Morton salt everywhere

[pameladean]

That is to say, however much of a cliche it may be, it never rains but it pours.

David was selected by the state lottery and got vaccinated yesterday in a cavernous sports facility in Eagan. He said the National Guard was handing out second masks, repeating, "Blue side out! Blue side out!" and also directing traffic in the parking lot and foot traffic inside.

Also yesterday, I got my notification from HealthPartners that if I was quick like a bunny to make an appointment,I could get vaccinated at one of their locations. They've started on people 65 and older after being stalled out at 70 and older for what seemed like forever.

This morning I woke to a text and an email informing me that I had been selected by the state lottery system to get a vaccine by that route.

I hope this means that a lot of people who have been waiting and waiting will be vaccinated soon. I don't know if it's the addition of the Johnson & Johnson vaccine to the mix or the promised huge increase in production of the other two promised by the companies that make them, or both; but it certainly is welcome.

I also got a mysterious claims lettter from HealthPartners from December 11 saying that they were writing to let me know the status of a claim from a provider designated only as IBX. They said the claim needed additional review and would probably be resolved within 21 days.

Once I got past all the Blue Cross stuff when I searched on IBX, I found an outfit that proclaimed, "We are IBX, one of the world’s largest biorepositories. A global leader in biobanking, bioprocessing, and analytics."

The date of the claim was 12/11. I certainly had no medical procedures done that day, but claims are often presented some time after the actual medical service in question. We all ordered saliva tests from the state after Lydy tested positive for COVID, and Raphael and I sent ours in on December 11. The tests are supposed to be free to us, paid for by the state, but maybe they charge your insurance if you have any. In any case, it was a strong reminder of how things are trying to look up.

P.

Comments

[halfmoon_mollie1]

Yes. The J&J vaccine is being given here 24/7. I have my second appointment for my second jab - Moderna - this Friday. And of course, the place where I live is having a clinic.

What did your mysterious claims letter from HealthPartners say?

[pameladean]

Sorry, just actually finished the entry. I'd failed to decide whether to just delete that paragraph or replicate the results of my search. It seems to be a claim letter about the COVID test I got in early December, but the entity isn't the one we directly interacted with; that was Vault Health, not IBX. I guess we'll see.

I get my second shot -- Pfizer -- on March 23. David is done, unless they come out with a booster that works against the South African variant, which I certainly hope that they do.

P.

[graydon]

Huzzah for unstuck logistics!

May the second dose be completely uncomplicated despite an apparent proliferation of options.

[sovay]

This morning I woke to a text and an email informing me that I had been selected by the state lottery system to get a vaccine by that route.

Congratulations to you and David!

[nineweaving]

Congratulations! To use a metaphor for the days of analog, so glad that the needles have come unstuck.

Nine

[bibliofile]

Hooray for vaxxing!

Hmm, sounds like one of those medical bills that eventually get paid but, in the meantime, they send you invoices. Once my mom got onto Medicare and had supplemental insurance, she gave up on paying any bills until after they'd been through the insurers a couple of times. It was kind of a mess -- but one that didn't cost her much in real dollars, in the end.

[pameladean]

Thank you! I'm just going with the appointment I already have with HCMC. Nobody questioned my right to have it, and if they want to spread their net wide to include former patients, that's fine with me. And hey, maybe there is a bit of faerie mixed up in it somehow. I wouldn't want to rock that boat by being ungrateful.

I wish I could pass my two unneeded opportunities on to somebody else, but I guess that will happen indirectly anyway.

P.

[pameladean]

*hug* IT IS SUCH A RELIEF.

P.

[pameladean]

When they do, they do it thoroughly, I have got to say. P.

[pameladean]

Yes, I've already experienced a little of that with Medicare. I broke my ankle in early 2018, and they wanted me to wear an air boot for a couple of weeks. I could either just buy it or rent it from a medical supply company it would have to be returned to -- and all the return places were in remote suburbs. Medicare should pay for it but they weren't sure. I elected to rent the boot, and then, predictably, did not make the complex arrangements for returning it. (I don't drive and it was a very icy winter and spring.) I got a declined claim for the purchase of the boot, which I had not agreed to, from my supplemental plan; and while I was still puzzling out what to do about that, I got a letter from Medicare saying that they would cover the cost of the boot. So I have an air boot. If other things happen to my right foot, I guess I'm covered.

I also got told the supplemental plan wouldn't cover the Shingrix vaccine, but I might be eligible for Medicare cost-sharing. That was pricy, but much less so than the boot. I just paid up; and the next thing I knew, I had a check from Medicare in the mail, reimbursing me for the entire amount. When I got the second shot, I just waited, as our mom has learned to do, and Medicare just covered it.

If they want to be byzantine about it, I guess one just has to let them.

P.

[dreamshark]

I guess that's what it's like with Medigap insurance? I have a Medicare Advantage policy with Health Partners, so everything goes through them without all the double-billing confusion. It's basically the same type of HMO-like insurance that I always chose when I had health insurance through employment. So far they have been easy to deal with and everything just gets paid for except for co-pays. The only confusing bills are the fricking CPAP supplies, which run through a different part of the Park Nicollet billing system that appears to be unconnected to everything else.

[carbonel]

Does your insurance pay for any of your CPAP supplies? A couple of years ago, I gave up on trying to be reimbursed for mine, and was able to get the nice woman at Methodist to look up the non-covered rate for filters and a replacement for a part that had gone missing, and pay that myself ($14, IIRC).

Right now, I have a generous supply of masks and hoses, but presumably those will eventually get used up, and I will have to brave the wilds of Medicare for replacements. (I need to sign up for Medicare in July or so.)

[dreamshark]

The insurance seems to pay 75%-80% of the CPAP stuff. It's hard to figure out because their billing is so misleading and obscure. There is the price list they give you when you first get set up, with massively inflated list prices. When you order equipment, there is no way to see any prices except those, and they are jaw-dropping. But when the bill finally arrives there are two completely unrelated prices listed: one for what you owe and in parentheses the amount paid by insurance. Presumably if you add those two together you get the real price.

For example, a pack of 2 filters has a "list price" of $18. The actual price they charge appears to be $2.70 ($2.10 paid by insurance and $.61 by the consumer). That calculates to insurance paying about 77%, which is baffling. Given the way insurance usually works I would have expected either 75% or 80%. Whatever. I'm willing to pay $.30 for a tiny little square of cotton, but I sure wouldn't pay $9 for that.

The most amazing disconnect between list price and actual price is the nasal cushions. List price $250. Actual price: $20.

Incidentally, Medicare has an extremely detailed policy for exactly how many replacement parts per month/year they will pay for, and it is very generous. Google around and you will find it.

[carbonel]

My problem was that when I was first buying supplies, they wouldn't be paid for by insurance until the deductible was all paid back. So I ended up paying the list price out of pocket, with the only advantage being that it went toward fulfilling the deductible. Which is how I paid $350 for a Quattro mask about three weeks before I decided that surgery was necessary. And after that, I didn't need a full-face mask. Money down the drain.

I have a much lower deductible now (different insurance), but AFAIK it's still the same situation regarding being charged full price. I hope things will change somewhat once I have Medicare.

[athenais]

What good news about more vaccinations! We, on the other hand, are short and a huge swath of people could not get their second shots in the preferred three-weeks-later time slot. But I believe more vaccine is arriving this coming week so they will get called up.

[dreamshark]

Well, it's up to you to decide what Medicare insurance you go for, but you might want to compare the policies on that. Clearly Medicare itself is required to pay something for CPAP supplies, but I don't know if they pay the full 75-80% or if they pay less than that and my insurance fills in the rest. In any case, Medicare will pay for part of it.

I have Health Partners Journey Stride (Medicare Part C, aka Advantage) and that's how mine works.

[pameladean]

I have a Medicare Advantage plan from HealthPartners, and on the whole things run smoothly. The air boot was apparently a vexatious matter for some reason -- maybe medical equipment is covered by different rules, I don't know -- and while at this point they would just pay for the Shingrix vaccine, I think, when it first became available there seems to have been a lot of confusion.

P.

[pameladean]

I sure hope so! I think the J&J vaccine is really going to change the situation for the better.

We were also short for a long time and it was very fraught. I feel for those people who couldn't get their second shot. We had some cancellations here as well, because of the extremely cold weather over much of the eastern part of the country.

P.