Thursday, September 24, 2015

Pope Francis, Pretty Words, and My Medicare Nightmare: A Report from the Ground

I am poped out, folks. And you?

It doesn't help, surely, that I'm still battling pain from the root canal I had two days ago, and finding it difficult to muster much energy for reading and thinking as a result. But I'll also admit that I find much of the popealooza spectacle frankly stomach-churning — the endless superficial remarks on Twitter and television about how he turned his head this way, what he meant by that sidling glance under his eyelids, whether he said hulu or hula when he lapsed into Italian and Spanish (and the subtle difference between the two words), how inspiring his use of the words "peace" and "justice" was, all delivered (on television, at least) in reverential tones reserved for, well, Moses or Christ.

And God bless America!

Popealooza is not the heart of the Catholic faith. Jesus Christ and following him are the heart, the foundation, the raison d'ĂȘtre of the Catholic faith. Popealooza spectacles are a relatively recent development in the Catholic tradition, and in their potential to distract us from the heart of our Christian faith, they're more than a little unedifying, to my way of thinking — especially when the pretty words we hear during said spectacles do very little at all to change anything at all in the real world, particularly for those on the margins of society.

And there's also this: as this spectacle is taking place, I'm struggling once again, while trying to get past my recent root canal, to make some headway, any headway at all, with a nightmare connected to my Medicare status that simply will not end. I won't bore you with a blow-by-blow account. (And then that's precisely what he proceeds to do.)

In a nutshell, here's what's going on. As I may have mentioned in some previous posting(s), when I became eligible for Medicare this 1 April, I made the best choice I could of various Medicare options available to me at that time, and chose a plan A and plan B for my coverage. I had no choice except to opt for this arrangement, because, at that point in time, my state of Arkansas was refusing to acknowledge the legality of my marriage in May 2014, and the result of that refusal of the state to acknowledge the legality of our legal marriage was that I was blocked from being covered by my husband's healthcare plan.

He's a state employee, and if the state had done what it was legally and morally required to do in May 2014, I'd have had coverage as his spouse from that point forward. But since our morally obtuse and conspicuously craven state Supreme justices slapped a stay on same-sex marriages soon after we married and refused for over a year to say a single word as they dealt with the "expedited case" of same-sex marriage, such coverage was not on the table.

Not until the federal Supreme Court issued its Obergefell ruling, at which point the morally obtuse and conspicuously craven Arkansas Supremes breathed a sign of relief, since this ruling obviated their need to stick their own necks out and issue a ruling. To its credit, within days after the Obergefell judgment came down, the state of Arkansas announced that it would adhere to the ruling and permit same-sex spouses of state employees to be covered by their spouses' healthcare plans.

Since Steve and I understood that the window for me to make changes in the Medicare plan I had chosen on 1 April without a penalty was very small, we immediately got me enrolled in his insurance plan, and I contacted Medicare to ask how to go about canceling part B of my coverage, which I no longer needed. The person to whom I spoke in the national Medicare office told me to write a letter to their office, stating that I wanted to drop plan B and wanted my Medicare choices now reconfigured to show that I am covered by my spouse's insurance as primary coverage, and Medicare as secondary.

I wrote that letter on 30 June, sending it to the national Medicare office in Baltimore and a copy to the regional office in Kansas City (which handles, I understand, the state of Arkansas). As of 1 July, which is when we understood that the window for making this change would close, I have been covered by Steve's insurance plan, with Medicare as supplemental to that — and with no plan B.

Or so I understood. 

Then this happens: in the last weeks of July, I get a bill for plan B coverage. I go to the account I have set up at the Medicare website, which allows me to monitor my Medicare plan, charges, payments, etc., and see that no change at all has been made in my plan.

At the same time, this also happens: the medical supply company in Tennessee which is supposed to be sending me replacement parts on a routine basis for my CPAP machine stops sending them. I write letters to complain. This has happened before with this company, and I know that they will not respond to me unless I file complaints with the state insurance supervisory office (which tells me its charge is not to assist Arkansas consumers who have problems of my sort, though its mission statement plainly says the opposite), with Medicare, with any regulatory body I can think to notify of the refusal of this medical supplier to honor its commitment to send medical supplies per its own schedule to insured patients.

My doctor finally decides to try to make an end run around this situation by switching me to a local group providing these same supplies. I contact them. They're happy to supply me with replacement parts, but when they check my insurance coverage, they tell me it's not clear whether Medicare is my primary or secondary provider, and they can't do anything until that's resolved. 

I am for months without replacement supplies for a machine I'm told by my doctor and the companies supplying replacement parts I must assiduously replace, in order to safeguard my health.

I make endless calls in the final weeks of July, trying to resolve these problems. In some cases, I'm placed on hold for over an hour. I call Medicare again. I do online live chats with their representatives, printing these out and filing them in the voluminous file of documents I'm accumulating about these Medicare problems. I'm referred to the state Social Security office and the state DHS office.

The former tells me it has no idea what to do, the latter never answers its phone (as it turns out, it's busy at this time dealing with the new GOP governor's charge to weed the Medicaid rolls of purportedly ineligible Medicaid-covered citizens). I'm told to call the national Social Security office, the Medicare Claims Processing Center.

I dutifully do all of this, finally reaching someone in one of these offices — I think it was the national Social Security office — who tells me that, yes, he can pull up my Medicare file on his computer and see in the file the 30 June letter I had written asking that my plan B coverage be cancelled and my spouse's coverage be made my primary coverage. "Just wait a little longer," he tells me.

"But I have a bill from Medicare for plan B coverage," I reply. "What do I do about that?" 

"Just ignore it," he tells me.

That's late July. All through August, nothing changes. Then right before Labor Day, I get a call from a Medicare person in Texas, who has just now gotten the letter I wrote earlier in the summer about my inability to get replacement CPAP supplies from the company in Tennessee. She tells me that she can help break through the barrier with the local company providing these supplies, to which my doctor has switched me, but has no idea how to get the changes that I requested on 30 June to have made in my Medicare plan.

She refers me to another Medicare person for that. This person tells me there's a form that I need to fill out to drop plan B coverage and reconfigure my Medicare plan. She is the first person who has told me of this form and my need to fill it out.

She sends it to me. Typed on the form is her statement that I understand I will perhaps incur a penalty for making this change at this late date, and that it will not be made until October.

When I had written a letter on 30 June to the national Medicare office, per their instructions, requesting this change . . . .

It's now almost the end of September, and nothing has changed. I sent in that form on 10 September.

And why tell you all of this now? Because I had to deal with the tangle all over again this week when I went to the endodontist, and they checked my insurance coverage, and noted the lack of clarity about who covers me and whom they should bill for the procedure . . . . 

And why do I tell you this in a posting that opens by talking about the pope and the nice things — the pretty words — he has been saying about building societies that serve the common good and seek to meet the needs of all citizens, and which are marked by peace grounded in justice?

Because the incomprehensible problems I have been facing for months now, which wear me down and are even harder to cope with as I'm struggling to overcome a root canal, are as much of his making — as in, as much of his bishops' making — as they are of the making of anyone else. After all, those very bishops whom he praised yesterday as courageous have fought relentlessly for years now against the rights of LGBT citizens like myself.

They fought quite specifically to block LGBT citizens like myself from the right to the kind of spousal insurance coverage I now have by virtue of being married. They have fought bitterly against a federal healthcare plan that seeks to extend healthcare coverage to many citizens living on the economic margins of society, because that plan comprises contraceptive coverage for women (and, let's face it, because it was crafted by a Democratic president whom they have sought to undercut at every turn).

So those pretty words Pope Francis has been saying the past two days? The ones about the common good and peace and justice? For me, they've gone in one ear and out the other. 

How can I possibly hear them? I have a difficult viper's nest of problems to try to unravel regarding my medical coverage, and that viper's nest has been created for me, to a very great degree, by factors beyond my control — by sheer prejudice and hatefulness on the part of people speaking pretty Christian words in our public square. 

For all I know, at least part of this tangle is a direct result of people with whom I am dealing in various government offices who can see plainly that I began accessing my spouse's medical coverage right after the Obergefell decision. In several cases, in fact, they have asked direct questions about my spouse when I've made these many endless calls to government offices, trying to untangle the tangle — which would not have been there in the first place if my legal marriage of May 2014 had been recognized by my state, as all other marriages were immediately recognized in that month, and the door had opened to healthcare coverage for me at that point, before I became Medicare-eligible and had to take a second-best choice that now needs to be undone.

I've pretty much had it with the pretty words, to be blunt. They haven't done much to change anything in my own life or the lives of others like me.

And, when all is said and done, they're coming from the leader of a religious body that has sought in every way possible for years now, through its top leaders, to make the lives of LGBT human beings as miserable as possible. So they're pretty in a deceptive, glossy way — like pretty poison drops danging from a bejewelled but very deadly plant.

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