Cue the Violins

I took today off of work, I was hoping to get caught up on scheduling a lot of Caroline's appointments. Instead I felt guilty about falling behind at work and spent the day fighting with Cigna.  I am MAD, fighting mad--life is not supposed to be this hard.  I try very hard to be helpful to people in every aspect of my life but I feel like that kindness is rarely returned. I know cue the violins---I am totally feeling sorry for myself.

Today, I got a call back from the office of a speech therapist who I would like to work with Caroline.  She explained how my benefits would work for both in network and out of network coverage. It boils down to in network--I pay $0 for up to 100 visits, out of network, I have to pay 40% of each visit which comes out a little over $1,100 a month--this is only for speech therapy.  I called Cigna to find out if there were any in network providers in my area. Turns out there are none, one is listed but it is a wrong number.  So the customer service representative explained to me that I could apply for a network exemption because there are no speech therapists contracted with Cigna in a 40 mile radius--great.  So I call the therapist back and get the necessary information. I call Cigna back, explain to the customer service rep what I am trying to do, she says no problem and transfers me to pre-authorization.  Well, the woman in pre-authorization explains to me that network exemptions are only allowed for specialists, speech therapy is considered an ancillary service.  She actually said, "I don't want to sound rude but you could drive over 40 miles or use your out of network benefit. You know people with an HMO don't have the option of going out of network."

Wow! Just wow! I did not know it was possible to literally blow my top---if I could reached through the phone... Instead I inhaled and loudly asked,  "Do you know how much I pay a month in premiums, much, much more than someone with an HMO. Also if you look at my record you will see that I met my out of pocket max some time ago so you can surmise the cost of my annual medical bills. And the very fact that you would suggest I could drive 40+ miles, one way, at least twice a week, when my daughter needs to receive three forms of therapy on a weekly basis and is currently followed by 10+ specialists shows how callous you and Cigna are. I wonder how do you sleep at night knowing that you work for a company that crafts policies to limit payment of medically necessary services to medically involved children with disabilities because you know their parents don't have the time to fight the system...no really how do you sleep at night?"

She did not take kindly to my question and just kept asking if there was anything else she could do to help me. I made a few suggestions including sending a donation to help pay for my daughter's medically necessary speech therapy.  She did not ask for my current address so I am not really holding my breath for her donation.

I am also gearing up for the second installment of Caroline's IEP meeting.  We have several appointments scheduled with specialists to address a myriad of issues ranging from possible asthma to ruling out vision issues.  There are not enough hours in the day to coordinate Caroline's care, work full-time, and be a wife and mother.   My hair is falling out and for the first time in my life I have high blood pressure. Having said that, I have to say that despite the stress for the first time in a long time, I am happy. Thank you, Lexapro. I am realist--I know when I need the help of chemistry to get by.  I am trying so hard to find balance and to roll with the punches but my body knows how stressed I am, despite my efforts to convince it otherwise.

So today, I am feeling sorry for myself--because I have to spend so much time fighting for the care Caroline so desperately needs--time that I would much rather spend with her, because the money I work so hard for cannot go for a down payment on house but rather will be spent on therapies that insurance should pay for, because I am always so tired, because I don't have time for real therapy so I over-share via my blog, and because I am mentally, physically, and emotionally exhausted.  Tomorrow, I will put the violins away and rally.

How do you keep going? Where do you find the strength to keep fighting?

--written as I pack for a business trip to Georgia.