Thursday, December 5, 2013
One person's journey through trying to get Insurance for 2014
For those of you who don't know me or haven't read my blog before let me start by saying that I have Breast Cancer. I was first diagnosed 10 years ago in 2003. Since then I have been diagnosed with Metastatic Breast Cancer, also known as Stage IV. This means that the cancer has spread beyond the breast. In my case, into my bones in several locations. I am one of the "lucky" ones because, so far, it has not spread to any organs. My doctor tells me as long as it stays just in my bones that is the best we can hope for. The treatment for this varies by individual and by what works for each person. Personally, I take an oral chemotherapy and don't have to get any other infusions at this point.
My husband and I own a small business and therefore have had to purchase our own healthcare for the last 7 years. Because of my cancer diagnosis, I have been insured through the Texas State Risk Pool. This is/was an insurance for people who could not get insurance any other way because of pre-existing conditions such as cancer. We have dutifully paid the higher premiums over that time and I am thankful that I had this insurance when the Stage IV diagnosis was given to me in 2010. I had 2 surgeries during the year after my diagnosis, radiation and other chemotherapy.
Fast Forward to 2013. The State Risk Pool sent letters out to all insured stating that the Pool would shut down as of December 31 because we would be eligible for health care now that the Affordable Healthcare Act was being implemented. That letter came in the summer of 2013. In the fall, prior to healthcare.gov going live, I received another letter reminding me that the system would be shut down and on October 1st I could go online and apply for insurance.
I did not go on to the website on October 1st. Honestly, I expected it to be bombarded by those trying to get insurance. I waited about a week. After 3 days of trying to log into the system I finally got on. I completed the application and was sent a "determination letter". Our income level is such that we should qualify for some of the "tax credits/subsidies" whichever term you wish to use. When I received my determination letter it told me that I qualified for a tax credit but told me that credit was $0. My next step, according to the letter, was to select an insurance plan.
Well, as many of you know, the website had a few glitches. Every time I tried to log into the system and select a plan it sent me back to my application. I was never able to see what plans were available for me. I finally went back on the website after the media told all of us how it was now fixed and working. I was able to log in, it showed that I did have a tax credit available (not $0 any longer) and I was able to search for a plan.
Given my history, I did not even look at the Bronze plans. I began sorting through the myriad of policies that were available in my area. Three of the companies did not list my current doctors in their plans, so I immediately ruled each of those out. I have had the same oncologist for 10 years. He knows my history and I am very confident in his abilities. I obviously do not wish to change my doctor.There were 3 "big name" insurance companies that all showed my doctor listed in the provider list.
Now that it was narrowed down to companies that I had heard of and that my doctor participated in, it was time to decipher the cost and benefits associated with each of those plans. I will be honest with you, I think I am a fairly intelligent person. I went to college, have a degree in business and am certified in my field. I should be able to decipher the information out there. But as I waded through the descriptions of each of the plans, I began to doubt what I was reading. There was a variance of over $400 per month in the premium amounts between the lowest and highest plans that I was considering. Each of them had different charges for seeing a specialist (oncology is a specialty). Surprisingly, the most expensive monthly premium plan was also going to cost me the most each time I saw my specialist. If they are all supposed to offer the same coverage then why was there such a discrepancy in the monthly premiums. It made me think that there was something that I was missing in the comparisons. I needed someone else to look at the plans and figure out what I was not seeing, I certainly did not want to enroll in a plan because of a low premium only to find out later that there were many other hidden costs that would cost me more in the long run.
I began to see if the plans were going to cover the chemotherapy medication that I currently take. None of them seemed to include my medication in their formulary. If they did, it was considered a specialty medication and would either not be covered or it would be covered at 50% and not included in the deductible. Let me just say that I picked up my medication today and a 2 week supply, before any insurance adjustments, is over $2,600. Under my current plan, thankfully, I do not pay anywhere near that amount.
So as I worked through all of this information I decided that I should call my doctor's office and see what they said about each of the policies. I wanted to get some information to see if they could discern if my medication would be covered, what their experience was with each of the companies that I was looking at and any other questions I could think of. So, when I called and talked to them I was told that "we have not yet determined if we will be accepting any of the insurance under the ACA". My mouth dropped and my blood pressure went up. I have insurance until the end of December through the risk pool, and my doctor is telling me that they won't be participating under the ACA???? Now what?????
Yesterday in the mail, I received a letter from the state Risk Pool stating that they would be extending the pool through the end of March since so many people were having a hard time getting signed up under the new insurance plans. Now my option is to continue for 3 months in the state risk pool or sign up for a plan that may not be accepted by my doctor. As a family we currently pay 24% of our GROSS pay towards insurance premiums. That does not include all of the copays and the deductibles that we pay for my treatment.
Tonight I sit here and wonder what will happen in 3 months when the Risk Pool is shutting down (again). Will there be a plan that will be available for me. I do not have the luxury of a group plan to cover my insurance and even if I did what confidence would I have that I would not be running into the same problem.
I have phone calls into several different places to help me figure this all out. I will keep you posted on what I find out
Wednesday, November 20, 2013
The Architect
Why? The age old question. Why does this happen to that person? After our dog was diagnosed with a tumor (cancer) a couple of weeks ago, I was struggling with this question. I had lunch with one of the pastors at church. She patiently listened to me and felt my pain. She did not try to placate me with words like "everything happens for a reason" or "God has a plan". She listened, and listened and listened some more. She did not offer words, she just let me talk through the thoughts going through my head. After lunch she gave me a book to read entitled "Why? Making Sense of God's Will" by Adam Hamilton
Some of you may be wondering why I would be asking that question about a dog. First, if you aren't an animal lover you may not fully understand. Second, she (our dog) is just over a year old - much too young to have this kind of problem. And third, it brought back memories of 3 years ago when I saw the x-rays where the bone was gone (for me, my hip and for her the bottom part of her leg). I had a hard time coming to terms with what this meant for her. And thinking about having to go home and tell my daughters what this was going to mean, as well.
One of the chapters in the book (it is a quick read - I read the entire book on a plane ride) discusses "collaborating on the story of your life". This spoke to me. We have all heard someone say "God has a plan for your life." But there is also the discussion of free will. If we have free will, then how can God have a plan for your life.
My interpretation, after reading the book, is that God has a blueprint. I'm not an architect (nor have I played one on TV as the old commercial goes), but I do know that a blueprint is a plan, a starting point. Thinking in terms of building a home, it is easy for a new homeowner to think "oh, I would like to be able to put the refrigerator over there" after seeing the walls go up. A thought like that can have several different impacts to the architect. If you put the refrigerator there, we can't put the sink here and the stove won't fit there. The cabinets that were ordered may not fit. Or perhaps while looking through design magazines the excited home owner sees a new design that they want to incorporate. While these changes may seem small to the owner, the architect is behind the scenes adjusting the blue prints so that the new homeowner's vision becomes seamless.
In this scenario, I am the homeowners and God is the architect. Decisions by me, or even by those around me that may impact me, or perhaps even a force of nature like a tornado or fire, change the plans. God takes the decisions/events in our lives and makes the adjustments to the blueprints. It is our choice to look at the new blueprints and decide if we like the new design. God can take the challenges and the decisions that may not have been in the original plans and turn them into something beautiful.
Every day the new blueprint is placed before us, we have to make the decision to accept the changes or throw them out. Which decision will you make?
Wednesday, November 6, 2013
Resurrect Personal Connections
I find it all a little crazy. When it the right time to use Twitter vs. Facebook. And since you can post from Twitter to Facebook is it overload? What about Instagram? I used to just post pictures directly to Facebook. Now, we use Instagram and use filters to make the pictures look like they were taken in the 1970's and they have faded. Glad we have upgraded our technology...
I was with a bunch of high school kids at a church event and we were doing an Instagram Scavenger Hunt. I told the kids that since they had to be in the pictures I would take them and post them with the Hashtag. One of the kids said "YOU have an Instagram?" "Yes" I replied "I have kids that keep me up to date" That brought a laugh from everyone but it was a reality check.
Why do we have to have so many different ways to connect? And does it make our connections any better? Do we connect differently now because we have these social media hubs. I'm sure there are even more that I have no idea about. I'm pretty sure that my college age daughter uses some other apps that connect her to different groups at school. But is it all too much? What happened to have a face to face conversation (and I don't mean FaceTime).
How many times have you been out to dinner and noticed that at the table next to you there are 4 people and none of them are talking to each other. Instead they are looking at their phones and either posting pictures of the food they are eating or reading updates from others. Or, they are just texting the next person that they are going to see. How sad that a phone with the world in your hands makes you not see the world right in front of you.
I admit I have been that person with the phone on the table waiting to see who would text/call or Facebook me while I was out. I have tried to make an effort to put the phone away while with people. Let's get back to making connections with people in person. It is a skill that is dying, let's resurrect it.
Monday, October 14, 2013
Essential Oils...Feeling Better
So I mentioned before that I would be keeping you updated on my use of Young Living Oils. I have been using these oils for a couple of months and have seen some incredible things so far.
I began using the oils to help my feet and hands as a result of reactions to chemotherapy. I take Xeloda for my Stage IV breast cancer.One of the side effects is hand and foot syndrome. Basically, it is like a chemical burn on your hands and feet from the inside out. It hurts to walk at times and the dryness of the hands and feet can be somewhat painful. The feet and hands are dry and cracking. A friend, and my upline distributor introduced me to Copaiba oil. I began using this on my hands and feet for inflammation. It definitely helped.
But we wanted to try more. The Copaiba lessened the tenderness but the dryness and stiffness was still making it difficult to bend my hands at times. So we continued to research different oils that might help. I have been using the peppermint oil for cooling effect. Just a couple of drops in water and then place it on my feet. Pretty amazing stuff!
Another oil that we have been trying these past few months is Frankincense. Yes, as in one of the gifts given to Jesus at his birth by the wise men. As it turns out, this is a very healing oil in many respects and is great for Cancer. So, yes, I began to take a few drops of this amazing oil daily. Is it curing my cancer? Don't know the answer to that, but I'm still doing really well so far.
One of the more interesting things we have tried is a blend of oils (in a capsule) that works for pain. My husband likes it better than taking over the counter pain pills. He loves how much better his joints feel when he takes that. A natural pain pill. Love it.
I did have someone comment to my husband the other day asking what I was doing. He noticed that I was happy, looked like I had lost weight (unfortunately, the scale says differently, but Yeah for people thinking that), and generally looked good.
So I have just placed my second order with Young Living OIls. Looking forward to exploring more with the new items I purchased.
If you want to learn more, you can visit my sponsor's blog at www.keepingitholistic.com
If you would like more information on Young Living Oils please visit the following website Young Living Essential Oils
Thursday, August 8, 2013
Do you know the whole Story?
As you know I have had my struggles the last 3 years. Some of which has "earned" me a handicapped parking permit. For a long time it was very necessary, for example when I was in a wheelchair, or using a walker. Now I walk under my own power, with a slight limp. I still have the handicapped permit, and for a while I actually felt guilty using it. Not when I go to something that might require that I walk a mile to get to my destination, but at places like church or the grocery store. I have gotten "the look" from people wondering if I really needed the handicap spot. When that happens I hear that saying in my head "You see my face, but you don't know my story".
We all have stories that make us what we are. Most of us do not take the time to understand that there may be a reason that the person in front of you in line can't find her wallet in her purse and is holding us up. Perhaps she just came from the hospital where she was told her mother is in critical condition. Or her husband just came home and told her he wanted a divorce and she has no idea what her future will look like. Standing behind this person in line, many are thinking "why did I choose this lane, she is going to make me late". Wouldn't having compassion, even not knowing what they are going through, lower frustration levels for everyone involved? I know this has been my experience as I have let that little saying play through my head.
Yes, admittedly, there are some people that are just rude by nature, but wouldn't your frustration level be reduced if you made up a story about them in your head that would make you feel compassionate instead of angry? So the next time a car cuts you off in traffic, or takes the parking spot you were about to park in, remember you are just seeing their face, and not their story.
Saturday, August 3, 2013
Listening or Hearing?
I read a post in my cancer support group about words that a doctor used. Although the doctor thought he was saying the appropriate thing, the wording made it very uncomfortable for the patient. He was trying to say the drugs she had taken in the past did not work for her, but the wording came out as though the patient was the problem, not that the drug didn't work. As a cancer patient, I know that if I am taking a drug as prescribed and it doesn't work, that is NOT my fault. It is not even the drugs' fault. It is just that the two were not compatible. Not unlike a relationship where it seems people are right for one another, but it just doesn't work out. No one's fault. Just not a good fit.
Last night was one of those episodes with my husband where we were saying the same thing just in COMPLETELY different ways. I was frustrated because it seemed like he was not listening to what I was saying, he was frustrated because it was technology related and he really doesn't like to talk about technology. He is what I like to call technology challenged. He does not do much on a computer other than games and email. If he has to create a document it is outside his comfort zone. And don't get me started with the smart phones. In his opinion, they aren't all that smart because a programmer doesn't think like him.
Last night I realized, a little later than I should have, that we were having one of those conversations. Instead of calmly stopping and saying that we were talking about the same thing, I let it continue on and get frustrated.
So I am working through, in my head and on this blog, a new goal to actually take the time to HEAR what someone says. Many of us just listen, but we don't hear what the other person is saying. I have a feeling it is that same way with God. We listen, but we don't hear what He is saying. If we could learn to Hear the words of others there might just be a little less frustration in the world.
So slow down, HEAR what people around you are saying. You might just learn something new.
Thursday, August 1, 2013
Sometimes I forget
This past week I forgot to listen to my body. I was very wrapped up in helping my daughter get ready to go off to college. We took her to school this past weekend. A 3 hour car ride there and 4 hours back (got to love traffic on I-35 on a Sunday afternoon) plus walking around campus. With all the running around and the car rides I somehow managed to strain my back. Mind you, the slightest pain makes me incredibly nervous. A new pain to most is not a big deal. You rest a little, maybe take some pain medication and you go on about your life.
If you are a stage 4 cancer patient, a new pain tends to freak you out a bit. The last time I had a pain in my back I attributed it to over exertion and kept thinking it would heal. It took me 4 months to realize that it wasn't getting any better and thta I should go to the doctor. As you may have figured out that was when we found out that the cancer had metastasized to the bones in my hip. As a result, I was a little anxious about the pain in my back and decided that I should see the doctor early this time around. This fit into one of the goals that I set for myself when I was originally diagnosed with Stage 4 - to let people know that if they have any new pains, especially if you are a cancer survivor, then you should have it checked out. The sooner you get it looked at, the better your chances. Perhaps if I had gone earlier, I might not have had to had such extensive surgery on my hip. But if I can convince one other person to go sooner rather than later, I will feel like it is worth the effort.
The good news, this time, is that they seem to think I just over extended myself and that a little rest, and doing not much, letting my family wait on me a little will let my body heal. (I think I heal a little slower than the average person). So I am sitting with my feet up, an ice bag on my back and a large glass of water next to me watching TV. I am praying that this will allow me to relax the muscles in my back and let everything get back to normal.
Tuesday, July 23, 2013
Enjoy the Season...
That word for me lately has been SEASON. The word has been everywhere lately and culminating on Sunday when both the sermon dealt with that and then on the way home from church they were discussing things on the radio. The word used over and over on the radio was SEASON. There it was again.
I've been pondering this a lot lately. Although this may not be the official definition of season, I have come up with the definition that God has been putting on my heart. And that definition is CHANGE. The sermon Sunday, if you step away from the word season, was talking about how we are different at different points in our life. We change. We go through seasons. The speaker on the radio was talking about how we have different seasons in our lives, referring to, again, change. Even in my cooking we have been playing with seasoning our food with different spices to explore the change that comes with that and the wonderful new flavors that can be experienced.
Right now my new SEASON is that my daughter is going to college. This is a huge change in my life. My daughter has lived with us for 18 years. We have watched her grow to a beautiful young lady. Still, as any parent would tell you, I can look at her and see that little toddler that needed my help for most things she did. I am very proud of her and how she is pursing her dreams.
Looking back just on the last 3 years there have been many SEASONS in my life. Beginning with the diagnosis of cancer. To having surgery and radiation. Learning to walk with a walker, to finding out that I would be having my hip rebuilt and learning to walk again, this time without a walker. The seasons have been ever changing.
How does this relate to my Goals and Dreams you ask? Well, I am looking forward to the new SEASON and not looking back on the seasons that have passed. Embracing the change and not ignoring it or burying my head in the sand. We all have Seasons of CHANGE and if we don't embrace it, we may just miss out on all of the blessings that are wrapped up within that Season. And remember, just like the seasons on the calendar, another SEASON in our life will be just around the corner. Looking forward and not backward will keep you excited about what is just around the corner.
Friday, July 19, 2013
1 Week into One of my Goals
I said I would keep you posted on my adventures in juicing and essential oils. I have been using the essential oils for 5 days now. That may not be long enough to tell a difference yet, but I am on my way to feeling better.
One of the side effects of the oral chemotherapy I take (I told you the cancer played a roll in my life daily) is burning and redness in my hands and feet. The doctor explains it that it is like a chemical burn from the inside out. Not much helps it. I've tried lotions and creams and ice packs. Although the lotions help temporarily, pain relievers have been the only thing that at least take the pain to a tolerable level to do my daily activities.
I'm not trying to sell anyone on these essential oils (at least not yet), but I have been using an oil on my hands and feet. It has really helped to take the redness and even some of the pain down a notch. I haven't done anything different other than use a drop on each hand once a day. I'm curious to see what happens during the chemo cycle (I take the pills for 2 weeks and then have a week off). It will be interesting to see if it can keep the pain and redness down before the next cycle begins. So far, I am greatly pleased with the results of this oil.
In addition, I have added another oil to my daily routine to help with weight loss. I'm trying very hard not to step on the scale everyday. In fact, I have told myself not to step on the scale but once a week to see how things are going. So no update on the weight loss for a while :) Remember, the language post. It is not a try to stay off of the scale. It is DO NOT get on the scale.
As for the juicing, my husband is the master mixer of the juices. We have been trying different blends and getting used to the idea of drinking one of our meals a day. We made several different blends this weekend and used them this week to supplement our meals. So far it is going well. I am amazed at how filling a glass of juice can be when you are actually getting all of the nutrients that your body is craving.
Keeping it Positive....
Tuesday, July 16, 2013
Change in Language
For example, we were looking at the clothes in my closet. I could probably have been a project on TLC's "What Not to Wear". I dress for comfort. I like jeans and t-shirts or shorts and t-shirts. Lately, I have been trying to upgrade my wardrobe. For my birthday I got dress shorts instead of gym shorts. Of course, I had my daughter looking in my closet to find a shirt to go with one of these new pair of shorts because I didn't think I had anything that would go with the fashion color that I got. As we were talking, I said "If I get to my goal weight". As I said that out loud it occurred to me that if I truly want to make this a goal, I need to change my language.
IF makes it a dream. What would make it a goal? WHEN. So I corrected myself and said "WHEN I get to my goal weight" I would go shopping for cute clothes, not just t-shirts. We even talked about who I would go shopping with.
So now I am reevaluating my use of language. Am I using the correct language to visualize the change that I am looking for, or am I using the dream language. I'm certain there are other areas that I am not using the positive language that will help create the change. It is an attitude thing that says "HECK YES, I'M GOING TO DO THIS".
So today, and this week, I will actively listen to the words I'm using and ask myself if those are words of change or are they words of dreams. What is your choice of words saying to you?
Thursday, July 11, 2013
I diverge today
In today's summary of emails was a post about a group member who passed away this week after her battle with cancer. Usually I don't know the person and this was the case today. However, there was a link to her blog and since I am new to this blogging, I clicked on it to read.
As I opened it up it started with a blurb about herself and her cancer. She was diagnosed in October 2010 (like me) with Stage IV, she was in shock, like most of us are when we here that news, but she planned to Kick Cancer's A**. The quick blurb felt like she was attacking cancer with the same attitude that I would like to think that I am. I try to live each day kicking cancer in the a**. It sucks, but it is the hand I was dealt, and I am going to bluff my way through this and try to win the game.
I scrolled through some of her posts and although our situations are/were different (she had mets to organs, not just bones) I felt like I would have really enjoyed getting to know her. Based on her blog, she seemed to be upbeat right to the end. In fact she had created a post as late as June 14th in which she seemed to be positive about how she was doing and what she was doing. Her last post was about a fund raiser for the Breast Cancer Research Center (BCRC) which is a non profit that helps those diagnosed with Breast Cancer. They have patient navigators to help anyone that contacts them to understand the process and even go to doctor appointments with you. I personally have not used their resources because I have a great personal support system through family, friends and church, but I have heard really great things about this organization. (If you are looking for a charity to donate to, I would appreciate you looking into this organization).
This blog and the attitude of this lady that I did not know really struck me today. It made me realize that my goal that I set earlier this week is even more important to me. None of us know how long we have the gift of life. So appreciate each day, appreciate the people in your life and don't sweat the small stuff. Please realize that each of us comes with a set of baggage at every encounter and we may not know what that may be. But please, be encouraging, instead of discouraging; pleasant instead of rude; and leave every encounter with others with the feeling that you won't regret the interaction if it happens to be the last you may have with them.
Thanks for reading
Wednesday, July 10, 2013
Dreams....lead to goals
Instead, I have reached out to find that there are many people that have lived 10 or more years with metastatic breast cancer. But how do I turn this dream into a goal? Great question. I have found that when you begin to research you can find information to support the two sides you know most about, and then you find you that there is actually a prism with many different faceted sides.
I have found that carbs are bad, carbs are good, the paleo diet is great, the paleo diet is bad. You should eat an alkaline diet, you should eat a balanced diet. If you eat flax seed and cottage cheese you can cure yourself. Etc, etc. etc. You get the picture. I don't doubt that many people have cured their cancer with whatever it is they say they have eaten, or not eaten, whatever the case. But just like the "who gets cancer" is the fact that each one of us are different. If you would have asked me if I thought I would get cancer the answer would have been a resounding NO. No one in my family history has ever had breast cancer and they have all lived to be a ripe old age (at least into their 80's , if not their 90's).
So now my dream of seeing both of my girls graduate from college will come down to me discovering the best way for me to beat cancer. My goal is not to try each and every idea that I have found on the internet. My goal is to discover the type of diet that is best for breast cancer, will work in my family's life style, and that will keep the cancer from growing (oh, did I mention that I haven't had any new or growing occurrences in my last 2 scans). Juicing and essential oils are the first 2 trials. So keep reading, I will be sharing my progress along the way.
Tuesday, July 9, 2013
Defining My 1st Goal
Monday, July 8, 2013
Day 1 - Again
I have been a breast cancer survivor for 10 years this coming October. I'm not sure that I is the term any longer. Actually, now I am in my 3rd year of living with Stage IV or metastatic cancer. I want to be known more for living rather than surviving. The connotations are very different, at least in my mind. Survival, to me, is getting through whatever obstacle is in front of you. Living is not letting the obstacle get in your way. I did survive, first chemo and then radiation 10 years ago. I lived a really good 7 years not even giving thought to the cancer that had disrupted my life for 10 months. I had fought through and survived. Don't look back. WRONG. Seven years later, the cancer fought back and now I have bone metastasis in several locations. The good news, it isn't anywhere else. So now I LIVE with cancer. I take an oral chemo therapy and have had several surgeries and a couple of rounds of radiation to help slow the growth and stop the pain that I was in.
Now, three years into this new life, I am fighting my inner self with the goal setting issues I have had over the years. Fear and will power have been my two greatest obstacles to battle in my fight for my goals. Accountability has also been lacking in my past attempts.
I am hoping that this blog will become my accountability for my new goal. What is the new goal you ask? Tune in tomorrow to find out.......