Things I'm not Looking Forward to

I hate making phone calls like this.

A couple of weeks back, I had to call the state's Department of Health. It was one of those phone calls that started out for one reason and ended up somewhere else entirely. 

A couple of years ago, when Sam applied for, and was accepted for, assistance through SSI, this acceptance automatically enrolled him in the state's healthcare plan. It's not that he needed the state's healthcare - he was and is covered by private insurance (and will be, hopefully, for another couple of years). But this, apparently, is the way the system works. 

At the time, I called and pointed this out and was told that, even so, he should stay on the state plan - if for no other reason than to have it as a backup. And also, when he does eventually age out of the private insurance, this will already be in place. Fine, that makes sense. Sounds easy enough. Then the paperwork showed up.

For what turned out to be this first packet of paperwork, we (and by "we" I mean "me") had to choose a plan. This involved selecting the right plan from buffet containing a myriad of mysterious codes and just as mysterious providers. Importantly (too us, at least), we had to find a plan that his current doctor accepted. (I won't go into the details on all of this because, first of all, I don't remember all of the details and second of all, of the details I do remember, I don't understand them.)

Anyway, Sam and I filled out the paperwork (well within the time frame, it is important to note) and trotted this packet off to the post office. Literally, the very next day, another packet arrived. This packet contained information about the provider and plan the state had gone ahead and assigned to Sam. Needless to say, this was a doctor in practice we weren't even remotely familiar with. (Given Sam's history, I'm really not interested in getting up to speed with someone who is unfamiliar with his lengthy history.)

This meant a phone call to the state- a call meant to switch Sam to a plan that was carried by his then (and still) current physician. The conversation went nowhere. The person on the other end couldn't even talk to me - at least not about anything specifically related to Sam - unless Sam gave his written permission. As I recall, this also meant they weren't interested in talking to me about any general issues, either. 

In any case, a waiver was faxed to me for Sam to fill out, giving the State permission to talk to me about Sam (and, I assume, to talk to me in general). This faxed-to-me waiver could not, for some reason, be faxed back. It could only be mailed back. So Sam and I filled out the faxed-to-us waiver and mailed it back to the state and after waiting what I assumed was the appropriate amount of time, I called the state again. I got nowhere. This time, they could talk to me - but ultimately, the plan didn't get switched. By the time we got confirmation, Sam was out of his annual re-enrollment period - so that was it for another year.

Rather than fight it (further) I decided to let it ride. We were several years away from having to worry about it and if the state insisted on assigning Sam a doctor that we were never gong to visit, that was up to them. As long as Sam could continue see his regular doctor, under our private health insurance, that was the important thing. Besides, I had more burning issues occupying my time (Hello IEPs! Hello transitioning out of school! Hello SSI and MRC and DDS - and finding Sam a job! Hello everyone and everything Sam related!).

So the years have rolled by and the clock continues to tick. Every year, his annual change of enrollment period comes around and we get a packet which, it says, we can ignore if we don't want to make any changes. At least once, if not twice, I called to make the changes and was met with the usual success - which is to say, none. And since those more immediate issues were still burning brightly, those are the issues that I, with my dwindling amount of sanity, focused on.

This year, I felt I had enough breathing room (Ha!) to try and tackle it again (Ha!). So when the annual notification for Sam's change of enrollment showed up, I made the call. This was the phone call of a couple of weeks ago - the one that started off in one place and ended up in another place entirely.

So, for the first time in what felt like years, I made the call to once again get Sam's plan switched. Somewhere along the line of talking to whomever it was I was talked to, it came out that Sam is also covered under private insurance(!). Why this is surprising, I don't know. It was, after all, not only brought up by me in the past, but also, it was noted somewhere in that original packet we had to fill out and mail back. Apparently though, they can't find that original packet(!) and shockingly, the state doesn't have detailed notes from any of my previous phone calls. But it's not a complete loss. Thankfully, they at least have Sam's mailed-in (not faxed-in) waiver.

In that most recent phone call, I ended up talking to at least three different people, each time being switched to the next person by the person before. At least two of those people told me that Sam shouldn't even be on the state health insurance if he already has private insurance. I was told that I (meaning "Sam") need to wait until Sam (meaning "Sam") ages out of the private insurance (in two years) and then, at that point, call and enroll him in a state plan (which, I was NOT told, I am sure will go smoothly). 

The thing is, this "not needing the state plan" contradicts not only what I was told multiple times previously but also, I know of at least one of his close-to-the-same-age/close-to-the same-situation friends that has both private and, weirdly, a state plan.

I asked both of those aforementioned "at least two of those people" several if this was correct, that he shouldn't be on a state plan - and both were very clear that, no, he shouldn't be - clear enough, anyway, where both of those nice people were getting not-quite-as-nice by my repeated, just-to-be-sure, questioning. Each of them assured me that, not only was this correct (and not simply their uninformed opinion, as it was implied, I think by me), but that I would get a letter in a couple of weeks, stating this to be the case. 

Ok, if you say so.

This letter came in Saturday's mail.

(Side note: Why do I always get these kinds of letters on Saturdays - when there is no one I can call and instead can only stew on it for the rest of the weekend? Coincidence? Or part of that vast right-wing conspiracy designed to make my life even more miserable than it already is (which, by the way, if this is the reason, it's working)?

Anyway, the letter does indeed confirm the private insurance, but down at the bottom, there's this paragraph (emphasis mine):

"When you obtain health care services from a doctor, hospital, pharmacy, dentist, or any other [State Healthcare] provider, you must show your other insurance card along with your [State Healthcare] card. [State Healthcare] requires that you use the other insurance first, and follow the other insurer's policies and authorization before using your [State Healthcare] benefits."

Maybe I'm reading this wrong but this strongly implies that a person who has private health insurance also has [State Healthcare] (emphasis  mine). 

So it's back on the phone for me. I hate making these kinds of phone calls. I have two years left to get this straightened out - and I'm beginning to think this won't be enough time.