The Dental Insurance Debacle

Last year we leveled up, adulted up and got some Dental Insurance. Big deal, right? So with the proper coverage we have been chipping away, again pun intended, at tooth troubles, left and right. We've managed to keep it affordable.

When we got insurance I had just had my office move from Downtown Clearwater to St. Petersburg so I got all my primary care providers together in St. Pete, most in walking distance from my office.

I found a great dentist. They have given me exceptional care for almost 8 months. I was due for a 6 month check up, which I had scheduled out for this month in January of this year. I got all my confirmations and a bunch of calls, and the one call that was weird and inconvenient.

My dentist called and said that somehow my dentist had been selected as the same as my husband and daughter's, which was near our home, and nowhere near our work, and I have never even been there for an appointment. In fact since we got this policy, I've only ever gone to the St. Pete dentist.

I called our provider, Humana, and they said they could change my dentist to my actual dentist until...uh oh, my dentist is not in their network. Hold on, when I originally selected this office in October, it was on the list of providers accepting my insurance. My ration side thought, well I haven't had an official visit this year, maybe they changed in 2019. Wrong.

I called the dentist and they said they DO IN FACT accept my plan, my insurance. I call Humana back. Humana says no. I call the Dentist and cancel my appointment, they say they have spoken with Humana 3 times and don't understand why they are putting me through this and all my previous appointments have been paid for BY HUMANA, with no issue so everything should be fine.

I call Humana, again. They say nope. The Humana stuff sucks, we're talking 5 minutes to get past the automated system, then getting someone who sounds like they are in a call center in Siberia who doesn't actually listen to me, regurgitating the same story and being given different information. I spent over 2 hours on the phone. I tried to call the Humana store location by my house, they transferred me to Siberia. I tried to talk calmly to anyone and wasn't being heard, and worse? I had no chance at an appointment anytime soon and I actually have an issue I wanted to look into.

Why not just go to the same location as husband and kids? Completely out of the way from work and life, and they are not open weekends, but trust me, at this point I might just suck it up and go there just so I can be seen.

This misinformation drains me, possibly more than most, because it gets tied in with humiliation, and feeling helpless. See, we did everything "right." We were given a list of providers, we selected said providers, confirmed that they take our insurance and then set appointments. Now it was imploding, I was being mistreated and threatened with declined services bills and no one seemed to be remotely understanding.

I called again this morning, more store locations, more customer service, more being passed around. I fought back the tears on more than one occasion. How is this so impossible? Finally I tried to troubleshoot. What if I upgrade our plan? What if they take me off the family plan and I get a separate provider? 

By the time I called my dentist they were just annoyed and not as nice and understanding as yesterday. Then Humana finally called me and said that we just have to wait. They said something about the business billing address of the Dentist versus the physical address and we just had to wait and see what happens. There was no apology or understanding again, just enjoy the exile and purgatory time.

They sent me a list of other providers and none of them are remotely convenient. I literally just mentally shut down. I could feel the helpless frustration wave engulfing me and I was definitely drowning. How could it have taken almost 9 months for this to become an issue? How could this be so unsolve-able. Why couldn't I just "fix" it somehow? It was maddening.

I consider myself mostly pragmatic, but when no one give the rules, or gives the wrong rules, how should I be able to proceed "correctly?" This has been a theme I'm struggling with and it shut me down. Usually I would vent this at everyone until it made the situation diminish or get better. This time I just wanted to sleep. I wanted to not "people" anymore. Everyone sucked and I was done.

I finally broke down and told hubby the whole problem and didn't even feel better. It was all so pointless, which I hate. On top of other miscommunications this past week, and other ways of feeling disrespected and inferior, I finally broke down and just cried off all my make-up. 

I still have no resolution and now my eyes hurt. I work so very hard, and diligently I might add, to stay positive. I mantra the shit out of "This too shall pass," "this is temporary," "every problem has a solution," and so on. Right now I just felt like Jack Sparrow in the Upside Down chasing crabs with no hope, wandering with no rum.

It makes me feel so...useless. Also, I think I have so much PTSD of medical paperwork, fighting and misinformation from the car accident (which is one month from the 3 year anniversary as of Wednesday) that I'm just not equipped. It also just hurts me that customer service representatives aren't taught how to be understanding and empathetic, they are taught to be robotic. Sometimes we just need someone to listen to our side of the situation. The few people who did, unfortunately have nothing to do with the fix. Fail.

After all the emotional output I can say this, I'm going to conquer house work tonight to feel more in control. I'm going to power through this weekend and not let this eat away my sanity. I'm going to make sure I'm taken care of in more ways than one through this all.

I'm definitely taken down a peg, but I'm not completely out of the game. If anyone has any advice, reach out. The medical community can get ugly and difficult to navigate. We must tread lightly. 

Miscommunication, Frustration, Humiliation

Last night was girls night. And I needed a good night out. But it ended messily. Without over-pouring the entire scenario, I can say this, my attempts to do something nice and something that I thought was communicated to me well, fell flat, and before I knew it, it got really awkward and uncomfortable.

I'm a person who just needs to know the rules, ramifications and outline of things clearly and then I can be insanely respectful and understanding. If you don't communicate and I fall into a weird situation, things can get bad and fast.

One of my mom friends stood up for me but I had a rough time and felt attacked because, while she made a good point, I shared mislead information and I felt so horribly humiliated it all went awry. So, I wanted to suck it up and make it up to them.

My friend sweetly said it wasn't necessary, but I was so embarrassed I just wanted to cover it up. I felt like a child who asked their parents if they could have ice cream, and the parent said, "Sure, whatever," only half paying attention. Then the parents caught me eating the ice cream and sharing it at a party and were like, uh...what are you doing? Then I spilled it, broke the bowls and had to clean it up and pay for the bowls, not letting my friends know we weren't supposed to have it in the first place.

That's the best, weird analogy I can come up with to best describe the debacle. The thing is, at the end of the day I was frenzied, broken and frustrated. Today was a new day, most definitely and I refused to obsessed. I did however, enlist hubby in the discussion.

Much to my relief he was all in and understood. I just told him that, it was really hard for me. The way the whole thing went down was so strange and I just wish that the structure was clearly laid out for me. You can give me parameters, but not vague rules. Clear. Simple. Easy.

I spent most of the morning reeling and finally kicked it once we hit the beach. My daughter and I are both exhausted but beach therapy is real. I mean the fact that we live where some people vacation is such a blessing and I told my daughter, "I know you want to see the snow, but look at that gorgeous water." We had a few meltdowns by the end of the beach trip, but we came home grateful, which is what it's all about.

I struggle so much with miscommunication. It irks me to no end. Frustration is a daily visitor I feel and navigating it is rough. Humiliation is something I don't take lightly. It makes me super angry, and over-sensitive. I'm getting better at dealing with all of this, but it's such a process and last night was such a lesson in what I want, what I can handle, and how far I've come.

Weekend posts are difficult for me, but I was really feeling all of this so I wanted to share. Tomorrow I may do something smaller as it's Mother's Day and I'd love to just relax a bit, but who knows. Happy Weekend readers and thanks for sticking with me!