One thing...

My neighbor got a new job, which has benefits.  She has not had benefits since her husband died about six years ago.  And, when she did, he took care of all the decision-making and paperwork.  She asked me to help her go through her options and fill out her paperwork.  As a communications professional,  I used to help fellow employees understand benefits all the time, and, frankly, I have had to take care of this for myself since I was 21.  Thus, I used to speak this language with great ease, able to scan a plan and see the big picture of those costs and benefits with very little effort.

Last spring, I struggled mightily trying to wade through the Medicare options.  I worked with a Medicare counselor and made what I thought was the right choice.  However, many medications ended up being either not covered or restricted.  I was rather discouraged at the first non-covered drug letter.  By the sixth (and last) one, I was merely nauseous.  And numb.  Both the pharmacy and my doctor's office spent months working through some of the approvals (not all).  They are only valid through the end of this year, so those approvals will need to be obtained all over again in January.  Neither the Pharmacy nor my doctor's office are looking forward to this process.  Both have made numerous comments as to the arduous nature of obtaining the approvals I did get.

Despite that heavy weight of failure hanging about my neck, I met with my neighbor and went through her benefits and paperwork. I taught her about Flexible Spending Accounts and Health Savings Accounts.  I made a spreadsheet of her costs between the two health plan options, itemizing out expenses based on her past few years of healthcare.  I taught her about the value of the 100% match on retirement encouraged her to max out that benefit because she would make substantially more in the match than she would saving the money on her own.  I showed her, also, how pre-tax dollars are actually less than post-tax dollars and thus a savings in itself for the time being.  And I helped her research her Affordable Healthcare Act obligation since she still cares for her autistic son who will be 20 soon, but who does not work or is independent in any fashion.

We filled out all of her paperwork and wrote up a list of questions for the agent who currently sells her major medical to see if keeping her son on that plan by himself, adding him to her new work plan, or going through the exchange would be most economical.  I created a comparison chart for her to fill out as her questions were answered. I also wrote up a list of questions for her tax preparer to see difference between claiming him as a dependent and paying for his medical, but not receiving a subsidy since she has a work plan now or having him file his own return and receive the subsidy.  In short, I helped her make her 2013 and 2014 decisions for herself and outlined a course of action to arrive at the decisions for the 2013 and 2014 decisions for her son.

Her world, though, is still easy for me to see.  She and her son are both healthy and are on no medications.  We reviewed all the ER trips, doctor visits, and annual check-ups and testing for the two of them for the past several years.  We looked at the increase in her salary and her current budget.  Her world is simple, really, though low-income.  The greatest gift her husband did was to insist they save for and pay for their house in cash.  Not having rent or mortgage drastically affects a budget!

My world? Well, the Medicare exchange opens up today and at 12:01 AM I was on the website.  I received a letter last week informing me that my current plan is adding a monthly drug premium and increasing all co-pays and deductibles.  That got me to thinking about the Part B premium itself and a Google search seems to indicate that is going up as well.  From the letter and the indicated increase, my monthly medical expenses of just premiums and prescriptions, will be rising just over $100.  The letter made me nauseous and numb.

From the past four hours of searching, I discovered that my options are limited to 13 plans from which to choose, down from the 39 of last year.  I suppose that is good news ... less to weigh and consider.  I am fairly sure that, cost wise, there really are just 2-3 plans that I could choose, primarily because some of them have monthly drug premiums of up to $98.  By comparison, the new $17 premium is more palatable.  However, breaking down the expenses between my current plan and the only other real option I see as plausible, is confusing to me.  Drug and premiums would be annually close to $1,100 less.  That is a significant amount to me.  However, the other coverages are harder to compare.  For example, the new plan is $85 more per day in hospital stay, but that drops to $0 after 5 days, whereas my current plan keeps the co-pay in place through seven days.  Of course, given how quickly folk kick you out of the hospital these days, I am not sure I would be in on day six and seven for that savings to reverse between plans.

The interesting thing I noted was, with the current covered drugs, my annual prescription cost at current market prices, without the drug plan, would be $49,992.  GULP.  If that isn't inspiration enough to figure out which plan to choose, I don't know what is.

But back to math ... the new plan is less for outpatient care, but more for an ER visit.  The new plan is more for an ambulance.    The new plan has a greater out-of-pocket maximum, but gets me through the donut hole of prescriptions faster.  Those prescriptions will be less, as I noted.

I could go on, but needless-to-say, I am struggling to create a spread sheet that fits my world and considers my future.  It seems that, at first pass, remaining with my current insurance plan, even with the rather difficult to swallow increased monthly costs, will be the best course of action.  But then I start to wonder.  What about those other 11 plans.  Some double and others triple my estimated annual expenses.  Why in the world would someone pick those plans?  I looked at the Blue Cross options, since the news reports say those are the most popular health exchange plans thus far, and they are all more expensive and I see no difference in coverage than the one I am currently on, save for the aforementioned extra cost in outpatient services.  That line item is ten times greater in my plan than any other.  So, really, I would avoid any and all outpatient services if at all in my control.  Other than that, I can see no benefit of spending three times more in prescriptions.  In fact, it looks as the flat coverage of 70% kicks in during longer care options rather than a daily cap.  Now, if you were in the hospital for something serious, a daily maximum cost of $245 would surely, surely be the better option, given all the medications and specialists and labs and such that add up exponentially.  Plus, oddly, the mail order option in both of those is far more than my beloved Target pharmacy.  The researcher in me wonders.  What am I missing?  Why pay ever so much more for no discernible gain in benefits?  I simply have to be missing something.  I have to be missing something.

One of the burners on my new stove is broken. Given that I never used it before trying to cook an egg on it the other day, I am certain it has been broken since the stove arrived here.  This concerns me, but it also means a warranty repair man ... a strange man ... coming to my home.  Monday.  Afternoon.  Another battle I will be facing.

I will confess, since I struggled with the strain of helping with childcare for two weeks and facing that letter, that I called the cardiologist office last week and asked to reschedule my appointment that was tomorrow.  And, truthfully, I was concerned about the $50 co-pay.  I wanted to reschedule until after my credit card cycles, until the last week of this month.  Unfortunately, the next available opening is January 8th.  In my mind, if the heart monitoring showed anything dire, I would have been called back immediately.  Given that that did not happen (and I have a copy of my Theophylline level check), I accepted the delayed appointment.  I couldn't face working up the courage and the strength to face going back to a male doctor after the past two weeks.  And, now facing the aftermath of my rather substantial panic attack Saturday night and my confusion and worry over making the healthcare choice, I am even more relieved about the lack of an appointment this week.

Although not always possible, I really do best with facing one task at a time.  This week, gathering Medicare data on all 13 plan options, checking prescription formularies and in-network doctors, comparing and contrasting and calculating costs.  Next week, facing the strange man in my house.  The week after, perhaps calling the county recorders office to see if the contractor followed through on his threat of a lien.  I know if he did, all I would have to do is ask for a hearing and present the contract.  All those ridiculous extra expenses would be disregarded and a lien removed.  Still, just making the call terrifies me because of the mere possibility of having to, first, go to court and, second, being in the same room with the contractor again.

And, of course, laced with all of these things is trying not to punish myself for being weak, for being afraid, for no longer being able to do what I can do or handle (with any sort of grace) what I used to be able to face.  Trying to balance the loss of the old me and accepting the new me is exhausting.

I have written before about the solace of Psalm 27:

The LORD is my light and my salvation;
Whom shall I fear?
The LORD is the defense of my life;
Whom shall I dread?
When evildoers came upon me to devour my flesh,
My adversaries and my enemies, they stumbled and fell.
Though a host encamp against me,
My heart will not fear;
Though war arise against me,
In spite of this I shall be confident.

One thing I have asked from the LORD, that I shall seek:
That I may dwell in the house of the LORD all the days of my life,
To behold the beauty of the LORD
And to meditate in His temple.
For in the day of trouble He will conceal me in His tabernacle;
In the secret place of His tent He will hide me;
He will lift me up on a rock.
And now my head will be lifted up above my enemies around me,
And I will offer in His tent sacrifices with shouts of joy;
I will sing, yes, I will sing praises to the LORD.
Hear, O LORD, when I cry with my voice,
And be gracious to me and answer me.
When Thou didst say, "Seek My face," my heart said to Thee,
"Your face, O LORD, I shall seek."
Do not hide Thy face from me,
Do not turn Thy servant away in anger;
Thou hast been my help;
Do not abandon me nor forsake me,
O God of my salvation!
For my father and my mother have forsaken me,
But the LORD will take me up.

Teach me Your way, O LORD,
And lead me in a level path
Because of my foes.
Do not deliver me over to the desire of my adversaries,
For false witnesses have risen against me,
And such as breathe out violence.
I would have despaired unless I had believed that I would see the goodness of the LORD
In the land of the living.
Wait for the LORD;
Be strong and let your heart take courage;
Yes, wait for the LORD.

Oh, how I savor that one thing.

One thing I have asked from the LORD, that I shall seek:
That I may dwell in the house of the LORD all the days of my life, 

For me, I really do see that dwelling, here and now, as hiding in the Living Word, especially the Psalter, as hiding in the certitude of the Christian Book of Concord.  I hide there.  But I also long for safety.  Oh, how I long for the forgiveness that I can grasp when I hear the Living Word read to me, for me.

Thinking of all the thoughts and feelings, of how my body, mind, and spirit were so thoroughly felled Saturday night, I still long to hear the Word.  It quiets me, washes me clean, if only for a while, of the shame that clings to me.  It sustains me. It restores me.

How in the world can I think about and wade through medical math when what lingers in my mind is how I felt then and now?  Truth be told, I long to wad up that outfit and toss it in the fire place so that I have no cool option for the performances next Spring.  Truth be told, I've had six showers since I returned ... along with a few stays in the small, dark end of my closet.  Truth be told, that panic attack is still not quite over for me.

One thing.

Is is possible that one of the new instruments I saw at the symphony was a contrabass clarinet?  This was the one that was used in Johannes Brahms' Symphony No. 4.  I am still trying to discover what those instruments might be.  The celesta was used in the first warm-up, Phillip Glass' The Secret Agent.  The other warm-up, from another American contemporary composer, was Christopher Rouse's Oboe Concerto.  Strangely, for one who loves the oboe, I found this piece to be utterly unsatisfying.  No long, glorious haunting oboe notes.  They were all high and filled with runs and jumps and skips and hops and nothing I ever thought would come forth from an oboe.

Did I mention that there were 24 violins during the Brahms' piece?  Next up is Pyotr Ilyich Tchaikovsky's Serenade for Strings.  The two warm-ups for that evening are Jean Sibelius' The Swan of Tuonela (which makes me think of Robert Jordan's Wheel of Time series since Matt marries Tuon) and César Franck's Symphony in D minor.  If there were 24 violins during the Brahms' piece, with a whole selection of violas, cellos, and basses on the other side of the stage, just how many stringed instruments might there be for Tchaikovsky???

One thing.

Did I mention that I have started watching Albrecht Meyer's Carnegie Hall Oboe Master Classes on You Tube?  I love them, even though I do not understand a single thing the master teacher is saying, not being musical in the least.  You should watch this one.  And this one, for sure.  And maybe this one, too.  And, here, can also get a mini-lesson on how air changes your life.  Or you could just revel in Albrecht Meyer playing himself ... 11 minutes and 47 seconds of Bach bliss.  And here is 15 minutes and three seconds of Schumann bliss, with lots of lingering haunting oboe notes and someone playing something called a clavier.  But Albrecht Meyer really is a phenomenal, intriguing, entertaining teacher.  So, maybe just watch them all.

One thing.


I am Yours, Lord.  Save me!