Slight Detour: Wednesday Album

Twas a feeling of total ecstasy this morning when no weather bombs or atmospheric rivers appeared to hanging out in the area.

We've had a little spitting snow this morning but hardly any cause for alarm or for groaning.

Yesterday our daughter Annie took a day trip to San Francisco with some colleagues and returned to Seattle when the weather bomb was blowing around that area.

She said the landing at Sea-Tac was a bit unnerving but successful.

Other family members over that way told of trees down and power off, so, I guess----so far---we're pretty lucky.

Yesterday afternoon here turned out to be nice and sunny with a little chill in the air.

Plus, the wind was blowing when I spent some time at City Beach.

Overall, it was gorgeous around the boat docks, with willow trees, still filled with golden leaves, fluttering in the breeze.

Lots of geese, some ducks and seagulls were hovering in the water not too far from the jetty.

Most didn't even fly off as I walked closer with my camera.

Just a lot of squawking among the species of water birds.

Happily, I was able to scoop up some more leaves south of the house.

I told Bill that yesterday's pickup could be my last for before winter because the poplar trees have just a few hangers on as does the oak tree.

If it snows much more today, those that fall might be covered.

This morning also started with some good news when we learned that Willie's girls basketball team defeated Post Falls last night, giving them a 2-0 record.

So, that's really good.

I also have some sorta good news in the long saga of trying to get my nearly $400 drug bill from September reimbursed by my Humana pharmaceutical insurance policy.

So, far I've accumulated a small booklet of letters from Humana, including some blank pages, two permission slips to use the drug I've already used, and two reimbursement rejections.

In the past couple of weeks, I've been told three different reasons for having my reimbursement rejected. This information has come through phone calls with agents and letters.

In one case, I was told by the agent that rather than going to Super Drug as directed by the pharmacist at Wal-Mart when they did not have the meds I needed, I should have, instead, gone to the local hospital pharmacy and then the company could reimburse me.

I'm guessing that most patients when they are sick and need drugs don't know such protocol nor do they have time to go through a primer on what to do procedural steps.

Like me, they probably just do what they are told at the time.

When I balked at the reason over the phone, the agent named Henry asked me to hold again and he would come back with some more information.

He came back and told me that I was only allotted so much to pay for the drug that had been prescribed and he was wondering why had Super Drug charged me that much.

Again, I said that I was not privy to drug prices because my insurance is supposed to pay the cost. He then said he would call the local pharmacy, ask some questions and then call me back the next day.

That was last week.

Still no call back from Henry.

Yesterday, I received two letters from Humana in the mail. The first told me that my reimbursement had been rejected because I purchased the prescription twice in too short of a time.

The actual fact: I purchased the entire prescription in two parts because of a clerical error on the original order. This was also clearly noted in the reimbursement form that I had sent to Humana via certified mail.

So, it seems strange that three different reasons for rejection came up over a period of time.

The second letter said that my reimbursement had been approved and that in so many days I'll be receiving a check.

BUT,

it also pointed out that, for a variety of reaons like co-pay and deductible, said check which I should receive in the mail could simply amount to $0.00.

That information made my day, and the fact the both letters included appeal forms did not bode well.

So, I'm waiting patiently to see if that check gives me my money back or if it's the nothing amount that the letter suggested.

This saga to receive a reimbursement for an out-of-pocket drug payment started in early October, and the stories continue to unfold.

My question: why is it so difficult for a company to send a reimbursement form for the patient to fill out and send back and then simply pay the reimbursement.

The company has yet to send me a promised reimbursement form. I used one sent to me by my insurance agent.

In this process, I have talked to six or seven Humana agents who have all told me different stories, and my paperwork (my own and Humana's) could fill a book.

It seems like there's something wrong with this picture.

Yesterday, after showing Bill the correspondence I had received in the mail, I once more reiterated that, yes, it's about getting the money back but more importantly, it's the principle of paying for insurance and then having to claw and scratch every inch of the way to receive what the insurance promises.

For some reason, I suspect that many patients in the situations similar to mine simply grow weary and give up and keep paying that premium.

Seems like a good deal on someone's end.

Okay, that's enough ranting for this morning.

The snow is still falling, and because of warnings of atmospheric rivers, I do have some indoor projects to do and will get at them.

Happy Wednesday.

Enjoy the photos.