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Saturday, October 2, 2010

Don't Kick Me While I'm Down

Anyone who has sat in the waiting room of the DMV knows the government it not a well-oiled machine.  The right hand has no idea what the left hand is doing so all you can do is pray to the paperwork God's that you filled out everything out correctly cuz if you didn't its back to paperwork hell and another line for you!

I completed the paperwork.  I checked and rechecked our applications.  I kept all the information I've been sent and yet, I am still so confused I find myself crying to strangers on a regular basis.  Navigating government aide is so hard I am certain that those who use these programs their entire lives are definitely smart enough to get a job if they can navigate this system.

 I have a wonderful three month old baby.  She is healthy and happy.  This is a great thing because she has not been to the doctor since she was two weeks old.

I haven't taken her in because we were in the process of moving and then I applied for Medicaid.  My caseworker told me over the phone that we do not qualify for Medicaid because we have over $2,000 in savings.  Basically, if I wanted to qualify for Medicaid I had to be irresponsible with our money and blow it all, put the money in someone else's name or I could pull it out of our bank account and hide it as cash.  

Changing the name on the money or pulling it out in cash would be illegal and wrong so I decided against that and found that we don't qualify.  But I think there are a lot of people I have sat with in waiting rooms recently that have lied.  The government seems to have a knack for rewarding those who are stupid with their money.  Crap-why can't my concience let me lie this once?  Oh yeah--it's cuz  I don't want to be a leech forever.


On the bright side, I believe my caseworker said my children may qualify for CHIP (a low cost government insurance that is separate from Medicaid).  At least I think that is what he told me...he didn't speak clear English so I can't be sure.


It's like winning the poor person's lottery when you get a letter saying you qualify for a government program.  Having government health insurance for my kids lifted a huge weight off my shoulders.  I didn't have money to pay for private insurance...but now if the kids get sick I can get them treatment by the graciousness of the taxpayers.  Where should I send the "Thank You" cards?


Each state runs their own CHIP program.  In my state you are sent a packet containing information on 3 different insurance "plans" you can choose from.  You pick a program and then a doctor within that program who will be your primary care physician or your "PCP".  Your co-pays and other expenses are based on your income.  We have nearly no income so we have no co-pays for doc visits and a $3 co-pay for the ER or hospital.  And the maximum we will pay in a 12 month period is $41. 


Being the dutiful mom, I asked my neighbors who the good doctors were and called them up to see if they took the CHIP program I'd chosen.  Most didn't. 


Eventually, I found a doctor and got an appointment.  My daughter would only be a few weeks behind schedule on checkups and immunizations.  Whew!  Then I got another letter.


The next letter said my infant was denied CHIP because she was already on Medicaid.  Huh?  I had not received anything from Medicaid and had been told we were denied Medicaid.  I called CHIP.  They didn't know what it meant.  Then I got a another letter from Medicaid saying if I did not choose a health plan and doctor for my daughter within 7 days they would tell me which doctor I had to go to.  I thought I didn't have Medicaid?  I was so confused.


Finally, I got hold of Medicaid.  A nice woman helped me get my youngest child enrolled in a Medicaid program and said she would help me search for a doc.  She used her computer system and searched for doctors in the area that would take my chosen Medicaid plan.  She came up with a great one near our house.  I canceled the original appointment with the doctor who took CHIP and called the new Medicaid approved doc.


I once worked for a pediatrician.  It was a lot of fun.  I loved the kids and helping people and I now want to be a pediatric nurse practitioner.  Part of my job was taking co-payments and insurance information at the beginning of patient visits.  Before I even took your blood pressure, I had to know how you were going to be paying the office.  That is how I got to know the "Medicaid mom's".  


Stereotypes are not nice...but they exist because they are true.   Medicaid moms were the women with either too little or too much makeup and rowdy, disrespectful kids who all had different fathers.  Some were clean, but the majority of our "stinky" patients were offspring of medicaid mom's.  They were also the first to complain and the last to say "thank you."  It's a different culture.


Because of this stereotype I expect to be treated a little differently when I mention to a doctors secretary that my child is on Medicaid.  Even though I expect it...it is still hard to take. 


I called the office that took my new Medicaid plan to get an appointment.  She was nice at first.  Then she asked which plan I was enrolled in.  I told her and she asked for my daughters Medicaid number.  She searched the system and informed me that even though I had enrolled in a "plan", the process would not be complete for 45 days...so they will not see me daughter until then.  What?  


It's silly, but I began to tear up.  I already felt like a horrible mom for being behind but I thought I had made up for it by being so precise and aggressive with getting CHIP as fast as I could.  Now, despite my efforts, my daughter still could not see a doctor for another 45 days!  The secretary informed me that if I wanted to have her seen I would have to find a doctor that took general Medicaid.  What the hell is general Medicaid?  I'm so confused.


I called the first doctor back and asked if anyone there took general Medicaid.  She told me they didn't and she sounded very annoyed-- so I promptly burst into tears again.  "I'm so sorry." I said, "This is so embarrassing.  We don't have insurance because my husband is in law school and my baby is already a month behind."  I sobbed.  The poor woman didn't know she was gonna talk to a basket case when she answered the phone that day :)  


She became nicer and told me she would have someone call me back.  "I don't mean to be abusing your office," I said.  "I just don't know what to do."  She told me it was ok and I apologized one more time before we hung up.


By this time my three year old had entered the room.  "Why are you crying mommy?"  she asked.  I told her I couldn't find a doctor to help her sister and I wasn't sure of what I was going to do.  She got me a paper towel to wipe my face and told me not to worry anymore.  This, of course, made me cry harder.


Eventually it came down to 3 options.  I can wait another 45 days to take the baby to the doc, I can take her to a doc far away that takes Medicaid but does not speak English very well and then switch to a different doc in 45 days, or I can pay $75 for a well-check at the doc I wanted her to go to and get her immunizations started at the free clinic in the ghetto.  I chose the ghetto.


I don't feel comfortable waiting another 45 days to take her to the doctor.  I wouldn't mind taking her to the far away doc...but I'd have to change docs and records again and I'm not certain they really take Medicaid cuz no one could give me a direct answer.  I really don't want to pay for a visit--but I can find $75 and I hate going to the free ghetto clinic but maybe this time if I get there when they open it won't be too bad. Besides, I've been to the immunization clinic before and they turned me away...which caused me to burst into tears as I tucked my tail and left.  It'll be good to pick up my bootstraps and face them again.


Bright and early Monday morning the little one and I are headed to the ghetto immunization clinic.    I pray they don't kick me while I'm down.  Wish me luck!

3 comments:

  1. I don't know who you are, but I KNOW what you're going through. You have no idea how many times this has happened to me. Sharing your story is THE ONLY WAY TO GET IT FIXED! Thank you for being brave enough to do it! People always act like we're just ungrateful if we complain about gov't assistance... but the system is VERY broken, and no one will ever know if we don't speak up and voice the problems. I hope you don't mind, I'm following your blog. :)

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