-t, I don't know what it's like with Kaiser, but my understanding is that with an EPO plan it is easy to get burned with unexpected out-of-network expenses like "the surgeon was in-network but the anesthesiologist was not."

That is an excellent point, I have heard of that happening a lot. Kaiser procedures tend to happen in Kaiser facilities so I think that is less of a risk

I am finding the emphasis on "appropriate levels of care" very upsetting.

I am finding the emphasis on "appropriate levels of care" very upsetting.

My company, which for some reason has a health care plan that runs July to June, was the same way. There's just more and more emphasis every year on making sure you question if you really need that trip to urgent care that you think you do.

It's the emergency room is covered only if it's for something life-threatening that is bothering me. If I'm afraid it's life-threatening but it turns out not to be, do I get the full bill? That's how it sounds. And the way they put it "you want to get that taken care of before it's a problem rather than getting hospitalized, that will save everyone money" [emphasis mine, but seriously, you are saying that out loud?]

That is horrifying.

It's the emergency room is covered only if it's for something life-threatening that is bothering me. If I'm afraid it's life-threatening but it turns out not to be, do I get the full bill? That's how it sounds.

I fucking hate that one. Like, you don't want to guess wrong on a heart attack. Or, as another random example, a stroke.

Which reminds me: Tim's dad got transferred to a rehab facility yesterday. The plan is for him to be there for 2-3 weeks, with 3+ hours of therapy a day (not 3+ hours all at once; it'll be spread out over the day). I need to ask Tim if he or his brothers have tactfully told the staff that their dad *will* make incredibly inappropriate sexual comments to the female staff. (It's a known thing with dementia. I'm not saying that to excuse it, but it really is a common thing in patients with dementia. I personally am getting more and more uncomfortable being around him because of it, although he has yet to direct any inappropriate comments my way. It's a really, really sad part of dementia, seeing the personality/behavior changes that are happening as the cognitive deterioration gets worse.)

I hope the rehab facility takes good care of him. I'm sorry to hear he's got that effect, that must be really difficult to put up with

I'm sorry to hear he's got that effect, that must be really difficult to put up with

One of Tim's brothers came up with the phrase "No ugly words" to use as a response to their dad in the moment, when his dad says something inappropriate, and it seems to cut it off pretty well. The problem is that (1) his short-term memory doesn't retain anything new, so he won't remember "no ugly words," and (2) the cognitive deterioration isn't reversible, so his filter is *gone.* So it's just a Sisyphean task of telling him, in the moment, "no ugly words," and then the moment eventually repeats.

But it doesn't matter how much I tell myself that it's because of his dementia, it's really rough to hear him saying that kind of stuff. If I walk away from it, I feel like I'm unjustly rejecting him, but I also will not subject myself to his gross commentary.

It's a really, really sad part of dementia, seeing the personality/behavior changes that are happening as the cognitive deterioration gets worse.

It happened to my grandfather, who was the mildest, most dad-jokey person. I was only exposed to it a couple of times, thank god.

Yeah, that's brutal. Staff would have to be used to it, though.