Test Driving the New Insurance

New year, new insurance plan, new doctor, new state. I also needed new Rx refills, and the old doc in the old state was getting tired of providing services long distance. It was working, at least for me, after finally finding a clinic with a lab that would test my blood coagulation levels, after which I'd call the old clinic with the information and they'd tell me whether and how to adjust my Warfarin levels and when to test again.

January 1st was the start of the new plan. After a lot of phone runaround, I found a clinic within the plan who actually had a doc accepting the insurance and new patients. Hey, who knew their card and inch-thick catalogue of information wasn't perfectly accurate? At any rate, the 6th was the first appointment I could wrangle, and managed to convince the old doc that if she'd keep me in meds through then I'd quit bugging her for refills.

It was the usual new patient visit. It started last year with a pre-visit to fill out paperwork to transfer my medical records, plus 6 pages of my summary of my medical history. Gotta wonder how much of anything actually got read. And really, who actually remembers exactly what date my tonsils were yanked or my tubes tied? Now the caesarean date I celebrate every year, so that's easy to remember. Some procedures I can winnow down to my age at the time, like 5 for tonsils, 12 for appendix, and 40 for gall bladder. But when did I have Bells Palsey? Break my nose or wrist? Especially the latter, since, without insurance and with the urgent need to keep working anyway, I treated it on my own and never sought medical help. I found a couple ways to immobilize it and let others assume it was just carpal tunnel, a sprain, or some such for a few weeks. It let me know when it was usable again. And family history? Hey, bro, if your health status is anything other than "healthy", I guess I lied on the form.

Other than blood pressure, O2 levels and pulse, the visit was just questions, followed by a perfunctory stethescope check through my shirt followed by being sent over to a lab for samples and told to report back in a week. For the record, the BP was fine, especially for being taken 30 seconds after walking in the room rather than sitting for 5 minutes. Pulse was 60, O2 was 97. I was given a sheet with the lab address, a new appointment for next week, and sent on my way. Oh yeah, the mandatory co-pay was made at the point of entering the office. I'd given them the insurance card back at the pre-visit.

The lab tests were to be made while fasting. Nothing for 12 hours before. He apparently doubted the diabetes diagnosis, either because he hadn't made it himself, because I was controlling blood sugar levels by regulating carb intake, or because that status somehow affected my insurance. I've been relying on A1C tests semi-annually at the old doc's office for a couple years now and hadn't needed any fasting tests. Let me just state for the record that when I get hungry, there is an amazing correlation with with a mood condition best labeled CRANKY. Keeping this in mind, I'm very proud of myself for my forbearance with the rest of the next  morning.

The lab takes both appointments and walk-ins. So did my old doc's lab, though hers was about two doors down the hall from the exam room, and not several blocks away. At any rate, I got up, caught the first few minutes of local news while the dogs were in the back yard, and did the usual getting ready to leave the house routine. I figured 8:00 AM was a good time to show up, get poked, and go find breakfast on my way to pick up my filled prescriptions. After finding the lab, I signed myself in and managed to find one of the two remaining empty seats in the waiting room. they must have had over 30 chairs in there. Not looking promising so far.

Eventually they called my up to the desk. Was I new? Did I have insurance? Had the doc send (emailed) over his orders for which tests? Yes, yes, yes, and... Oops! They didn't take this particular insurance plan. Or perhaps the plan didn't take them. Whatever.

They were both very sorry and very helpful. I was given a map plus name and address of the right kind of clinic, and they printed out a hard copy for me of the tests my doc wanted taken. They were so nice that I didn't bother to ask just why they were snickering about something on his orders for one test. I wasn't sure I wanted to know. I was sure that I figured a little amusement on their part was reward enough for putting up with the inconvenience of an unpaid visit as well as their respectful treatment of me.

Before leaving the parking lot I pulled out my cell and called the the doc's office. No help there. It was just a few minutes till 9:00 and they weren't open yet. While I sat and waited, I made a call to the insurance company. I needed to verify that this new lab was indeed in the system and this visit would get paid for before driving the mile or so over there and waiting again. They confirmed it was in thier system. So, since it wasn't the one the doc recommended, did I need to get ahold of him to reissue his orders to the new one? No, but I should call his office and let them know what was going on. Something along the lines of a polite reminder that insurance status needed to be checked out before referrals were made.

Fine. I could do that later. If I were going to eat, I needed to get moving and get the testing over with.

On the way over, my cell rang. I recognized the number: I had just called it. My doc's office was now open, and they were calling me. I doubted that they returned missed phone calls, and wondered what was up. This time it was their recommendation for my new-to-be cardiologist. Since I was still driving, and pulling off, parking, and reentering traffic is a tad complicated down here on major streets, I asked her before giving me the data whether she could check with that doc's clinic and verify that in fact they took my insurance, giving her the story of my current expedition for lab work. She said she'd check and call back.

This lab was harder to find than the last one. Phoenix has this habit of putting buildings with an address on a particular street behind other buildings along the street, separated by parking, shaded reserved parking areas (often covered with PV solar panels), more parking, and wandering driving lanes undistinguished by any traffic lane designations, designations of intersections, or indications of who should yield to whom whatsoever. In short, you better know where you are going before you attempt to navigate to safely get there. AND prepare to stop for everybody else as they won't see or stop for you. At least this building had an open handicap parking spot.

This lab had also done a decent job of clearing out their waiting area. I began to hope I was getting closer to having breakfast.  After handing over my accumulated paperwork, they handed me a cup and asked if I could please pee into it. I reflected that it had been enough of a delay since leaving home that it should indeed be possible. The request surprised me, however. Other than random drug tests and possible infections, I hadn't been asked to do that as part of my lab work for years. Before heading back, however, they asked for my credit card, and handed me another form to sign stating that I would cover whatever part of the bill (over $500 for today's tests) the insurance refused to cover.

Oh goodie.

The process itself was speedy, punctuated by a conversation on the scar tissue inside my elbows from being a 10-gallon Red Cross donor, an apheresis donor, and a plasma seller at the stab lab during the really lean years of single parenthood. A good phlebotomist can navigate through it, but it gives the rookies fits. She was good.

OK, now breakfast?

Well, no. I needed to head to WalMart for the meds, plus grocery shopping. If I didn't go straight there this late in the morning, all the electric scooter carts would be in use. Besides, there was nowhere I passed on the way that offered anything even remotely tempting. And topping it off was the niggling thought that I wasn't sure if the drug plan had a deductible at the start of the year or not. If not, I knew one of the meds cost nearly $60 in WalMart prices per month and the scrip was written for three months. That kind of consideration is not best conducive to a hearty eating-out appetite.

I wound up having to pull off and stop along the way anyway. I got my callback with the cardiologist referral, now confirmed to be in the insurance system. What should have been a quick off/on turned into a long wait for the green light and a resulting backup just to get back onto the cross street.

There was a solitary scooter left for me at WalMart, functioning even! I got in line to pick up meds. It happened to be the longest line I've ever seen at any WalMart, just because I was hungry, I'm sure. Even with two waiting the counter, it stretched back between the benches and around the corner down the main aisle. Lucky me, I was sitting down for it. Of course, to get near the counter required a bit of scooter jockying for the sharp angle. As I was backing into place, I nearly ran over the elderly lady who saw my maneuvering as her opportunity to approach the counter for her own order. Lucky for us all her daughter of about my age was with her and pulled her out of the way, also gently letting her know it wasn't her turn quite yet.

It's never a good sign when the clerk starts hemming and hawing, preparing to tell you something about your order. One of my meds was there. The other one, the pricey one, would be coming in, say, maybe the next afternoon? Good thing I have about three days worth left. It's not a medical emergency. She checked on its ETA for me. I hate the hassle  for nothing. Their ETA translated for me into either coming back late enough in the evening that there are again some scooters available and working, i.e. charged, but early enough that the pharmacy is still open, or I head over early the next morning. With that being Friday, that means really early, but late enough that the pharmacy is open. Hmmmm......

I still didn't know if I had a deductible on the meds. The one I paid for was about the same price with or without coverage. I'll find out. Tonight. Tomorrow. I'll decided when I decide.

Breakfast was finally accomplished at 11:30, breaking into a pre-cooked chicken before leaving the parking lot. And using about three of the doorful of napkins I keep in the car, left over from dozens of take-out meals back in the days of 12 - 14 hour work days.