Kafka Calls Medicare

Hospital Journal

This is a little post about being intimidated by the big, scary institution against the little person, especially when it comes to health and staying alive.

If you read my last Substack post, linked below, you would have read about my issue with Medicare. It seems Medicare contacted Kaiser, my provider, and informed them that I had left them for another health provider. Therefore, Kaiser dropped me as a customer right in the middle of my chemotherapy treatment.

On that day, I spent several hours calling Kaiser, Medicare, and the supposed new provider to let them know that I hadn’t changed providers and hadn’t signed or agreed to any change. The fact is, I knew nothing about it until I received a letter from Kaiser formally informing me that I was no longer with them. Two words came to mind at that time: Franz and Kafka. Also, a touch of my favorite TV show, The Prisoner, with respect to what Number Six had to do to remove himself from a prison of his own choice.

The first hour of phone calls was hopeless and downright depressing. But I finally contacted someone at Kaiser who specializes in the relationship between her workplace and Medicare. She told me that morning that three other clients or patients had called her with the exact same Medicare problem. That was my first step toward getting to the bottom of this insurance nightmare.

Originally, all three organizations told me they couldn’t help me because it was early March and nothing could be done until April. I explained my situation: I have cancer, and I’m right in the middle of chemotherapy treatment. In fact, I was supposed to go back to the hospital for round three.

Those whom I spoke to at Medicare, when they realized that I was in a tough pickle, commented, “Oh my god,” or “Oh no.” That is actually a good response, because they now realize how serious this is. I told them that this is a matter of life and death, and I can’t wait until April to get back to Kaiser to continue my treatment.

From a strong no, I finally got a yes from Medicare, and as of this writing, within two business days I will be fully back with Kaiser on my old plan, which I’m happy with. I succeeded in leaving the “new” provider after Medicare contacted them.

As you can gather, this was a nightmare to deal with, but I handled it with a mixture of anger and politeness. Those two go together like a peanut butter sandwich.

I’m writing this to you, dear readers, because all of us will eventually have to deal with unfair practices and the fear or intimidation of powers that are larger than ourselves. Like in the novel 1984, those powers can do things simply because they can, which is frightening. And we live in times when the rug can easily be pulled out from under our feet.

I can’t speak for all organizations out there, but with my issues with these particular institutions, I was pleasantly surprised that they didn’t want to make me suffer. In fact, everyone I contacted was professional, and they listened to me. They knew I wasn’t being a bastard or a bitch, and that I had a realistic concern for my health.

I was pretty much raised to fear those who are more powerful than me. And they are more powerful—but that doesn’t mean they are evil people. I truly believe now that there are those who do want to help you and make your life better.

My route to that positive outlook is to make time to communicate fully with those I am dealing with, and not to be afraid to show anger or disappointment. But be specific about why you feel that way. I explain that I’m frustrated with the system, but nothing personal with the person I’m speaking to. Once they understand that, they are often more willing to be on your side.

Medicare contacted Kaiser, and Kaiser contacted Medicare, and now things are very much cleared up. At present, I’m back in the system and back at Kaiser.

I’m writing to say that you have to be patient and consistent in your communication. In the end, the system corrected itself. But it took persistence, patience, and a lot of phone calls.

Illustration by Franz Kafka