More means Less, and Equal

When your life greatly depends on funding from medical insurance, it can get complicated. One phone call this week set off a chain of events that's still unfolding.

On Tuesday, the head of the nursing department I use for night coverage called. On July 1, 2018, my insurance provider increased the amount they paid per hour for nursing services. However, they also have a daily limit on what will be covered, and that was not increased. Therefore, the change meant that only 7.5 hours were covered instead of the nine I get every night.

I wasn't aware of this until the call. The agency had just been covering the extra 90 minutes during 2018, but were no longer willing to do so. Therefore, the company would be making the same amount on providing care, but by covering fewer hours. The fun doesn't end there though.

Medicaid allows one hour of nursing visits per day, five days a week. I don't use this benefit, so that would allow my night hours to return to 8.5 per night and the agency is willing to cover the final 30 minutes, making my usual nine hours covered five nights a week. That leaves two nights a week that would be short the regular time.

At the end of December, I received a letter from my insurance provider stating my nursing services would be covered January 1, 2019 through July 30, 2019 up to 10 hours a day for a certain amount. If changes were needed, then the agency should contact insurance for adjustments. After getting the letter scanned, I mailed it to the supervisor and pointed out the line about changes. His response was that he tried with another family and it didn't make any progress.

Wednesday, I called my insurance provider's case manager and let her know what was going on. I provided more details Thursday as I knew more and as of Friday, someone else is reviewing the changes needed and will hopefully get back to me early this week.

My parents and I chose Saturday and Sunday to be short on hours, so this has been the first weekend with decreased coverage. I'm thankful I have loving parents that are willing and able to do the extra work and go with changes. We are hopeful it's only temporary, but won't know for a while.

Living the quad life is rarely boring. I somewhat look forward to what may come this week, but I know God is in control whatever may come.