nakedjen

Marching Off the Edge of My Map

1.  "We feel that medication is not effective for the treatment of your specific condition."

I really could not believe the words that I had just heard, so I asked the woman at Humana to please repeat what she had just said.

"We're declining to pay for that specific prescription because we do not feel it is effective for treatment."

"Can I just ask, please, when you became the doctors and got to decide what might or might not be effective for treatment of my very specific medical conditions?"

The woman at Humana didn't even pause and continued, "We're partners in your excellent medical care, Jennifer.  Your prescribing doctor will need to call us to discuss and authorize that medication for you."

"The same medication that I have been taking to help control my seizures for the last ten years?  That exact same medication?  The one you have decided with my excellent medical care in mind is not effective for treatment of my medical condition?"

"You will need to have your doctor call us.  Is there anything else I can help you with today?"

It's no secret that for a lot of my life I haven't even had medical insurance.  I happen to have it right now, but I'm not even certain how it is helpful when the people who are in charge of actually providing it get to make decisions about what is and is not appropriate in terms of medication for my specific condition. 

How is this good medicine? 

I do understand that there are profit margins to be considered, but the health and well-being of our fellow human beings should always come first.  I do not believe that allowing a computer generated data program to decide that one drug is more effective for treatment than another drug just because it costs twenty five cents less per pill is the best possible treatment for anyone. 

I have paid for my drugs out of pocket for a very long time.  Last week, I paid for my drugs out of pocket, again, simply because I couldn't wait for the insurance company to have a conversation with my doctor about what might be the best course of treatment for someone in my condition. So I'm paying insurance premiums for drug coverage that I really do not even receive. 

God Bless America.

 

2.  "I'll pray for you."

J is sitting across from me in the very crowded waiting room at our public mental health facilities.  I'm there because life turned upside down, as it sometimes does.  A trip here to find an angel in torn jeans and an ancient Ramones t-shirt and paint splattered shoes who can help make sense of the cacophony of voices screaming in my head just feels like a better option than another manifesto written in sharpie on the walls.  At least this time around.

"What are you here for?," J asks me.

"My head is full of all kinds of noise. I need help."

"Oh, are you schizophrenic, too? I am. But they're really good here. They'll help you. Do you do drugs, too, to shut everyone up?"

"No. Not anymore."

"Oh, that's so lucky. I try to not do them, but it's so hard."

"Are you here to get off drugs?"

"I'm here to stay off. I've been sober for five days. But it's so hard.  I was on Meth and I don't want to do Methadone.  But they're really good here.  They're going to help you so much."

"How were you paying for all those drugs?"

"Prostitution. I am always terrified I was going to get chopped up by a chain saw.  Getting in cars with strange men.  I'm usually so high, though, I don't even know what I'm doing.."

"I'm so sorry."

"Don't be sorry for me. My mother did it, too. I've been out there since I was 16.  Do you read the bible?"

"I have read it.  I don't have a lot of faith in organized religion."

"You need to find religion, Jennifer.  It's the only thing that's going to save you.  Well, it will help you save yourself."

I hear my name called.  Intake. To sort demons from angels. To hear my own voice the loudest.  To love me.  Again.

"I'll pray for you."

 

3.  He slammed his fist on the counter and erupted.  In that instant, in that single moment of his anxious frustration, everything changed.

I had to leave.

In the leaving, in the walking out, in the moments of deciding that it was safer for my heart to not be there with him than to be there with him, I was so hurt and confused and small and broken that I lost all parts of my voice and could only barely whisper.

"I don't know."

I really did not.

Know.

We walk, in each relationship that we choose, on a fine edge between all that has come before and everything that we're choosing and hoping will be. We're not alchemists, exactly, of our hearts, though the wishes for just that can be bigger than either of us dancing the dance. 

My edge has thorny branches that reach out and stab at the most unfortunate moments. His edge is unchartered territory for me and the guazy veil that hides it makes the navigation to leap from my edge to his, the alignment of our selves against each other, sometimes more difficult than I wish it would be.  We have our old maps that we're trying to use and they're failing us.

Wishing and twisting and trying to find North, though, doesn't make either of our edges any softer or the navigation any easier. 

These moments of breaking happen, the cracks appear in the surface, the veil slips and allows a better view of things that truly terrify us.

The very bad endings of old fairy tales should never be allowed to write the beginnings of your new romance.

I love my professor in ways I did not even know I was capable of loving. 

This is all brand new and un-chartered territory.

That is what I know.

 

 

Putting Medicare on Notice

I received a Medicare Summary Notice in the mail last week.  Remember when there was all that hullabaloo last month about my breasts and the moles and the possible cancer?  And we all held our collective breath and wondered out loud about that golf ball only to find out during the mammogram and ultrasound that I have the wonderful fat free breasts of a twenty year old.

Well, the Medicare Summary Notice for those of you who are not lucky enough to receive those copious and confusing pieces of paper yet, tells you what bills have been submitted to Medicare by your care providers and how much of those bills Medicare elected to actually PAY and how much you may be BILLED and then there are notes just in case all of that is not confusing enough. 

Trust me, even if you're quite intelligent and got all A's in math, this shit is damn confusing.

So I looked at this particular Medicare Summary Notice and it was pages and pages because of all those various doctors visits.  And one thing I noticed was that Medicare did not pay a single penny for my annual gynecological exam.  Not one cent. 

Now I ask you, the lovely and smart people of the Internet, does this make any sense at all?  I thought it was just an oversight on their part, so I spent a large portion of my day today trying to get to figure out just what went wrong.

Of course because I'm NakedJen, even this wasn't so easy.  First you dial an 800 number.  Then you answer the voice-automated systems questions for what feels like forever.  Eventually, if you're good and kind and patient, a human voice can be heard on the other end of the line.  This human voice will then ask you EVERY SINGLE QUESTION ALL OVER AGAIN THAT YOU HAVE JUST ANSWERED TO THE VOICE RECOGNITION SYSTEM!  Oh yes, our tax dollars are at work in full force on this one.  It is really a good idea, though, to just stay in some place of zen and provide them with all those answers all over again.  Eventually they will ask you for your birth date.  If you're me, you'll tell them that it is January 21, 1964.  Because that is, in fact, the day you really were born.  They'll then tell you that date is incorrect. 

You will stammer.  You will begin to explain that you realize that they have the WRONG date in their system, but you, your naked self, have gone to the local Social Security Office with your birth certificate what feels like a GAZILLION TIMES and had them update the records to reflect your correct birth date.  And you have NO IDEA WHAT DYSLEXIC IDIOT mistyped your birth date into the system to begin with, but after updating it A GAZILLION TIMES, you'd think by now it would be correct.

The snippy (yes she was now snippy) person at the Medicare office will tell you that because you do not know your birth date she can give you no further information and she will hang up on you.

Lovely. 

At this point, I chatted with DearSweetDave who reminded me what birth date they actually DO have in their system.  So I called back.  Went through the entire exercise again with the voice recognition software.  When I got to speak to an actual human being, I didn't hesitate for a second.  I told her my birthday was January 24, 1964.  And onward we went.  What was my question?  How could she assist me? 

I felt like such a poser.

I asked about my office visit on August 9, 2005.  The one where I had a pelvic exam and pap smear and breast exam?  The one that cost $422.00?  I asked ever so nicely why that particular visit to the doctor was not covered by Medicare?  Her answer??

MEDICARE DOES NOT COVER ANNUAL EXAMS.  EVER. 

I was totally flummoxed.  Not ever?  I asked this woman if Medicare would prefer that I actually get cancer instead and then we deal with that?  I asked how it possibly made sense that I NOT GO TO THE DOCTOR BECAUSE I CAN'T AFFORD A $422 OFFICE VISIT, and instead get CANCER and the Medicare system then has to pay for all my care for that? 

She explained that if I was truly upset about this I should talk to Congress.  They make the decisions.  The Medicare offices just follow the rules set by those people on the Hill.

I did speak to another person at Social Security about this later in the day because it turned out that since nothing is simple in the world of NakedJen that the Social Security office not only has my BIRTH DATE WRONG, but they also have my SOCIAL SECURITY NUMBER WRONG, as well.  I might as well just not exist.

This other person, who was quite competent, by the way, explained to me that the reason Medicare does not cover ANNUAL EXAMS or preventative doctors visits of ANY KIND, is that originally Medicare was created for people over the age of 65.  Our good congress people figured those folks didn't need preventative care.  They were OLD. 

Well, there are those of us who receive Medicare benefits who are very much well below the age of 65.  And we're disabled.  Which means we don't have loads of cash lying about.  We're on fixed, limited incomes.  We need to be able to go to see our doctors.  Sometimes for preventative care.  Those visits should be covered.  Or at least provided at a reasonable fee. 

I had another chat with DearSweetDave.  Here's the transcript:

goddessnakedjen: they do not cover PREVENTATIVE office visits  EVER
goddessnakedjen: they would rather i get CANCER and then deal with that
goddessnakedjen: then have me go to the doctor for a preventative screening visit
goddessnakedjen: and pay for that
dsals: which appointment was this?
dsals: mammogram?
goddessnakedjen: the woman actually told me if i have a problem with that then i should talk to congress because they make the rules
goddessnakedjen: it was in the doctors office
goddessnakedjen: to have my pap smear and pelvic/breast exam
goddessnakedjen: they totally covered the mammogram and ultrasound that RESULTED from that visit
goddessnakedjen: but not that visit
dsals: weird.
goddessnakedjen: it's so fucked up
goddessnakedjen: i don't understand it
goddessnakedjen: why on earth would they NOT cover an annual exam for a woman??
dsals: maybe you need to run for congress.
goddessnakedjen: i'm going to call back AGAIN and see if i can get a better explanation from another person
goddessnakedjen: i won't win
goddessnakedjen: if i run for congress
goddessnakedjen: because i've done too many drugs
goddessnakedjen: and been associated with too many shady characters
goddessnakedjen: it's just fucked up
goddessnakedjen: i wonder who in congress is on the medicare decision making board
dsals: well at the very least this sounds like good bloggin gmaterial.
goddessnakedjen: oh yes.
goddessnakedjen: it is very good blogging material
dsals: i need to go pee.
goddessnakedjen: so i got someone very competent just now
goddessnakedjen: at social security
dsals: cool.
goddessnakedjen: and she even was able to SEE that my birthday has been updated umpteen times
goddessnakedjen: but for some reason, the MAIN birthday is still the WRONG birthday
goddessnakedjen: and she doesn't know why that is at all
goddessnakedjen: and can not figure out why it hasn't pushed the WRONG birthday out
goddessnakedjen: when the latest record says, January 21, 1964
goddessnakedjen: however, the record that comes UP says, January 24, 1964 across the board
goddessnakedjen: so weird
dsals: very weird.
goddessnakedjen: so she also said that medicare does not cover annual exams
dsals: nice that someone was finally willing to look at the screen instead of just telling you to go away.
goddessnakedjen: because medicare was originally created for OLD PEOPLE
dsals: ah.
goddessnakedjen: and they didn't worry about annual exams
goddessnakedjen: but she said i should definitely write to my congress person
goddessnakedjen: so i will do that
goddessnakedjen: i will write to both feinstein and boxer
goddessnakedjen: who are OLD WOMEN
goddessnakedjen: who will want to know that medicare will not cover annual exams for women
dsals: yes.
goddessnakedjen: meanwhile, i will also blog about it
goddessnakedjen: and encourage the rest of the world to also write and complain
goddessnakedjen: and i'll pay the bill
goddessnakedjen: so that i can go back to see the doctor
goddessnakedjen: about my finger
dsals: okay.
goddessnakedjen: which is not happy
dsals: were they not going to help you until you paid your bill?
goddessnakedjen: oh no.
goddessnakedjen: they would see me
goddessnakedjen: i just want to also pay that bill
goddessnakedjen: because i don't like outstanding medical bills
dsals: okay.
dsals: well, I'm still very glad you took the exams, even if we have to pay for them.
goddessnakedjen: even though last year i had outstanding medical bills for over a year
goddessnakedjen: yes, me too
goddessnakedjen: i mean, i've had cervical cancer
goddessnakedjen: i can't risk having it again
dsals: and you couldn't have gotten the other tests (which medicare did pay for) without doing the exams first.
goddessnakedjen: i wonder, if i had disability because of cervical cancer if that would have been covered?
goddessnakedjen: i mean, the exam??
goddessnakedjen: right.
dsals: who knows?
goddessnakedjen: it's just fucked up.
dsals: yes.
goddessnakedjen: so off to congress i go
goddessnakedjen: to lobby
goddessnakedjen: on behalf of women everywhere
dsals: okay. good luck to congress.
dsals: I hope they survive.
dsals: (but not really)
dsals: "Jennifer Neal, world mover"

Dear readers, I each of you to also write your congress person, if you're so inclined.  Why, it's national Breast Cancer Awareness Month.  But isn't it a shame that your grandmother (if she's dependent on Medicare) has to pay for her doctor's visit to get her breast exam?  She should not have to do that.  And neither should you.

Let's get this changed.  If we're serious about doing something about Breast Cancer (and all cancers) this is a very good step.

It's Not Monopoly Money!

If you're a regular reader of this blog, you know how I feel about Social Security.  And about our current president and his plans for Social Security. 

Moveon.org has some very entertaining flash programs that can help you learn more about the current debate.

Go here to learn more.  Really, it's worth it to at least know what all the fuss is about, don't you think?  I mean this is ultimately "your" money they're playing with.  It's not Monopoly money.  It's yours!

Random Thoughts on Tuesday Evening

Random thoughts in no particular order.

It’s beyond freezing in Washington, DC.  I haven’t lived there in over a decade.  I searched for fuzzy boots today.  Turns out everyone else have snatched them up.  I’m out of luck for warm boots.  I’m going to freeze, people.  There will be more bitching about this later. 

Remember my visit to Social Security when they told me I was a special case?  I found out how special.  Turns out I’m so special that they’ve been keeping a stash of money for me hidden in their deep dark coffers.  Hidden so deep that I don’t think even King George knew it was there.  It was locked up tight in that lock box Al Gore was always ranting about, I’m guessing.  They told me they owe me $1400!  From 1998!  I informed them about all the interest and penalties I would be levying against them for late payment.  Jeff, my caseworker, laughed so hard he had tears in his eyes.  Funny man.  But he also reminded me that I am a very special case and that social security would be reinstating my disability benefits as well as my Medicare coverage.  Of course, I’m such a special case I told him I didn’t want to go to all that trouble since I’m sure I’ll have a job soon.  Again with the laughter holding back tears.  Jeff told me I definitely needed to file the papers.  So I signed my name to a whole bunch of forms and he told me my checks would start coming in about two weeks.  I am not ungrateful.  But I must admit I still don’t completely understand it. 

I called my father tonight to ask him to pick me up at the airport in Baltimore on Thursday and to take me to the hospital.  My father did not know that John is in the hospital.  This is not unusual, but I could tell it made him upset that he was just now learning about it and that no one had told him.  I told him I have wanted to tell him for the last week, but every time I think to call him it’s the middle of the night in Baltimore.  He wanted to know why my mother hadn’t called him.  I explained that she doesn’t like to call him.  Those two have been divorced for over 15 years, my father is remarried, and he still expects my mother to call him every time there’s “news” in the family.  John could have called him, but my father is notoriously horrible at keeping in touch with people.  Even his own children.  And I doubt that John even had a phone number for Albert.  Albert (I have called him Albert since I was about 4…and that is his name) then wanted to know why I wasn’t staying with him.  I explained that he lived in Baltimore, the hospital was in Washington and it was accessible by the Metro from my mother’s house, but from his I would have to rely on him.  He then understood.  Albert is anything but reliable.  However, he did say he would pick me up on Thursday at the airport.  I made sure he wrote everything down. 

I’ve got all body parts crossed for my husband.  That’s all I’ll say for now.

So today I go to the post office to mail a bunch of packages. Babies are being born and must be acknowledged.  Folks need herbal treatments in far off places.  Friends need to know they are loved.  I did not put mailing labels on my packages because I was going to use the ones they always have at the post office for Priority Mail.  I should say always HAD at the post office.  I went to the post office on Morrissey today and there wasn’t a mailing label to be found in the entire building.  So I put all my packages back in the car and contemplated going to Staples, but thought I’d hit the post office downtown since I had to go there anyway to get ingredients for dinner.  I was very lucky because I found a parking spot right in front of the post office.  That never happens.  I gathered my packages and went inside.  I searched all the tables and stands, but again, not a single mailing label in the entire lobby. 

When I entered there was a line of folks waiting at a small door.  This door is opened occasionally to assist those who are there to simply pick up large packages or mail. The person working the door does not sell stamps or weigh packages or anything of that sort.  Just goes and finds your mail and brings it to you.  I got in that line.  And then my friend Collette walked in.  I said hello and she said, what is this line you’re in?  What’s this special door?  I told her that it was basically for picking up mail.  She looked at my packages and asked if I was going to pick up more.  No, I told her, I was going to ask if they had any labels.  At that moment a very grumpy man who was standing in front of me growled that I could get this door was not for that and I could get those labels at the desk.  I looked at him and explained that I didn’t want just a sticker that said Priority Mail; I wanted an actual blank label so I could write the shipping address on it.  He growled at me again and very sarcastically told me I would never get that from this guy.  I noticed that his name was Edwin (he was holding some mail) and I said, “Excuse me, Edwin, but sometimes in this world, if you ask for something really politely and you smile, kind folks will do nice things for you.”  He snarled again and said, “Oh really.  Not here.  You won’t get your labels.”  I told him I was going to just wait and see and hope for the best.  He snapped, “Suit yourself.”  You all know that I not only got the labels for my boxes but I also acquired an entire stack of extras (without even asking) to take home for next time.  Poor Edwin.  He needs to learn how to smile.

I love my family.  But a family visit under these circumstances and for this long will certain be blog fodder.  Stay tuned.

 

It Always Helps If You Smile

“Do you think this is all just part of the bigger bureaucracy?” he asked me.

“I’m sure it is.  Absolutely.  Just one more government line to wait in.” I said to him.

We stood there, quietly, shifting our weight from foot to foot, waiting.  Wondering just how long this was all going to take.  More people entered the building and stood in line behind us. 

“Look, there are even more people now.  Do you think they only have one person working for a reason?”

“I don’t know,” I said.  “It could be that it’s five minutes until they close and everyone else left early.”

“I’m from Africa,” he said.  “This is all seems to take so much time from a person’s life.”

“Yes,” I replied. “But I think they figure we’ve got no where else we need to be today.”

He sighed.  “Every time I come here, I have to wait and wait and wait.  That woman over there is particularly mean.”

“I’ve never had anyone here be anything but nice to me,” I told him.  “But then, I’m usually just trying to get them to stop sending me checks.”

“She points her finger and screams!” 

“Well, that isn’t nice for anyone.  But especially here.”

Even more people had come in and were now stacked up behind us.  He gazed back to the end of the line.

“There are even more now.  Do you think they’ll see everyone today?” 

“I don’t know. Certainly not if they don’t get more people at the desk.  You could sell your place at the front of the line!”

That made him chuckle. 

“My name is Evan.”

“My name is Jennifer.”  I took his hand and shook it. 

And then from behind door number three, there appeared two more caseworkers.  I turned to Evan.

“You’re going to be next.”

“Well, we’ll see.  I do like her, though; she’s the nicest one of all the people here.  Quiet and just does her job.”

“Yes, I like her, too. She’s always been very kind to me.”

The kind woman yelled, “Next in line?”  And with that Evan went to her window.  But all she did was take his Social Security number and reason for his visit and sent him to off to take a seat.  Then she was asking me the exact same questions.  So I gave her the number and the reason and then took a seat next to Evan.

We chatted while we waited for anyone to call our name.  He was born in the Sudan, but had lived in Greece most of his life.  He had been in the United States for nearly 30 years.  And he had even been a member of our Armed Forces.  I didn’t ask what branch of service.  I realized while sitting there that I was actually in the Social Security Office and as I no longer have a Social Security card this would be a prime opportunity to get one.  I ran over to a counter and grabbed an application.

I started to fill it out.  Evan noticed that I was born in Washington, D.C. 

“Washington, D.C.!  The center of bureaucracy.  You were right in the boiler plate.”

“Yes,” I said.  “It’s the reason I love Santa Cruz so much.  Lots less bureaucracy.  Unless of course, you’re at the Social Security Office.” 

“Are you always this cheerful?  Do you always smile so much?” Evan asked me.

“Well, yes.  I do smile all the time.  I’m a very optimistic person.”

“I could use a friend like you.  Someone who is always smiling.”

“I’ll be your friend,” I told him.  And I meant it. 

So then the very nice lady called Evan again and he was off to figure out why they were withholding so much from his monthly checks.  In a few minutes the “mean” lady called me.  I told her that I was there to reinstate my Medicare Benefits.  She looked at me over the top of her glasses and asked, “How old are you?” 

“I’ll be 40 in three weeks, but I’m on permanent disability.”

“Hold on.”

She typed a few things into her computer and then printed out page after page of what must have been my Social Security Historical File.  And then she sat and tried very hard to decipher what it all meant.  Then she looked at me and said, “Are you ready to file again for disability?” 

“No.  I don’t think I have to go through all of that again.  I think I can just reinstate my Medicare coverage.”

“Nope.  You can’t.  You stopped paying for it.  Now you have to reapply for disability and wait two years before you’ll get coverage.”

“I don’t want to argue with you, but I think you’re mistaken.  I stopped because Medicare told me not to carry it while I had insurance from my job.”

“Look, the rules are that if you stop coverage and go off of disability you have to reapply and get reinstated and….wait a minute.”

She disappeared behind Door Number 3.  I stood there wondering about all of it and if I really would have to reapply for disability.  I thought about LaVonne and all she goes through in this challenge.  I heard the woman at the caseworker next to me sobbing because she had tried to get disability and had been denied and couldn’t possibly face going through all that trauma again.  I felt so bad for these people.  I know how hard it is to get the “brass ring” and it made me angry that I live in the richest nation in the world and yet I have to beg to get proper medical care.  It shouldn’t be this way.  Not for me, but especially not for all those who unlike me don’t have the will to fight for their rights.  What kind of nation are we that we can’t take care of our sick and disabled and dying?  What monsters have we all become? 

Those were my thoughts.

And then the “mean” lady returned.  And said, “Everyone back there remembers who you are.  Turns out you’re a special case!” 

I almost laughed out loud.  Almost.  When have I not been told that I am a special case?

So she then told me that for reasons she doesn’t quite understand, I actually can just reinstate my Medicare coverage, but to do so, I need to have a face-to-face appointment with one of the benefits counselors just to make sure we cross all the right “t’s” and dot all the right “i’s” and everything is as it should be so the whole bureaucracy does not crumbling down around us. 

“The earliest appointment I have is January 29th.  Do you want morning or afternoon?”

“Afternoon, please.  I don’t do mornings.”

And with that, I suddenly had my paperwork for an appointment for January 29 at 2:15 p.m.  I was on my way.  When I got outside, there was Evan.  He asked me if I wanted his phone number.  He told me he didn’t want mine because he respected the fact that I was a lady and that it wouldn’t be proper.  So I told him that of course I wanted his phone number and I would gladly call him.  He gave it to me and I promised to call him to go for a walk or to get some tea.  We hugged goodbye.

It’s funny whom you’ll meet while standing in line.  It always helps if you smile.