So, I thought I would do another update.
After spending September traveling around the Southwest in our old jalopy of an RV (the suspension in it is very low end - it could rattle the fillings out of your teeth), during which we had pretty much a wonderful time, my husband and I decided to sell the house and move away from the area - we are planning to use some of the proceeds from the sale to buy a much bigger and nicer and newer (but not brand-new) RV and live in it for a year or so while we figure out where we want to live (probably somewhere in the Southwest) and while my husband remodels whatever we buy (I am NOT going to ever live in the house during remodeling again!).
But - all the kids are STILL living here. :-(
And there is still a metric ****-ton of stuff to do before we can sell it, starting with going through all of our CRAP and getting rid of a good deal of it, storing the rest in a storage area that we will be renting for a year or so, and Charles has to finish the zillion projects that never got done and redo a number of things that have gotten worn/broken/dirty/cracked etc. since he fixed them up several years ago. I am not hopeful that this is going to happen until the spring.
1) My daughter finally got a job at the beginning of July, the week her unemployment ended - but it was (and still is) only part time, making what her unemployment benefits were, but with NO benefits - no medical, no 401(k) - nothing. And that has not changed, despite a promise it would. However, she and her boyfriend now have plans to move in with some friends in their house, after they do a bit of remodeling (that I've already paid for in the form of first and last month's rent) to give them a bigger room for them and her dog and two cats. She should be out in a few weeks. And - she is being considered for a new paralegal job, working for my former paralegal who will not create the terrible atmosphere that so turned her off of the profession (she is enjoying her current position as an office manager for a start-up farm co-op, but there's no money in it), and the company she would work for seems to have a more professional and fun start-up environment (and they are VERY well funded).
And she is about to do the second round of oocyte harvesting, only this time her boyfriend is going to help her make embryos
because they freeze and thaw better than eggs, and they are talking marriage anyway. There are more insurance issues (see below), but they are going forward with it anyway.
2) A few days after the last update, my son shattered his femur in an ATV accident and was off work for over 3 months. During his recuperation, his g/f let him move back in with her. Great, right? Except last week, she kicked him out again. So - back to square one with him. At least he didn't lose his jobs during that time.
3) Stepdaughter is still here - there was a period of time when it looked like she and the STBX were going to get back together, but no. She FINALLY got a job - had orientation today - that is a hopefully seasonal to permanent job, but I don't care, I want her out NOW. I'm tired of her laziness and periodic insolence - I know she is stressed, but this is MY damned house.
We've told them the ALL have to be out by January 1st. I don't see it happening, except my daughter.
I've been doing a lot of fighting with insurance companies, some of it DS related, and some of it personal.
- After my daughter lost her job, the insurance battle with her self funded plan with Aetna continued - I can't even begin to tell you how horrible it all was. Basically, they insisted it was an excluded treatment as being for infertility, and I was arguing it was an adjunctive procedure to PRESERVE her fertility while undergoing treatment for stage 4 endometriosis. (Compare cosmetic breast augmentation to reconstruction after mastectomy - placing the implant is the SAME code in both cases, but the reasons for it are different.) And when I got to the end of the internal reviews (endlessly delayed responses, lost paperwork, side procedural grievances), I asked for an External Medical Review - which they refused to even give me the forms for, saying she wasn't entitled. Then when I got them to give me the forms, they didn't respond for months, and then said no again. I finally renewed and increased my harassment of their executive appeals director, and (most of) the money is being wired to my daughter tomorrow, so she can pay off the overdue bills (a "one time exception" - they are paying my daughter rather than the medical group, because they don't want it to appear to be acquiescing to the fact that I was right, and to avoid setting a precedent for paying for it).
- We are now at the IMR stage with her current insurance plan, which is a Blue Shield Covered CA plan, and thus regulated by the CA Dept. of Managed Health Care (DMHC) - again, egregious ******* around with us, at first saying the didn't have to even issue a formal denial because it was contractually excluded, and thus that we had no appeal rights. But after a metric ton more of BS from BSCA, they finally sent a denial (four months late) and then I appealed and they denied again, and now we're at the IMR.
- I just found out I won the first part of the IMR battle - the DMHC has ruled that the denial was NOT based on a valid contractual exclusion, but rather based on the assertion that it wasn't "medically necessary," and so it's off to IMR.
- I have some juicy evidence that BSCA doesn't consider it "not medically necessary" for SOME of their plans, like their small group plans, IF the doctor says that the patient is likely to lose their fertility - which is exactly her situation. And they worded the denial improperly (denying a procedure that is more than just oocyte harvesting and preservation), and failed to follow procedures like sending the EOC after citing it in the denial.
- AND - the DMHC has noted my multiple complaints of procedural abuses, and will be investigating BSCA when the IMR is done.
- My son got dicked around by his short-term disability insurance plan while he was hurt: he has two jobs, and supplemental disability insurance on just one of them; the supplemental insurance plan subtracted the state disability money he received from the OTHER job from what they owed, even though he should have gotten BOTH.
- And we have another tax issue that is going to Tax Court - we took a deduction that our accountant said was OK, and I still think it is, but it is a matter of interpretation, and you KNOW that the IRS did not review it properly.
I am tiring of this constant fighting, however. Why can't people just do their damned jobs and do them right??
I'd really like it if I could just go away now.
