I signed up for the High Deductible Health Plan (HDHP) option at work, thinking it would be a good deal for me and my husband since we are both blessed with excellent health. The deductible is $2000/person or $4000/family. One of the benefits of the high deductible option is that “Preventative Adult Care”, “Preventative Well Woman Care” and “Preventative Mammograms” are covered at 100% with no deductible. Another benefit is that my company contributes to a Health Reimbursement Account (HRA) on my behalf ($1500 for employee plus one coverage). Sounds great so far, hunh?
According to the description of the plan, “When you enroll in the option, you'll receive a debit card that you can use to pay for eligible expenses as long as you have a balance in your HRA.” My first problem was that I never received a debit card so I did not have access to the funds. When I contacted our Human Resources department, they informed me that the verbiage in the plan description was incorrect. I would not receive a debit card. The funds would instead be administered by Aetna and could only be used for “covered” medical expenses, so any expenses that Aetna denied or over-the-counter expenses would have to come out of my own pocket. Annoying, but I could live with that.
The next obstacle is that there is apparently no such thing as “Preventative” care because Aetna pays almost everything out of my HRA account.
My husband went for a physical and the associated lab tests weren’t considered preventative. Aetna paid the charges from my HRA. Cha-Ching. He went back to have his cholesterol level checked so he could get a refill on his medication and that isn’t considered preventative either. Cha-Ching. That was last year. This year, he went to a new doctor (because our old doctor was no longer in the plan). I have him strict instructions to specify when he made the appointment that it was for his “annual physical”. The doctor’s office billed the insurance company for two visits, coded “99203 OFFICE/OUTPATIENT VISIT, NEW” and “99386 PREV VISIT, NEW”. Aetna paid the $135 for the “PREV VISIT” but took the $100 for the OFFICE/OUTPATIENT VISIT” from my HRA. Cha-Ching. Aetna’s response to my dispute? “Our records indicate that the claim was billed for a routine visit as well as a medical visit. If there were issues discussed during the routine visit that are medical in nature, the provider can bill for a routine visit and a medical visit.” Amazing.
My routine mammogram required a follow-up because the technician saw something that might indicate a problem. The follow-up mammogram showed that it was nothing, but because they “thought” there was a problem, it wasn’t considered preventative. Cha-Ching. Another chunk of change from the HRA.
And the most distasteful of all? Aetna doesn’t seem to think a colonoscopy is preventative either. Do they think I just went through all of that prep-work for the fun of it? Cha-Ching, Cha-Ching, Cha-Ching. There went the rest of the HRA and I still owe $1329.95. My dispute over this one is still outstanding. I can’t wait to hear what response they come up with for this one.
I didn’t want to face it alone so I talked my husband Tony into going with me. We went after a few glasses of wine with some friends. I thought that might make the experience less painful, but it didn’t.
First we went to Marshall’s. We found the swimsuits in the sportswear section, although what I do in a swimsuit would never be considered a ...sport. When wearing a swimsuit, I quickly try to find the nearest body of water and immerse myself waist-deep in water that is hopefully murky enough to hide some of my – ahem – figure flaws.
Tony found the old lady section, “These are more matronly.” Thanks, just the description I was NOT looking for. Next came the “What size do you wear?” question. If I took the information I have learned from “The Biggest Loser” show, then I would need a size 3. I am always amazed at how these 5 foot tall 300 pound women lose 150 pounds to get down to roughly what I weigh and then go on and on about how they went from a size 24 to a size 3. I’m 5’7” tall and I haven’t worn a size 3 since I was in first grade. I decided that I must be a 12 since that is the size I was the last time I bought a bathing suit. Just in case, though, I picked out a few size 14s. Tony selected a few for me to try as well.
Then it was off to the dressing room. I am never sure what the protocol is for trying on bathing suits. I think you are supposed to wear underwear, but I am not sure what the little piece of tape in the crotch is supposed to protect. Are other people trying these on without underwear? What kind of germs are on that little piece of tape? I am a little grossed out by these thoughts. I strip down to my underwear and as soon as I do, I suddenly need to use the bathroom. “Think about something else,” I tell myself. So I put on the first bathing suit. My white cotton underwear sticking out from the bottoms makes it hard to tell how it really looks on me. It is a tankini (is this in reference to a Sherman Tank?), so I put on the top which covers most of the white cotton and parade out to the mirror where Tony is waiting.
He tried to make the thought “that looks hideous” sound as complimentary as he could, but the mirror was not so kind. I went back to the dressing room to try on the next one. As soon as I got down to just my panties, the urge to pee came back so strong that I could barely get my clothes back on in time to make it to the bathroom. The few glasses of wine I had drank made it even more difficult to keep my balance while I tried to pull on my pants & tie my shoes. I hastily grabbed all of the swimsuits and threw them at the clerk as I ran off in search of the bathroom, leaving a bewildered Tony sitting next to the mirror.
When I got back to the dressing room, Tony had somehow convinced the clerk whose native language was not English to hold the swimsuits until I got back, but I decided I had the picture of what these would look like and decided to go next door to TJ Maxx.
We picked out about a dozen swimsuits in a variety of sizes ranging from 12 to 14 and headed to the dressing room. I was only allowed to take 4 at a time to the dressing room. The dressing room closest to the door was labeled “Family Dressing Room”. After having seen myself in the suit at Marshall’s, I felt like I was the size of a family so I took that dressing room. The first few tankini’s convinced me (and the ever-tactful Tony) that I should be looking for something with a skirt that would cover more of my thighs.
I finally found two dress-like swimsuits that were acceptable and we headed for the cash register. When the clerk dragged them across the counter, the inventory control tag set off an alarm. I decided that must be the huge swimsuit alarm. “Attention customers, the lady at register 7 is purchasing two huge swimsuits!” When we got to the parking lot, the car alarm on the car next to ours went off too, signaling my huge swimsuit purchase.
I’m really looking forward to showing off my new suits in Florida next week! Hope the water is murky enough! Or better yet, maybe the weather will be bad enough that we never have to leave the room!
Happy Spring Break!
First we went to Marshall’s. We found the swimsuits in the sportswear section, although what I do in a swimsuit would never be considered a ...sport. When wearing a swimsuit, I quickly try to find the nearest body of water and immerse myself waist-deep in water that is hopefully murky enough to hide some of my – ahem – figure flaws.
Tony found the old lady section, “These are more matronly.” Thanks, just the description I was NOT looking for. Next came the “What size do you wear?” question. If I took the information I have learned from “The Biggest Loser” show, then I would need a size 3. I am always amazed at how these 5 foot tall 300 pound women lose 150 pounds to get down to roughly what I weigh and then go on and on about how they went from a size 24 to a size 3. I’m 5’7” tall and I haven’t worn a size 3 since I was in first grade. I decided that I must be a 12 since that is the size I was the last time I bought a bathing suit. Just in case, though, I picked out a few size 14s. Tony selected a few for me to try as well.
Then it was off to the dressing room. I am never sure what the protocol is for trying on bathing suits. I think you are supposed to wear underwear, but I am not sure what the little piece of tape in the crotch is supposed to protect. Are other people trying these on without underwear? What kind of germs are on that little piece of tape? I am a little grossed out by these thoughts. I strip down to my underwear and as soon as I do, I suddenly need to use the bathroom. “Think about something else,” I tell myself. So I put on the first bathing suit. My white cotton underwear sticking out from the bottoms makes it hard to tell how it really looks on me. It is a tankini (is this in reference to a Sherman Tank?), so I put on the top which covers most of the white cotton and parade out to the mirror where Tony is waiting.
He tried to make the thought “that looks hideous” sound as complimentary as he could, but the mirror was not so kind. I went back to the dressing room to try on the next one. As soon as I got down to just my panties, the urge to pee came back so strong that I could barely get my clothes back on in time to make it to the bathroom. The few glasses of wine I had drank made it even more difficult to keep my balance while I tried to pull on my pants & tie my shoes. I hastily grabbed all of the swimsuits and threw them at the clerk as I ran off in search of the bathroom, leaving a bewildered Tony sitting next to the mirror.
When I got back to the dressing room, Tony had somehow convinced the clerk whose native language was not English to hold the swimsuits until I got back, but I decided I had the picture of what these would look like and decided to go next door to TJ Maxx.
There were more matronly suits to choose from at TJ Maxx. Some advertised something about longitude with latitude control. Now that’s a reference you like to read on a swimsuit tag. Who thought up this advertizing campaign? Here’s what it brought to my mind. “Are you the size of the earth? Are you shaped like a globe? Try our new longitude with latitude control swimsuit.”
We picked out about a dozen swimsuits in a variety of sizes ranging from 12 to 14 and headed to the dressing room. I was only allowed to take 4 at a time to the dressing room. The dressing room closest to the door was labeled “Family Dressing Room”. After having seen myself in the suit at Marshall’s, I felt like I was the size of a family so I took that dressing room. The first few tankini’s convinced me (and the ever-tactful Tony) that I should be looking for something with a skirt that would cover more of my thighs.
I finally found two dress-like swimsuits that were acceptable and we headed for the cash register. When the clerk dragged them across the counter, the inventory control tag set off an alarm. I decided that must be the huge swimsuit alarm. “Attention customers, the lady at register 7 is purchasing two huge swimsuits!” When we got to the parking lot, the car alarm on the car next to ours went off too, signaling my huge swimsuit purchase.
I’m really looking forward to showing off my new suits in Florida next week! Hope the water is murky enough! Or better yet, maybe the weather will be bad enough that we never have to leave the room!
Happy Spring Break!