Lydia Archives - Page 4 of 47 - Ramblin' with Roger

Insurance stress: CDPHP, St. Peter’s

health insurance

I am experiencing some insurance stress based on two pieces of mail my wife and daughter received the same day last week. If you want to write a blues song after reading this, feel free.

The letter was from St. Peter’s Health Partners. It runs most of the city’s hospitals, clinics, and doctors’ offices that aren’t part of the Albany Medical Center. All of our primary care physicians are part of SPHP.

“Our records show that at the time of your last visit…, you… receive your health through a CDPHP commercial health plan.” CDPHP is the Capital District Community Health Plan. “Please be aware that [SPHP] has engaged in negotiations with CDPHP for a more equitable agreement to ensure we can continue to deliver high-quality, community-based care.”

Didn’t we do this dance a few years ago, which got resolved at the 11th hour?

In bold: “Our current agreement is set to expire effective January 1, 2023; meaning some patients may have increased financial responsibility when seeking care from [SPHP] in 2023 because CDPHP no longer includes the following facilities in its network.” Over a dozen facilities, including St. Peter’s Hospital, Samaritan Hospital, and five Eddy facilities, are on the list. Interestingly, no related mail from CDPHP has arrived.

On the coverage

Meanwhile, my wife and my daughter also received a Benefits Bulletin from my former employer, the Research Foundation for The State University of New York, or SUNY RF. “If you are a retiree or an eligible dependent of a retiree and you are not eligible for Medicare, your current RF benefits will continue for 2023 unless you make changes during open enrollment.” That window is November 1-30.

Just in case we need to make a change, I went to the SUNY RF portal to see if I could find the forms to change their coverage, but none of them seemed appropriate. Some were for the retiree (me), while some were for the retiree and dependents. I am on a different plan for administrative reasons.

So I called the SUNY RF number on Monday and then a different one on Wednesday. I was offered the same form to make changes, even though it didn’t make sense to me. If I change my wife and daughter to a Blue Cross program, I hope SUNY RF does not muck it up.

CVS

Meanwhile, a good friend of mine writes on Facebook: “We’ve…just been notified by [CDPHP] that CVS will no longer take our prescription insurance effective 1/1/2023… This is very upsetting because CVS is very convenient to where we live, has a drive-through, and the closest to our house is one of the only 24-hour pharmacies in the Capital District.” We got no such letter from CDPHP.

I called my local CVS pharmacist. They said that CVS has declined to take the CDPHP price schedule, so it may very well cost more to fill prescriptions there, but they won’t really know until they start filling them next year.

This issue will be a primary concern of mine this month because I can’t wait until the CDPHP/SPHP issue gets resolved in December if, in fact, it does.

To travel, or not to travel

Coming from California

I’m writing this more than two weeks after the fact, which is suboptimal. This continuation: To travel, or not to travel.

Tuesday, October 4: My usual Bible guys meeting at 9 a.m. I believe I’m the youngest member of the group, which used to meet in person before COVID. But once we started on ZOOM, we stayed on ZOOM. Unlike most meetings, a Bible study with four to seven guys is manageable.

Conversely, the weekly book review at the Washington Avenue branch always wants to be in person. There were some furtive attempts at offering it online, but it’s just better face-to-face.

I went home, and my wife and I started a largely futile attempt to clean the house.

Wednesday, October 5: My wife and I drove to the Albany International Airport. It’s “international” because it services trips to and from a few Canadian cities. I went to the luggage area and met my sister Leslie, who had flown in from SoCal. She was going to go to her high school reunion that weekend. I had agreed to be her Plus One.

My wife suggested going to the Iron Gate Cafe, where we had eaten only a few weeks earlier. But her ankle was now extremely sore, and she begged off but dropped us off there. My sister loved it, as my wife knew she would.

My wife drove Leslie to the Avis/Budget car rental in Colonie Center, near the former Sears; I had no idea it was there. We all went home, with me navigating for my sister; she could have used her phone, but why when she had me?

Medical

My wife was on the phone with her doctor’s office, but from my end of the conversation, it didn’t sound as though her pain or possible infection was being taken seriously. Moreover, the redness of her ankle and above was very concerning to me.

This was because, in 1979, two days before I started my first attempt at grad school, I got a little cut on my baby toe. Increasingly, it hurt tremendously. I hobbled through registration, then limped to the infirmary. The doctor immediately put me on bed rest AT THE INFIRMARY for six days. He feared that the infection, traveling up a blood vessel in my leg, would head for my heart and kill me. I started classes late and never did catch up.

My wife and I put Leslie up in a hotel so she wouldn’t have to put up with our demented cat.

Thursday, October 5: I called my wife’s doctor’s office at 6:10 a.m. Of course, I got the service, but I gave the person great detail about the swelling and what appeared to be spreading infection. To my amazement, her doctor called back at 6:30 and promised a slot as soon as the scheduler came in. At 7:40, the office called, and my wife had a 10:30 appointment, which my sister drove her to. My wife got doses of antibiotics. After lunch, Leslie drove us so my wife could get an ultrasound. The good news: no blood clots.

The reserves

Leslie and I were going to Binghamton that afternoon in her rental vehicle. To travel, or not to travel, that was the question. I would have felt uncomfortable leaving my wife but for one thing. Unrelated to the medical issues, my daughter had decided to come home from college for the long weekend. SHE would take care of her mother! This was a bit of serendipity

And from the reporting of the patient, when Leslie and I came back on Monday, she had done a fabulous job. This is not a surprise, based on a story my daughter told my wife. Someone at college had accidentally cut themselves, and another student tried to patch them up, but they didn’t do it correctly. Clean the wound, pat it dry, and then put the ointment on the bandage, not the wound. My wife had shown this method to my daughter, and the message took. Can you hear the maternal beam of joy?

Lydster: off to college

Western Mass.

Our daughter is finally off to college. We dropped her off at a location in western Massachusetts with her supply of almost everything she needs in her home away from home.

She is far enough away that neither she nor we are likely to just “drop in.” But she’s close enough that we could reach her in a couple of hours if necessary.

One of her primary projects over the summer was to clean her room. How bad was it before? We have no idea because we don’t go in there. However, shortly after she graduated from high school, we could not help but notice how much fuller the garbage cans became. And she was doing more loads of laundry

Empty nest?

Lots of people ask us how we feel being potential empty nesters. I don’t know. In the past two years, she’s spent a lot of time in the cave she calls her room, so there would be hours when she was home, but we wouldn’t see her.

She had been out with her friends a LOT. I attribute a lot of this to COVID, or more specifically that she wasn’t SEEING very many people during the various lockdowns and is trying to make up for the lost time.

But I also don’t think I’ll feel like an empty nester because we were older parents. We had a lot of life before she was born. We’re both retired now, though I rush to explain that my wife retired young. But I could be wrong; it would not be the 101st time.

Now what?

NOW, my wife and I have no excuse for not doing the renovation, cleaning, and other projects we need to tackle. Well, except for fatigue. Did I mention I am retired?

Still, I WILL miss her not being around, even if it’s me Instant Messaging her from the living room to her bedroom, telling her it’s time for dinner.

n.b. This was SUPPOSED to be the August 26 post!

Lydster: finally at college

Uh huh

My daughter is finally at college. As I noted, her experience this autumn was delayed by COVID, first hers, then mine, then my wife’s. The initial protocol for her to start college was for her to wait five days from her onset. But with her parents contracting the disease at her domicile, this meant waiting an additional five days.

So instead of arriving on August 25 for a week of orientation before classes began on August 31, we were instructed to arrive on September 5, Labor Day, three days after classes had started.

Yet we were promised a call back from the college closer to our departure date. It never happened. On the morning of the fifth, we headed toward campus. While my wife drove, I called every office on the college phone menu. One choice failed to transfer properly. The only one I reached was campus security, which was not helpful to the task at hand.

We arrived at her dormitory. My daughter and I found a couple of people in an office, and I told them our tale of woe. One of them listened attentively, then told us that it was their first day on the job. But they called someone who had access to my daughter’s room key. The three employees, my daughter, and I unloaded the car.

I neglected to mention that, as of Labor Day morning, my wife was STILL testing positive for COVID, even though my daughter and I had tested negative; first, my daughter, then me on September 2.

After unloading, we went out to eat. Then we returned, and the three of us made my daughter’s bed and moved around a couple of pieces of furniture in her tiny room.

At that point, the vibe was clear. “Thank you, parents. You can now leave.” And so we did.

Aftermath

The following weekend at church, no fewer than a dozen people, upon hearing that our daughter was finally at college, asked, “How is she doing?” My answer was always some variation of “How do I know.”

I messaged her that first week and told her that we were there to help her if she needed us but that we didn’t want to bug her. She wrote back: “Uh huh,” which I took to mean, “Noted.”

She did call me on the Thursday of the first week at 10 p.m. I knew she was calling me because my wife’s almost always in bed by that hour. She wanted a clarification of a book footnote, which I provided. This let me know she was actually reading an assignment, which was some comfort.

Then the following week, she called her mother. They spoke for nearly an hour. So it’s all good.

The family that COVIDs together…

Also, four hours in the hospital

What IS that old saying? “The family that COVIDS together…” I’m not remembering the rest of it.

As noted, my daughter developed COVID c. Wednesday, August 24, just as we were about to head off to college.

Friday, August 26, we were all going to get more substantial COVID tests at the urgent care place. But my wife opted out, deciding she had no symptoms. I chose to get one because I had a bit of a sore throat. Truth is, I often have a bit of irritation from allergies or whatever. My daughter was still positive, but I was negative.

My doc asked a bunch of questions, such as if I had chest pain. I had more pain in my right shoulder than in my chest, but she ordered an EKG. She discovered a variation from what she was expecting. Now, I was born with heart arrhythmia. My primary care physician calls it a regular irregularity.

A change in plans

The urgent care doc suggested that I go to an emergency room to get further tests. I called my wife to pick me up – taking the bus after I’d taken a COVID test didn’t seem sage – and got some lunch. Then she drove me to Memorial Hospital because it would likely be less crowded than Albany Med or St. Peter’s.

Everyone was very nice, a couple of doctors, a physician’s assistant, and the nurse. The nurse was great, actually, and I was distressed to discover that one of her other patients had tried to assault her while I was there. The hospital ran a bunch of tests and found me A-OK. My calcium was low, and some other minor things were discovered.

By Monday, August 29, I was feeling achy, and I was coughing, sometimes uncontrollably. More rapid tests. I was positive for COVID, and my wife was likewise, even though we were fully vaxxed and doubly boosted.

I can say that I have felt worse, such as when I had the flu a dozen or more years ago. But it is difficult to focus on much of anything. (This blog post of 420 words I had to do in two shifts.) I feel addled. I bollocked my Wordle on Tuesday – I got it in six – because I couldn’t focus. The word, coincidentally, was ONSET, some cosmic joke. My wife, from her activity level, seems to be feeling better than I am.

My daughter won’t get to college until Sunday, three days after classes begin. Whatcha gonna do?