Wednesday, March 26, 2008

Strong Winds, Good Vibes, a Joyous Alex, & a Song for the Lone Beader

Strong Winds and an Unpleasant Surprise

Yesterday I was away from home for about five hours which was the longest I’ve been out alone in months. The first stop was for my previously mentioned root canal. When I located the office (following my computer generated map) I had to park in a very large parking lot far from the office. The walk was demanding: I was dragging one of the large bottles of oxygen because all of my small bottles (that I can carry) are empty.

For some reason, the winds were so strong that it felt as if I was in Chicago facing a gale coming off the lake. It was a demanding walk, but at least when I got to the office I found it on the first floor, so I didn’t have to drag that oxygen up a flight or more of steps.

After I signed in and filled out three pages of insurance and medical history, I was hit with a surprise that, like the winds outside, almost knocked me down. My Humana Medicare supplement covered none of the root canal’s cost!

When I purchased the supplement the salesman told me that if I used doctors and dentists that were in the Humana “system,” the most I would pay would be 25% of the procedure’s cost. Thus, I had carefully consulted the humongous Humana PPO referral book to locate a provider who was “in system.” So…can you imagine my shock when the receptionist informed me that Humana would cover none of the root canal’s estimated $1050.00 cost!

That’s cost in almost 8% of my total yearly income—and I can’t afford it. Thus, I left the office for the cold winds outside without having the root canal done. I’ve spent most of this morning attempting to contact a human being at Humana who can explain why the policy isn’t covering what the insurance agent said it would cover. Thus far I’ve not been able to contact a human at Humana!

Of course, after my four months as an insurance agent, I believe I understand the problem: (1) insurance agents usually know little about the policies they sell; (2) insurance companies write the policies in jargon that even a Philadelphia lawyer would have difficulty interpreting; and (3) insurance agents are rewarded for sales not honesty, which is the primary reason I am not selling insurance.

The Journey Had a Fantastic Surprise

When I left the parking lot, I decided to avoid the Interstates for my return trip because I could see traffic backed up on I-71 and, since I’d not been so far from home in months, I decided to navigate by the seat of my pants and explore—a long time favorite pastime.

I drove northwest on a road I’d not previously traveled and suddenly realized that I was going to pass Nick’s (my oldest son) house. I turned into the long driveway and when I reached the house, I tooted my horn because I realized that I couldn’t make it up the many steps to his porch dragging the oxygen. I’d not seen Nick since before Christmas and I felt overjoyed when he came out of the house! When talked for at least thirty minutes and made plans to get together for a Bar-B-Q on my deck when the weather warms and the wind begin to blow from the south rather than the north. Wow! Even rotten experience like being screwed by one’s insurance company can have an upside!

A Jubilant Alex

After leaving Nick’s house, I spotted a pet food store that, thanks to research done by Bryan, carried Alex’s favorite cat food. The furball is ecstatic and has already consumed four packets of it. Purrrrrrrrrrrrrrrr.

In Honor of the Lone Beader’s Newest Project

Below is a draft sketch of the Lone Beader’s latest project: a 1946 electric trolley car as used by Boston’s Metropolitan Transit Authority:

When I read her post about it, I began singing one of my favorite Kingston Trio folk songs, the MTA:


  1. First of all, it's not the greatest thing ever that what got you out of the house for the first time in awhile was a lousy root canal! It should be for something fun and exciting! Secondly, that's just ridiculous about your coverage! Insurance stuff drives me nuts. There's a plan called AMERIPLAN that's apparently quite good with stuff like this and extremely reasonable. I know someone who can give you lots of good information about it, if you're interested. Go to if you're interested. It might be worth looking into. Seems like none of it is ever what it's claimed to be. I sure hope you get that figured out. You don't want a needed root canal to go untended!

    Glad you were able to get some good out of the day, though!

  2. Glad the day had a some good within mom has Humana so I have seen her books, good luck finding some where you can have the procedure done.

  3. I had a similar insurance snafu yesterday too! Cigna covering an "in network" provider as an "out of network" provider which resulted in a $500 balance due from the Dr. Hopefully yours will be cleared up as simply as mine was.

  4. Root canal, sounds painful and obviously very expensive. I would have been furious. Why do insurance companies do these things? It's like playing tricks with people's lives in one respect and all for a commission cheque.

    I pray you will be okay.
    Take care, Crystal xx

  5. Try these to get a human Nick - I haven't tried them, but found the info online, so it's worth a shot!

    Tips include simply choosing the hold option for rotary phones, pressing "0" repeatedly, or choosing the Spanish option, since operators tend to answer that call more quickly (who knew?).

    Humana At prompts say "member," "pharmacy," "prescription benefits"; give invalid ID. 800-448-6262
    Humana Medicare Claims Press *; at prompt press *; at prompt press 0; at prompt press 0; at prompt press *. No voice mail after hours. 800-457-4708

    Good luck!

  6. Nick, our medical system is just nuts. That sick people--including those in need of root canals-- have to devote stressful hours trying to figure out how to cajole someone to provide affordable treatment is a nightmare from which I hope we will awaken before it's too late.

    BUT great news about seeing Nick Jr. Time with kids is so great. My own young adults just returned to college after being home for 9 days of spring break. I felt a little sad when they left.

    Love the pink packaging of Alex's favorite food. If it tastes as good as that packaging looks, I might try some myself.

    "The MTA"--my folks had the album with that song when I was a kid. A ride down Memory Lane.

  7. Nick, remember that the Humana Corporate Headquarters is here in downtown Louisville. I just looked them up in the phone book:

    500 W. Main St.
    Louisville, KY 40202

    You can always go down there and harass them in person! Of course, you shouldn’t have to, but it is better than if there were 2000 miles away.

  8. That song is GREAT! I'll have to use that on in a future post, as well! Thanks for mentioning me:)

    And, good luck with the insurance companies.... :/

  9. You had quite an adventurous day. I enjoyed hearing again the songs MTA and 4 Strong Winds. Thanks, Nick.

  10. Nick, I'm angry that you weren't able to get that root canal. I think we should start a Humana-should-start-answering-their-calls link, and pass it around. Let the internets make some calls for ya!

  11. Hi Nick:

    So sorry about your root canal fiasco. I hope you will be able to get the insurance issue all fixed, so you can get the care you need.

    Alex looks so cute!

    And I'm so happy for you that you got to see your son!

    Thinking of you,

  12. Insurance companies are horrible to deal with. I had one time that they were billing me for just under 100 dollars. They clearly should have covered the cost but they said no. Each time I asked them why not I would chase down why they were wrong. In the end I do not think that bill was ever paid by either of us. At one point I got yelled at by the operator to stop calling. If I were smart I should have asked for the supervisor and filed a complaint against the operator. Good luck.

    Glad you found the food. Also real glad you were able to visit with your son. Family time is always a wonderful thing, or at least you hope it was.

  13. I am sorry that you had to waste your day going for the root canal that wasn't; but, what a nice way to salvage it. I cannot stand all those automated call systems; If you could just get to a person to begin with, it would save so much time and frustration!

    What about a website; do they have a contact form there?

  14. Insurance is never all that it is cracked up to be - there's always a catch as you know! What a shame you struggled all that way to find this out. Still at least you got to explor and Alex got his favourite food. :)