Dealing with state assistance vent

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Monty's Mom
Veteran Member


Date Joined Aug 2010
Total Posts : 664
   Posted 12/15/2011 2:19 PM (GMT -6)   
I have been waiting for an answer from my state assistance department for 45 days about reinstating my health benefits through the workers with disabilities program. I can't get a direct answer why I haven't gotten an answer yet. The people who do answer the phone are not caseworkers and treat me rudely when I call, even when I am being very kind. My caseworker says the coverage is denied, even though I meet every requirement that was stated on their application papers, income limit, disabilities, medications required for daily living, and getting other services that meet the federal guidelines for below the poverty level. Yet, the caseworker wants me believe that we make way too much to qualify for the medical coverage for me.

What I want to know is how someone who is under the federal poverty level is supposed to be able to afford health insurance? How do we afford the premiums, copays, and the medications and treatments the private insurance doesn't cover and still be able to pay bills and buy food? It doesn't make sense! Just throw us out and make me choose between the medications to be able to get the most relief for the least amount of money.

I am still waiting on the prescription assistance application reply from 2 companies. I haven't had my depression and anxiety medication for 45 days, because my PCP refuses to prescribe those medications, and I am allergic to SSRIs. She doesn't know what to give me to help. My psychiatrist is too expensive for me to see without insurance, and I am ineligble for the county's mental health help until the state decides I am denied their assistance. IN the meantime, I am a wreck. I can't sleep, have panic attacks,and am so depressed that everything makes me cry.

It seems like they make it so difficult that the people who really need help have the hardest time getting it. Sitting in their office for hours waiting for my interview appointment because they would not allow a phone interview, filling out six sets of paperwork, getting to my doctors an hour away twice for paperwork, and countless hours of followup and phone calls because nothing is moving. Who can handle all of this?

I keep praying my husband gets a new job that has insurance that will take me and cover at least some of what I need. THis way I will no longer be a burden to the system as I have so obviously become. I am so disgusted with the treatment, I called my state representative. His secretary called and is having them work with me today. If I am having so much trouble, I wonder how other people who are much less articulate and don't have internet and access to help cope with it.

Thanks for listening to my vent.
Mindy
The worst sin towards our fellow creatures is not to hate them, but to be indifferent to them. That's the essence of inhumanity. George Bernard Shaw
Pelvic adhesive disease, IBS, SI dysfunction, arthritis, fibromyalgia, depression and anxiety, 11 pelvic surgeries for pain, adhesions, endometriosis, adenomyosis, ovarian cysts, and ovarian remnant syndrome.

Betsey Ross
Veteran Member


Date Joined Mar 2011
Total Posts : 1056
   Posted 12/15/2011 3:05 PM (GMT -6)   
mindy

I feel your pain and Im right there with you. It is so hard to get any help from programs. I am ineligible because I am not in a nursing home. Our state which is Pennsylvania is very difficult to get health insurance,food stamps, and prescription assistance. I do wish you the best of luck in obtaining what you deserve.

Soft Hugs
Betsey
crushed lower knee and vertical fx of tibia/external fixator placed/plates and screws and tried to place big pieces of cartiledge under knee cap/tremendous pain in affected leg continously without improving/allergic to metal in left leg/leg isnt straight/ metal removed in July//then total knee replacement/straighten out leg/more phsyxical therapy/take oxycontin,flexeril,cymbalta,vicadin for BT

Monty's Mom
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Date Joined Aug 2010
Total Posts : 664
   Posted 12/15/2011 3:16 PM (GMT -6)   
Betsey,

I live in Pennsylvania too, and you are right, it is a nightmare to deal with and get the help you need here. It was amazing that about an hour after calling the state representative's office, I got a phone call that things were approved. I also got an apology for it taking so long. They bumped up benefits that we should have been getting months and months ago, meaning the office knew we should be getting more benefits and had deliberately not increased them because I did not ask for a review when our circumstances changed. What a horrible way to deal with people.

I am writing a letter to our state representative describing all of this. I hope that maybe this will help streamline the system and change some of the things they do. Imagine that we went for about 10 months getting only a third of what we should have been getting.

I still want private insurance, because no matter how much they say we should not be discriminated against, medical professionals who see medicaid insurance groan, complain, and prefer not to take patients on Medicaid. It would be nice to not have to know that a doctor's office takes me because they have to.

Hope everyone has a good, low pain day.
Mindy

NiNi53
Veteran Member


Date Joined Mar 2011
Total Posts : 816
   Posted 12/16/2011 9:10 AM (GMT -6)   
Hi, I live in Maryland so I guess thats what the difference is, when doctors see either medicaid or medicare, they love it, because they know for sure they are going to get paid.  For doctors in this state its a dream come true, there are very few doctors who turn down patients with either or due to the fact that as I said, with both medicaid or medicare, they are assured payment and quick payment.  I guess I am very lucky I live in Maryland.
 
Sorry for your troubles, maybe its time to move, that will at least make life easier for you insurance wise.
 
Good luck, and take care,
 
Kathy
degenerative disc disease, fibromyalgia, osteoarthritis, neuropathy, lumbar laminectomy july 1998 no help, rechargeable neurostimulator unit low right back w/lead wires to left side and right leg unit not working just sitting there.i am 57 years young in may will turn 58. i have 2 grown daughters, 25 and 29. i have 2 grandchildren, 9 year old grandaughter and 5 yr. old grandson

Jim1969
Veteran Member


Date Joined Jul 2009
Total Posts : 2042
   Posted 12/16/2011 12:38 PM (GMT -6)   
If PA is anything like IL when it comes to medicaid I can understand why doctors would rather not see medicaid patients.

Here in IL medicaid pays a lot less than most private insurance companies do but the biggest reason is doctors around here hate it is because the state is very slow in paying. Even before the recession it often took 3-6 months before doctors would get paid and now it is 6-12 months.

"Fortunately" the only doctors that I know of who have stopped taking medicaid patients are those who are in truly private practices and those doctors are fast becoming a rare breed as more and more often they are entering into practices with various clinics and hospitals.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.
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