[Note: This is another blog based on my weekly emails to my family on the mainland. Since much of my news these days relates to trying to age gracefully, this series might be called The Geezer Gazette.
6/20/26
Aloha Everyone!
I hope your early summer is going ok. I know there has been some nice weather on the mainland, but also some of the usual nasty stuff, too, like tornadoes, floods, and fires. No tornadoes here, and really not much to complain about weather-wise, other than we've had a bit of VOG from our volcano eruptions, and it seems to be clouding up earlier in the day than usual. The afternoon clouds aren't really a bad thing, though, because they make for easier napping......
I'm sorry to say that my news this week is unfortunately mostly bad. First up in the Geezer Gazette, my attempt to get an evaluation at Mayo Clinic for my eye problems has failed, and I'm getting a bit frustrated. The problem turned out to be insurance-related, like it was with the Stein Eye Institute at UCLA. Everything seemed to be going ok with Mayo, though I had to re-fax the referral form and letter. I called on Tuesday and a very helpful and knowledgeable representative was starting to schedule a vist when she noticed that my insurance was a Medicare Advantage plan from Aetna. Dead stop. Nope, as of January 1st Mayo is no longer accepting patients with that insurance. This may sound like the same story as with Stein at UCLA. However, when the Mayo person explained the problem, I realized it had it exactly reversed: It isn't that my insurance won't cover the evaluation, it's that Mayo (and Stein) simply won't deal with the Aetna Advantage plan at all. I learned that Medicare Advantage plans re-negotiate contracts regularly with providers. These contracts deal with things like reimbursement levels, timeliness of reimbursement, and criteria for denial of coverage and appeal procedures. It seems that a number of large providers, like Mayo, Stein, and others, are opting out of participating with Advantage Plans because it is simply too costly for them. Note, in my particular case it isn't a matter of Mayo doctors being in-network versus out-of-network, nor that I needed pre-approval for getting services from Mayo. Rather, the lack of a contract means no coverage, period. Welcome to health care in America, where none of the thousands of people with my insurance plan can obtain treatment at someplace like the Mayo Clinic which provides some of the best medical services in the world. So I'm now looking into my options. Of course, I could try to find yet another place to get my evaluation, and hope that I can get in before they too cancel their contract. I could also try to change insurance plans. But my current plan is through my retirement system, and changing would likely lead to much higher premiums and less coverage, including if I went with straight Medicare. Finally, I could pay out of pocket, an alternative nipped in the bud by the representatives at both Stein and Mayo, who said no way. Geez, what a waste of time. I'll let you know if anything changes.
Now to a more down to earth problem. Our neighborhood is currently coping with a couple of feral pigs who have been routing in people's gardens and causing a fair amount of damage. We've had trouble with pigs starting before we moved here, when we got calls from our gardener informing us that pigs had again dug up our irrigation system. One of the very first house projects when we arrived was to build a fence to keep them out. It works -- sort of. Sometimes a few adventurous marauders circumvent the fence by coming down our driveway, roto-tilling as they go. It's Open-Season on pigs year-round here, but hunting is with traps, knives, and arrows since shooting guns in residential areas (favorite hangouts of hungry pigs) would probably not be a good idea. Pigs, like nearly all other mammals, aren't native to Hawai'i. The first pigs were brought to the islands by the Polynesians who settled here about a thousand years ago. These pigs were a small, domesticated variety that stayed pretty close to home. However, in the 1800's Europeans imported and released wild boars for sport and for food.
What could go wrong, right? Well, these piggies are big, smart, and nasty in disposition. They also have no natural predators here to keep their numbers in check, lots of good food, and no deadly winter weather. I think you get the picture -- swine heaven. The two currently posing a problem are probably brothers from the same litter, and are hitting their prime. They are huge, bold and if they smell food, like ripe fruit or an abundance of garden grubs, they are very determined to reach it. Our neighbor two doors down has a fruit tree that is now bearing and has become a real magnet for the brothers, to the extent that they cross the un-fenced part of our lot, cross our immediate neighbor's lot, and then make their way to the area around the target tree. Despite their size they can be very quiet and agile, making them hard to detect until it's too late. We have a driveway alarm to alert us if they come that way, but their current trail to our neighbor's tree is not monitored. I really can't complain --- in Ohio I had to deal with deer, rabbits, raccoons, woodchucks, skunks, squirrels, and possums. Here it's only pigs and tiny frogs. Oh, and an occasional garden rat.
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| Where's Dinner? |
My final problem this week is that my car a.c. seems to be going weak again. Recall that this is my 2-year old Subaru Outback, which started having a.c. issues just a couple of months after I bought it. Eventually the dealer replaced the entire guts of the a.c. unit, and that seemed to take care of the problem. Until now, about a year later. I'm hoping this is still a warranty issue, particularly since the problem started early and is well-documented by the dealer. Still, it means making service appointment(s) and going through the hassle of taking the car in for it to be fixed. Grrrr.
I'll end on a more positive note. Yesterday marked the anniversary of the day we closed on our Oxford house 25 years ago. This was quite a relief at the time, because we had been owners of two houses simultaneously for a few months after sealing the deal on our house here. There was a bit of a cash flow problem that was relieved when the check for the Oxford house was deposited. No champagne for this anniversary, but we toasted with a nice glass of wine.
Ok, sorry to have been such a bummer this week. Hang in there, and remember, no matter how often a certain someone claims otherwise, down is not up, wrong is not right, cruel is not kind, lies are not facts, and ignorance is not knowledge. Carpe Vitam.
2 comments:
I had a similar problem with Aetna Advantage Plan and UW Physicians here is Washington State before they renegotiated their contracts. But there were months of notifications about this crisis and about a month without coverage. Now it’s good until the next contract negotiation.
I have `Aetna Medicare-STRS- PPO; been through major surgeries, MRIs, PT, etc. with damn near 100 coverage. I have been turned away a few times similar to your experience, but thus far wasn’t dealing with world prestigious medical centers. I offered to pay out of pocket and they too decline, Wonder why. As to the pigs, sounds like a real hassle. My daughter’s father in law is a big gun guy and hunter.For deer, he kills them and brings them home for venison dinners. I don’t like killing animals, but if it were my property, I’d have no objection to somebody killing them if you’ve exhausted the options. Aside from the material damage, and real threat I presume, from the look of them, they’re reducing your quality of lifThat’s a big problem, as you start enduring life in your 80s with its accompanying big problems other than unwanted animals. Any advice from animal welfare agencies, zoos, etc?
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