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A Day of Recreation w/ Mr. Grumpy Pants….

Published by Jessica on July 7, 2008 in General. 2 Comments

Well, Sunday was the last day of our long weekend and since we weren’t really able to do anything knock-your socks off fun this weekend (like mountain climbing or dirt bike riding) because Issa was feeling super poopie (the head cold thingie took over on Saturday and he spent most of the day on the sofa with his boo-boo face on, with the exception of going out to dinner with some friends from Issa’s work)….I decided that I was going to make the man get a little fresh air and sun since he is confined to his office all week and since it would undoubtedly make him feel better.

So, Saturday night we planned that on Sunday we would go to breakfast and wing it for the most part….we woke up early, and Issa decided that he wanted to get a run in first, since he was feeling better.  I agreed to accompany him to the gym, and while we were in there he got roped into watching Wimbledon.  I took my time getting ready as the game went on and on…it was actually quite exciting…but before I knew it we had spent most of the day indoors and then we went to brunch and that, too, was indoors…

Next on the agenda we were going to see the Hulk, but since the sun was still out, I decided that I would rather check out Irvine Park in the city of Orange. I had heard about it being pretty fun, but I didn’t know anything about it really and then as I was flipping through our Entertainment book, I found some coupons for paddle boats and bicycle rentals…and I delicately approached Issa with the notion. 

Well, he wasn’t happy and he right away began to complain. He was upset that I had thrown a wrench in his idea of how the day would go and he protested up a storm, but being the excellent and supportive husband that he is, he stifled his irritation and begrudgingly navigated the car in the direction of the park. Mind you, he didn’t speak the entire time….and trust me, when he saw that he had to pay 5.00 to enter the park he nearly lost it.  Once we were in the park, though, we had to work together and find a parking space because it was CR-OW-DED. That got him talking….

Then, I decided that to loosen him up, I would buy us two tickets on the old fashioned train that takes you around the whole park…he rolled his eyes and I was a little nervous that it wasn’t going to go well. “What if this is a bust?,” I thought to myself….but I slapped on my excited face and as soon as the miniature choo-choo rolled in and we boarded…he was like a different person.  The soothing ride, the breeze, the conductors jokes…he instantly softened and I was soo happy. 

With a cooperative hubby, I decided to ramp up the fun and rent a bike…a bike built for two…side-by-side….ohhh yeaaah.  Like a sport, Mr. Man hopped on and away we went, for an hour…up hill and down hills…seemed like more ups than downs, and we had a blast.

I can’t tell you how awesome it was to see him happy. It was such a nice departure from our usual local activities….and more than that, it felt so good to work together…to use all of our strength together and pedal ourselves up the hills….to know that when the hills got too steep, he would jump off and push while I would steer and pedal….and to know that there is no way I would take that steep hill soo fast with no brakes unless he was there, and I could be confident that in addition to making me brave, he would also keep me safe. 

By the end of the hour, even though it was late afternoon, we were both sweaty, hot, and sore and exhausted…and ready to cool off.   You will recall that Issa had been initially upset that we weren’t going to go and see The Hulk, we decided that there wasn’t any reason that we couldn’t.  Plus, I had promised him a frozen coke if he would just be a good boy–hee hee…..so we rushed to the mall, and caught an earlyish showing…The movie was so-so…but the company was FANTASTIC.

All in all it was a very good day, and I consider myself fortunate to have been able to spend time with Mr. Grumpy Pants. MWAH!

Fourth of July Fantabulessness

Published by Jessica on July 7, 2008 in General. 0 Comments

I hope you all had a lovely 4th! 

Well, as you may know….a 4th of July tradition in our home–when we are in CA–is the Del Mar Fair. (Now, the San Diego county fair)….  Despite being kind of on the fence about attending this year, because of the price of gas and all, we decided we couldn’t miss it….so on Friday morning, we kind of took it easy…we slept in, grabbed some lunch…ran a few errands, which included stopping at the pharmacy for medicine for Issa cause he was feeling kind of icky….and while he slept, I drove down to Del Mar.

You know, of late we have either gotten smarter or more tired…but we tend to go to theme parks and things of the like in the afternoon and spend 4-6 hours as opposed to going first thing in the morning and spending all day….  

I like to say that it is because my dear sweet husband is the best park mapper outter ever…He always has a plan as to how best organize our time there, and he does such a great job of getting us everywhere we need to go, he seems to designate just the right amount of time to everything that we have to do,we eat at the right time and we wait in the shortest lines, and by the end of a couple of hours we have done everything we came to do!

Issa, on the other hand says “I just don’t have it like I ‘usta!” (As I said, I tend to think it is the former).

Anyways, we got there, we went straight for the expos…although, we did stop for Issa’s chili dog.  And then grabbed some jerkey and dippin’ dots and cruised around the various booths getting our rings polished and hands lotioned and watching all of the cooking demonstrations….and after about an hour or so of getting pitched to, we decided to hit the rides….

Ok, now I am not a big fan of carnival rides. I think they are terribly dangerous, so we tend to go to the same rides every year–kind of a “never died on this ride before” type of thing…and they are the SAME exact rides every year as in the exact same machines we have been riding on for ten years or so….and some of them have seen better days….after one of those swirly whirly rides, where I am smooshed up against Issa, trying not to crack one of his ribs, and after a roller coaster that kind of deviated from the typical rides (Issa’s choice–I nearly cried while I was calculating the chances of surviving from the highest point of the coast if it were to collapse or eject me)….I was ready to slow things down a bit…

We took a moment away from the rides, Issa decided that he was going to win me something before we left…and so we wandered around until I found a prize I wanted….and we both paid three dollars to shoot the target with a water hose and be the first to get our horse to the top.  GUESS WHAT! That’s all it took! Issa won on the FIRST try. I was sooo excited, and he was soo proud. 

Since the mission was accomplished, we returned to the rides with a few remaining tickets in our pockets….and since it was my choice, I decided that the Ferris Wheel looked newish and safe(r) than some of the other options….Issa protested quite a bit, but he went along with it and so we hopped in line.  While we were in line (it was kind of a long line) we took advantage of people watching since the fair seems to being out the strange in folks…and just as we were rounding the last leg of the line–it happened….

SPLOOSH!

Yes, someone SPIT from the tippy top of the wheel landing sqarely on my pointy finger and Issa’s shoe….I threw a fit, being a bit of a germ-a-phobe….and swore to rip the spitter off of whoever launched the wad but everyone that came off the ride as we were getting on seemed to be innocent enough so…despite the fact that I had a part of my mind on washing my finger as-soon-as-we-got-off….I was able to enjoy the view from the top which was BREATHTAKING.  The ocean to one side, the fair to the other….the lights and tents and people looked just like something out of a postcard.  I wish that I had a camera, but then again…cameras can’t always give you the perspective that you get in a moment like that…

The ride was over all too quickly…and I made a b line for the bathroom…

All washed up and sanitized, we grabbed some dinner (french bread pizza–TO DIE FOR)….and scurried off to the most beautiful fireworks display I have ever EVER seen.  Thanks to Issa who helped me succesfully navigate the crowds, we found prime parking for ourselves and I stood in awe of an amazing display.  We are talking about stuff I have never ever seen….and I even got a little misty even at the finale….it was overwhelming.  We were virtually speechless as we were leaving, but we found a way to communicate a mutual desire for a cinnamon roll…and after partaking in a fair finale of cinnaminny cream cheese frosting goodness, we headed for home–off to bed…the whole weekend ahead of us.

It was a GREAT day.  Thanks, Spin!

Blue Cross: Disorganization or Deception?

Published by Jessica on July 1, 2008 in General. 1 Comment

I am sitting down right now at the computer in the business center of my apartment building and praying. I am praying as I type this that I will have the clarity to explain to all of you and to the California Department of Managed Healthcare why Blue Cross of CA should be held accountable for their wreckless and dangerously disorganized practices at the very best…or at the very worst, their intentional deception and fraud perpetrated on consumers.

For those of you close to me, you know the battle I have waged over the last seven months with this company. It has been one thing after another. From not being able to verify coverage for me, to not being able to provide me with an in-network specialist…and now…

The short, non-detailed version of what I intend to convey to the CDMH is this: As a participant in in the High Deductible Health Plan (HDHP) that Blue Cross provides to Issa’s employer, we have a choice (being in a PPO) to select either in-network or out-of-network providers. Our deductible is higher for out-of-network (OON) providers, as is our maximum–and none of the money spent on OON providers counts towards our in-network providers meaning that we have a toally separate deductible liability to see the regular doctor for a headcold or for an emergency room visit.

Because I needed to see a specialist, and Blue Cross was unable to refer me to an in-network provider for close to two months, we decided that I should see one that was out-of-network. As it turned out, I required some minor surgery, to be completed at another OON facility where my OON physician had privileges.

When the facility called to verify benefits, the insurance company confirmed that we were covered…that X amount of our deductible had been met, and that the amount we would be owning for the procedure was X amount of money. I, myself, called later when more of our deductible had been met to try to determine how much would be due on the day of the surgery so that I didn’t overpay significantly since we had a number of medical bills being processed from my OON physician…AND since the amount we were paying was substantial I didn’t want to pay more than we had to.

Never once was I told that the maximum that would be paid for an out of netwrok “Ambulatory Surgical Proceedure” was 350.00 dollars. Never once was I refered to that section of my policy, never once was I informed that the balance…over 2400.00 would be my responsibility, would not count towards my deductible or maximum….

We operated under the impression that the procedure fell under “All other specialty procedures” for which the limit was 25,000 per lifetime!

So, I hope that was clear because there has been so much smoke and mirror type stuff on behalf of Blue Cross that there are far more confusing details that I chose to leave out but they leave my mind cloudy and uncertain of which details are important and which ones aren’t. As it stands I have the equivalent of a full-time job just trying to get the services I contracted for. What they have done is a crime, in my books…and it should be a crime to the rest of society as well.

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