; luckily, I decide to go by surface roads, because a crash closes the offramp that leads from the freeway to said Costco.

• Lose my American Express card. Find it while on interminable hold with AMEX customer disservice robot.

• Dog is sick. Throws up. Tomorrow I have to carry her in the car to Yarnell, spend the whole day there, carry her back down to SDXB’s house, then drive her home. Hope she doesn’t throw up in the car, on La Maya’s floor, or on SDXB’s floors. What on earth could be wrong with her? She’s been under the weather for days and not only is not getting better, she seems to be getting worse.

Gaaaahhhhhhhh! Is there any question why my heart pounds like a gazelle’s on the veldt?  This is not a hereditary disorder. This is fuckin’ normal! Whose heart would not pound when every goddamn day plays out like that?

So as I was saying, one of CardioDoc’s appealing traits is his advice that the way to deal with all this is to indulge in a spate of wildly vigorous, totally exhausting exercise. I’ve tried this several times and it works.

Today when I came home from picking up the prescription, I fell in the pool and swam a dozen laps as fast as I could go without stopping. It worked. I feel pretty good right now.

And it’s almost 10:30 and I’ve gotta go to bed. Hope to get more than four hours’ sleep tonight.

So I get a notice from Mutual of Omaha that they’re jacking up the premium for my Medicare supplement insurance (known as “Medigap” because it fills the considerable gaps in Medicare Parts A and B coverage) by $433.58, an amount that happens to be exactly $433.58 more than I can afford.

In the mind-numbingly complicated maze that is the private Medicare supplemental insurance landscape, I have Plan F, a mid-priced scheme that effectively covers everything that Parts A and B do not cover. The last time I talked with Mutual of Omaha, their CSR suggested I switch to Plan G, which covers everything except a $147.50 Part B deductible. Part G premiums are so much lower than Plan F’s now that even paying the deductible out of pocket you still come out ahead.

Ooohkayyyy….

Meanwhile, I’ve compiled a list of a dozen companies that do business in Arizona and are charging less than Mutual of Omaha for Plan F.

Monday, I begin the endless round of calling with Mutual of Omaha itself, trying to get underwritten for Part G.

I speak with one Ernest. He says Plan G will cost $116.28, well under what I’ve been paying for Plan F. I ask about the underwriting. He transfers me to another agent, one Nicole. She says she’s a licensed agent in Arizona. But she also won’t talk with me. She tells me to call an 800 number and utter these words: “I have a Plan F and want to change to Plan G, and I want underwriting.”

I dial the 800 number and, interestingly, reach another Nicole. I say, “I have a Plan F and want to change to Plan G, and I want underwriting.” She is confused. Do I want the Underwriting Department? I say I was told to call her number, and I start to complain about the runaround.

She transfers me to one Carol. I explain what I want. Carol is in life insurance. She transfers me — to a phone tree.

Eventually, I reach one Cheryl. She says you have to fill out a whole new application for a whole new policy. She says they’ll send it to me.

Now I call Universal Fidelity. Kayla answers and says she can give me a quote. She says their Plan F is $133.85 — about what I’m paying now — and Plan G is $112.99. She explains that you have to trigger the Medicare deductible before Plan G will cover anything. This implies that there could be circumstances that Plan G will not cover, since not all issues covered by Medicare A & B are doctors’ visits. She says an agent will call me — some guy from American Health Underwriters in Ft. Worth.

I call Everence, where I reach one Jason. He says Everence is a fraternal benefit organization for fundamentalist Christians. Episcopalians do not count as Christians in their book.

Next I call American Family (the ever-annoyingly advertised AFLAC). Here I get an incredible electronic runaround and finally give up without ever reaching a human.

Moving on, at United Healthcare I reach one Don, who tells me that their Plan F costs $180 a month and their plan G, $160. He tries to corral me into an AARP HMO. I tell him to get lost.

Now I dial Heartland, where a person named Tracy transfers me to a male person with a name pronounced “Teal.” He’s with Equitable Life. He says their Plan F costs $149 and Plan G costs $140. There’s a $20 application fee, he notes. He says he will send an application and gives me a direct phone number at which to reach him.

Next I call Forethought. It’s after hours now on the East Coast, and their offices are closed.

I wonder if Government Personnel Mutual will cover state employees or the children of Merchant Marine officers. In the course of searching for an answer to this question on their website, I’m shunted to a webpage of something called Medicare Marketplace. I dial the 866 number and reach one Larry Peters, who presents himself an insurance agent & broker in Omaha. He says that Government Personnel actually started out serving only federal employees and members of the military, but it now covers civilians, too. Its plan G is only $110.70; if I want a Plan F, the next-best deal he can get for me is with American Continental at $141.94.

However, he says, it’s late at his office and the computer system is about to shut down. Could we talk the following day? We exchange phone numbers and agree to try to get in touch about mid-morning Arizona time.

On Tuesday I leave the house at 6:30 for a hike up the mountain and get back around 8:30. An hour or so later, I call him back. He says the application fee is $25. I agree to this and say I’m interested in Plan G. He asks the  underwriting questions and says he will send the form.

In the meantime, I’ve done a little research.

By Tuesday morning, I know that Universal Fidelity got a negative rating from A.M. Best in 2011 and again in March of 2012. Heartland has racked up a grade of F (for “flunk”) from the Better Business Bureau as well as 8 complaints at Ripoff Report. A. M. Best downgraded it in 2009.

Central States, which I  have not yet tried to reach but whose rates look pretty high, has an A. M. Best rating of A+; Manhattan, with slightly higher rates, has a rating of B+ and a long-term rating of bbb-; A. M. Best considers it to be “stable.” Government Personnel Mutual is rated A- (also in the “excellent” range) with a long-term rating of a- and a “stable” outlook; the Texas Department of Insurance’s excellent website shows no complaints against it.

Later on Tuesday, one Mike from Universal Fidelity calls. He says that company charges $129.85 for Plan F and $108  for Plan G. He’s a fast talker and he’s trying to maneuver me into committing to one or the other of these. In the course of conversation, he says the application fee is $45.

Since that’s clearly beyond the pale — the others are charging $20 to $25 for the privilege of asking humbly whether you may be allowed to purchase a policy to fill in the empty spaces around the capacious Medicare coverage — I ask him if that $45 is billed to me when he puts the application in the mail or only after I fill it in and submit it. He won’t give me a straight answer. I say, “You’re not answering my question. Am I billed $45 simply because you mail me a blank application, or am I billed $45 when you receive the completed application?” Disingenuously, he says I’m billed $45 when they send me a statement for the Part G coverage.

Annoyed, I say, “Look, you have competition. Why don’t you wait a couple of days before sending this application to me, until I can see what I can find out about Plan G from the several other companies that offer it in Arizona at affordable rates.” He flounders. I say, unequivocally, “Wait two days before you send this application. I will be in touch with you.”

This morning while I’m at a meeting, Mike calls back. He wants me to return his call. I’m involved with grading papers and writing a report about the meeting and so decide to delay that particular annoyance. While I’m still working, he calls again and leaves a message on my voicemail saying he had the prices for Arizona wrong, and that Plan F is actually $133.85 and Plan G, $112.79. They’ll divide the $45 application gouge between two months, making the first two months’ Plan G payments a bargain $135.29. Mighty white of ’em, eh?

Amazing picture, isn’t it? Over two days, I’ve called SIX insurance companies offering identical Medigap plans at six different rates and I’ve spoken to TWELVE different people and an impenetrable telephone tree. Of the twelve humans, nine could give me no information of any value, two tried to hustle me, and one may be hustling me but seems to represent a reasonably reputable company offering a plan at an almost affordable rate. Alleged plan G rates range from $112.99 to $160, for the same, identical, federally regulated coverage; “application fees” range from $20 to $45.

To start the underwriting process, I’ve had to give my Social Security number to a guy I met through an Internet page and who for all know could be Osama Bin Laden’s nephew, out to fund his organization’s enterprise with identity theft. And yes, I’ve asked around among friends and business acquaintances and been unable to find anyone living in Arizona who works as a broker for Medicare supplemental plans. The best I can say is that there is indeed a Larry Peters running an insurance agency in Omaha.

Ain’t private enterprise grand?

Why not  just have Medicare provide full coverage, instead of throwing elderly, frail, and often fuzzy-minded citizens into such a gawdawful briar patch?

What a flicking nightmare.

Apparently I’m going to have to go through this rat-race about once every year or two.

I did find an outfit that issues reports on Medicare Supplement and Part D (prescription drug) plans. The report on Part D will set you back $49. Their report on Medigap insurers is $99. So…that’s $150, just to try to get an allegedly unbiased comparison of these outfits.

Otherwise, there appears to be no help available to consumers for navigating this dangerous and expensive mess.