Dear Blue Cross PPO, you suck

For the last, oh say, five years--since I stopped working full time for the previously mentioned in past blogs giant soul-sucking pharmaceutical company--we have had to pay for our own health insurance. So instead of paying about $100 per month to cover my whole family (four of us) with a pretty good PPO plan, we now pay--wait for it--about $2,400. Fucking shocking, I know.

We chose a plan that would cover us with those pesky little "pre-existing conditions" like my migraines, my husband's barely elevated blood pressure and cholesterol (like many middle-aged men in America, right? To call that a pre-existing condition, well, don't even get me started.) JP also covers his brother who "works" for him (again, let's just not even go there), but his coverage is barely even basic and works as a write-off for him and the business. However, we still have to come up with the money each month.

So, what's my point?

In the past year, I found a dynamite neurologist here in the OC, Kennth Martinez, MD (www.thebrainpro.com) who realized that part of the reason for my migraines is intense tightening of my neck muscles, called cervical dystonia or torticollis (literally means twisted neck). Kind of like muscle spasms that don't go away. He can inject Botox at the site (or sites in my case) of the spasms and wah-la--headaches gone, tightening gone = RELIEF. Dystonia is an FDA-approved indication for Botox. Migraines are not. Are you with me so far?

So, the billing gals at Dr. Martinez office are whizzes at getting Botox approved--he specializes in all kinds of neurological diseases and uses it frequently to relieve people's pain. They submitted a "prior auth" (oh God, the dreaded prior auth--I thought I had removed that phrase from my vocabulary once I left the previously mentioned in past blogs soul-sucking vocation of pharma rep, but NOOOO) and got the pre-approval. Yes! I go in, get my injections, yay. It's all good. This is LAST NOVEMBER.

Or so I thought.

When I go back four or so months later for the next one, Lydia in billing tells me that Blue Cross hasn't paid yet on the first injection. Uh-oh. No worries, she says. This is quite common with them. We'll just keep resubmitting. (Can you see where this is going?) They went ahead and did another injection in, let's see, February. Ah, blessed relief. And another one in, hmmm, June. (I love that they are willing to inject patients while still dealing with these blasted insurance companies. They rock.)

Still, nothing.

Finally, though I am due for my next injections, they cut me off. Blue Cross has paid them NOTHING. Has DENIED all claims as experimental. WHAT? It's an approved indication! Yes, they know. They have submitted all the paperwork to appeal it. So I get on up on my high horse and call the insurance company myself.

And this is where it goes into the surreal.

I talk to Yolanda. She tells me that no, they did pay out. For the November bill of $2500 (just so you know, we're talking A LOT of Botox), they paid out .76 cents. So, it's been paid. Yea, you read that right.

I was like, whoa, chickadee. You are not laughing here, so I assume you are serious in telling me that your company considers this paid, correct? That is correct, ma'am. (oh, no, here we go with the ma'ams again.) All .76 cents of it? That's considered paid? Yes, that's right, ma'am. Oh, okay, my bad.

Wow. So, let me see if I understand this correctly, Yolanda. I pay, on a monthly basis, to your company BLUE CROSS OF CA PPO, what just one of these treatments costs. $2,400. (This does not include prescriptions or deductible-that's extra. Of course it is.) Multiply that times twelve months and that's...$28,800. Correct? Yes ma'am. I believe, Yolanda, that what I pay for is called COVERAGE, yes? Yes, ma'am. Well, correct me if I'm wrong, but do you see any coverage happening here?

Well, I got a long song and dance about how the billing girls at Dr. Martinez' never submitted it to appeals, blah blah blah which is of course total B.S. because I checked with Lydia who of course emailed me the plethora of forms on all this and she's done beyond and we figure they are just jacking us around. Of course they are. It's in their best interests not to pay.

I should be grateful, lucky I even have insurance, though, right? See, that's the racket right there. You pay all this money, a fortune! And this is what you get--and somehow I'm supposed to be sooo grateful for it.

Well, you suck Blue Cross PPO and I hate you. So there. I'm crushing your head.

Is Rachel Zoe TDF?

Unless you have been living under a rock, you have undoubtedly heard of Rachel Zoe, fashion stylist to the stars. Zoe is the gal who makes Jennifer Garner, Cameron Diaz, and Anne Hathaway (or Annie as she so ahem, endearingly calls her) look so amazing at the Oscars. She's the one who says frequently and for no apparent reason"I die" and "Bananas." Zoe also has a somewhat highly-rated show on Bravo called "The Rachel Zoe Project" which shows a snapshot in time, usually Fashion Week and Oscar Week, when Zoe and her oh-so-put-upon-assistant- stylists Taylor and Brad deal with any number of fashion disasters; i.e., Brad: "OMG I forgot the nipple covers! What am I going to do" and he starts to cry. (Now, girls, we can all relate to wardrobe malfunctions, so dearest Brad, dry your sad little tears. It's okay, honey.)

I for one love the fact that the show is still on. On the one hand, I do feel that some brain cells die every time I watch it. Why? Hmmm, let's see...well, how many times must we watch Taylor huff and puff in frustration that she's moved beyond her current position as she haughtily slams those $15,000 gowns onto those metal racks? (Cringe.) Do I need to see Brad cry again? Or see Rachel have her makeup done again? Or watch her drink her ten-thousandth cup of coffee? I get that repetition is key in developing characters, but...isn't the show about Zoe and what she does? When we get to see that, the show takes flight. When you get to see her brain in motion, and she quickly pulls together a look for a client, or pulls fab-u-lous jewelry and mountains of coutoure clothing for a shoot--WOW, amazing. The woman is literally a walking fashion encyclopedia. Her brain should be frozen and the fashion information extracted--oh wait, it has! Her book, Style A to Zoe, is actually very good (and a New York Times bestseller).

I actually do enjoy Taylor for the most part--I love her deep side-parted bleached blond, textured hair, her giant dark glasses that she refuses to remove even for meetings, the fact that she stomps around in those high heels rocker boots. But she's a tough chick whom exudes confidence, and for that I give her props. As for Brad, well, he's definitely comic relief. Is he the best choice for Zoe's second assistant? That remains to be seen. He seems quite fashion knowledgeable--though I'm not sure if his drama, lack of common sense, and emotions will trump his experience in the end.

And no matter what you think of "Product Rachel Zoe," in all her annoyingness, massive jewelry and wobbly heels, Zoe herself is, in my opinion, a wonderful example of a successful female entrepreneur mixed with a great marriage--and she does it all with style. (I choose not to comment on her weight here--enough has been written and said.) However...will I tune in next season to see if Taylor is still mad all the time and if she stays--if Brad wears more silly hats and then gets fired--if Rachel still talks like a valley girl and still has vertigo--if her husband Roger finally gets a haircut? Meh--probably not. Then again, if I flip on the TV and it's on, I probably won't shut it off either.

As her daily email The Zoe Report pronounces to you, glamour is contagious--share it with a friend. And really, isn't that what the spirit of fashion is all about? Lookin good, baby!

Check out all things Zoe at http://thezoereport.com/. She usually gives one opulent option that let's face it, only she can afford but is fun to gawk at (say, a Gucci bag for $3,500); but then she gives a "parallel universe" option for anywhere from $30 to a few hundred bucks that makes real fashion seem, well, real, to us recessionistas. Cool beans.

So, to answer the question, is Rachel Zoe to die for? Naw, but she's a kick and worth a little time.

BOOK REVIEW OF 31 HOURS by Masha Hamilton

"When Carol Meitzner jolts awake in the middle of a long night, she knows--as surely as a mother CAN know--that her son Jonas, is in danger. His girlfriend doesn't understand why but she knows she has lost him. He won't answer his phone. His father says it can't be as bad as they fear. But it is. Jonas is in a safe house beneath the Brooklyn Bridge. He ponders his newfound faith--and his specialized training. Over the next 31 hours, he will cleanse himself, mind and body, in preparation for the violent action he means to take when the subways are most crowded."

I found the novel to be a compelling look at today's world, especially in light of the terrors of our post 9/11 culture. Hamilton is clearly a gifted writer. She imbues the characters with a rich inner dialogue, fleshing them out so we really feel we get to know them well--not an easy task. The descriptions she gave of Jonas, and his mother Carol were particularly detailed and full of a backstory that seemed real. I felt that I really got to know Carol as a mother and how hard it was for her to let her son grow up and away from her, yet still hang on to him and know ultimately that something was seriously awry.

My only criticism was that I felt the book ended so abruptly; though I do understand why Hamilton made that choice. The point of the novel was what led up to the inevitable conclusion, not the actual act itself. She's clearly a poetic writer, not perhaps one looking to write about the gore we all saw first hand, and for that I'm actually grateful. Her prose is beautiful, her characters heartbreaking.

I give it 4 out of 5 stars. Definitely worth your time.

Maximum volume a.k.a. apparently the only level that men can hear

My sister Caren and I were in hysterics last night lamenting the fact that still--STILL--after twenty years of marriage for her and seventeen years of marriage for me, our men have still not figured out the relatively simple task of hitting the MUTE button during commercials. Really, guys, is it that hard? You've got your thumb POISED over it already, right? I mean, what good is the poising if you're just going to, you know, poise? Push the damn button already!

Now I don't know about your house, but in our house, my guy likes to watch his programs LOUD. This could have to do with the fact that he's trying to hear over the chatter of our little four-year-old who's usually spewing his stream of consciousness at a mile a minute...either that or fighting with his older sister. So I GET it. That doesn't mean I have to like it. I'm usually reading or on the computer anyway, so I've become quite skilled at tuning out da noise.

That is, until the full frontal assault of say, the "EL POLLO LOCO" song hits me full blast (and BTW, what is it with those commercials that they play them like every thirty seconds? So fucking annoying.) and I look up to see my husband actually watching the mindnumbing commercials like a zombie. Seriously dude? You are watching this nonsense? "Well, I'm just gonna have to turn it back on again" is his argument...puh-leeze. Like it's just soooo hard to push that little MUTE button.

No, no, nononononono. If you can't handle the job of the volume controller, then let go of the remote. Hand it ova. I know it is part of your manliness and all, but I won't tell anyone. Pushing the mute button is a job requirement. All part of the job.

It was written in the vows somewhere...I know it was.

Mealworms in my refrigerator

Yes, unfortunately, you read that right. And they are in my refrigerator on purpose, not because we have some kind of icky mealworm infestation (if that's what mealworms do--I know not). No, see, this is what happens when you have boys in your house. Let me explain.

Growing up, there was me and my two sisters. We liked kittens, and flowers, and music. My mom, bless her heart, was (and still is to this day) TERRIFIED of bugs of any kind, but in particular, spiders. Now, this could have to do with the day that a tarantula crawled up her hand as she was weeding in the ivy along the border of our lawn in San Bernadino--but I digress.

Worms. Growing up, my best friend had a creepy brother that would occasionally show off for me by doing gross things, like cutting a worm in half so we could watch both halves continue to wiggle--stuff like that. But I did not grow up with critters, slithering pets, or any type of weird animal that required anything as food besides, you know, food.

And yet...now I have a four-year-old boy who does BECAUSE I have a fifty-five year old husband who thinks collecting the lizards that hang out at our new place is cool. God love him. I mean it IS cool that he's teaching our son all about nature, and critters, and all that gobbledygook--and considering that he was a bug and dirt major in college, he really gets into all this. I'm happy for Lukas that he has at least one parent that's in touch with the gritty side of life--who gardens, gets their hands dirty, knows the names of plants and flowers, can identify the difference between a gecko and a lizard (???)--all important. Right?

However, I'll stay over on the other side, where I can identify a lengthening mascara from a volumizing one, a blusher from a bronzer, and a lip gloss from a lipstick (der). All useful information for my ten-year-old daughter, for sure; yet clearly out of the realm of knowledge for my husband--putting my college degree to work (Communications Studies)? You betcha.

Now if only they'll be sure to keep the crickets out of the house next time they feed them to the lizard, we'll be all set...

Letter to my blog

Dear Blog,

I'm so sorry for neglecting you. I've been a little busy. I know that's no excuse; however, with moving, my ex-boyfriend's sudden and unexpected death, my child's illness (now over), my new writing gig, and all manner of other little annoying things like lack of sleep, article research, grief, decorating, packing and unpacking...and various and sundry endless errands, as well as just dealing with the wonderfully tedious daily grind, well...you can imagine how it goes.

So please don't hate me because I'm ignoring you, my beloved blog...it's not you...it's me.

Love, Rachel

May you find peace, Duke

So, I was planning to write about how it's been almost a week, and we're kind of settling into a routine (sort of). I was planning to write about how we have made headway on the mountain of boxes and can actually walk around the rooms of the house without tripping on corners of boxes or each other (sort of).

And then...then...

I was on Facebook on Wednesday and saw, shockingly, that an old boyfriend of mine, that I had chatted with on Monday around lunchtime, had RIP notices on his wall. WTF?

How could this be possible? He was my age, 45. When he looked me up three or four months ago, he told me he was a daddy now. He had a 14-yr old son whom he was over the moon for. He seemed fine. Granted, I hadn't seen him in 20 years; hadn't spoken "live" to him; it was strictly a FB only relationship, and strictly friendship only. I'm happily married, 17 years on Saturday TYVM. He wasn't in a relationship and he made it clear that he regretted screwing us up; I made it clear I forgave him--I just wanted to understand the "whys" of what happened 20 years before--we had ended it very abruptly, no contact since. We chatted frequently--about our past, about life, his current job, wine, about our kids, my writing. I got no indication, none whatsoever, that most everything he told me about his life now was a lie.

I won't go into the details, but you can imagine he was not mentally well. I think for those of us outside his small circle, he hid it VERY well.

After a minor disagreement with his sister (who is a GREAT person BTW), he confronted her, pulled out the gun, said some things that had meaning between them, and shot himself in the chest--right in front of her. At least it was quick. She said he was cold, deliberate. She realizes how lucky she is that he didn't turn it on her first.

I ended our relationship because he had a hair-trigger temper, he drank too much, he cheated on me, he couldn't commit. He was the rebel, my bad boy. I was the good girl. Thank God I got out. But I did love him, so very much. And yet...all those experiences brought me to my honey--my JP, my loving husband and VOR (voice of reason). His poor sister has had to deal with him all these years, and had to witness his degeneration and this last selfish act.

When I asked her how she felt, she said "pissed."

I hope she feels relieved.

So, we did it. We moved. I would say I'm happy and excited but I'm so tired I can barely tap this post out. So, the bulk of the move is done. And so am I.

I've lost about five pounds. I think more from not having the energy to eat than from in any way trying to diet. Well, that and the fact that our food is still in boxes.

It IS nice not owning, actually. For all the stuff that doesn't work (all minor, so far), I just type a quick email to Erica at the management company and she contacts Fred The Handyman. Fred The Handyman, who is pushing 75 at least, but is very, very nice and well, handy, shows up within the hour and fixes stuff. And I pay nothing. It's great. I don't pay property taxes. I don't pay association dues. I just live here.

This leasing stuff isn't so bad after all.