Sydney & Denny

Sydney & Denny
September at the Park

Monday, October 17, 2011


So, I have this problem, and I've told you all about it many times. My health sucks, and in case you haven't read my accounts of it, here you go. On top of the RA, and the Fibromyalgia, I now have some sort of issue causing me esophageal issues that I have to take yet another pill for. And, on top of that, I'm undergoing tests to determine if I'm diabetic! So yeah, I have health issues to deal with. But, that's not the point of this blog post/rant. What I really want to talk about is my health insurance!

Every two weeks my wife receives a paycheck from her employer, and every two weeks they take out health insurance premiums. I'm not going to go into specifics of what we pay, but it's not terribly cheap, and it's not outrageously expensive either. But, she does pay it, and in return shouldn't we expect to receive health care coverage? Yeah, that's not too much to expect is it? Well, that's not what I am receiving at this point. And, I'm sure if you went around this great nation of ours, mine would not be the only case like this. 
How am I not receiving health insurance benefits you might ask? Well, let me tell you about one instance in particular. Bear with me, this might take a couple paragraphs. About a month ago, my wife had the day off, I think it was a Tuesday. I woke up in my typical amount of pain, stiffness and fatigue. It's a regular thing for me anymore, and I'm starting to get used to it. However, as the morning progressed, I started to feel a pain in my abdomen that is not my "usual" pain. I can only describe it as feeling as though a ninja had taken his sword and attempted to cut me in half at my belly button! Yeah, it hurt like that. I laid on the couch writhing in pain, knowing that I have had instances of this a handful of times in the last couple of years. What usually happens is I show up at the ER, they get my vitals, set me up in a room, give me pain meds(usually pretty powerful stuff like dilaudid,) make me drink some contrast so I can have a CT scan of my abdomen, get the results and tell me everything looks clear, and are unsure what is causing me so much pain. So, basically nothing gets done other than I get pain medication. Well, this last time was a little different, a doctor actually took the time to listen to what was bothering me and was able to hopefully solve the problem. She figured out from listening to me that it isn't in my bowels(from which I had my entire large intestine removed due to Ulcerative Colitis.) It is more of an esophageal issue and she prescribed me Prilosec. At last, a solution!
Of course, here is where my current rant comes from. Last week we received in the mail the typical explanation of benefits from our insurance company, BC/BS, telling me that none of my ER stay was covered by them due to "Diagnosis is Pre-Esisting." Let's just say WHAT THE HELL???
This explanation of "benefits" by BC/BS is just the last straw for me. I am unable to work at this point due to my health, and I'm lucky enough to still be drawing unemployment for a couple of more weeks, and believe me I'm totally grateful for that, but it's not enough for our family to get by. My wife works and earns what would today be called a decent wage, but again it's not enough. We never have enough money to pay all of our bills on time, but we manage our finances so that nothing is too late. Where the problem arises is my medical bill. I see a family doctor, a rheumatologist, and of course my ER visits. On top of that, they all want blood work done, so I have to go to a lab. Well, all of those doctors and labs charge money every time I go there, and they bill my insurance. My insurance doesn't cover all of any of those visits, leaving me with an unpaid balance to all of those parties. Well, I make payments to all of them, as little as $10 per month, but it's gotten to be too much. I had to change family doctors because the one I was seeing said my balance was too high and my payments too low, and they refused to see me. Now with the insurance company refusing to pay for a NEEDED ER visit, which was only $6,549.25! I have no way of paying that, so what am I going to do? No, I'm really asking you, what am I going to do??? It's getting to a point where no one is going to see me because I can't pay for my medical bills, yet I can't get a good paying job to take care of the medical bills due to a serious medical situation! So, this is exactly what "a rock and a hard place" feels like!!! What's the point of my wife having insurance premiums taken from her check if that insurance company isn't going to pay any of my medical bills??? It just seems really unfair that this insurance company is looking for a reason to not pay out on something like this. So, from now on when I have intense pain that makes it feel as though my insides are going to burst out of my body, I'll just stay home and suffer. I guess that's where we are headed in this country. The phrase "I can't afford to be sick"
Does anybody out there in the blog world have any ideas on how to fix this predicament? If so, I'd love to hear them please!!!

What is it about bacon that after you make it on a Sunday morning, you can still smell nothing but bacon in your house on Monday afternoon??? Don't get me wrong, I LOVE bacon, but at this point, the smell is starting to make me a little sick to my stomach!


  1. Dude. I've been working with medical insurance for the past 11 years. I don't have the time just now (I'm working), but maybe I can help you with ideas on what to do.

    email me at so I can talk to you there..

  2. My answer is Universal Health Care--it's ridiculous that so many people's lives are upended over situations like this. I hope Eric above can help you.