Medicaid Horrors

I’m getting more scares from Medicaid than from anything else this October and it’s not even Halloween.

I didn’t realize before moving to Chicago that the social service system in this state was so bad. Illinois is seriously financially conservative and Medicaid is fucked up.

Medicaid sent us letters and slips saying we were covered for the month of October, then, out of the blue, they sent us letters saying we both had been denied because we didn’t qualify as disabled. Ironically, I’ve been getting additional forms from the federal government to apply for disability, suggesting that they are seriously considering my application. Either that or they really, really like paperwork.

To make matters worse, the denial letter was dated October 5th and we got it October 7th. However, my husband had surgery, which his doctor said Medicaid had pre-approved, on October 6th. Fuck! To boot, the surgeon, while working at a hospital, did not count as a hospital employee, so we wouldn’t be able to get financial forgiveness of any sort from the hospital for the surgery or follow-up visits.

My husband repeatedly tried calling DHS to no avail as he couldn’t get anyone on the phone and no one returned his calls. Typical. We got in touch with our state senator, the same one who helped push our application along the first time around, and haven’t heard back from her yet. It’s been at least four days. We’re gonna have to call again.

We also called a discounted lawyers group and left a message. No response from them either.

I also called mental illness advocacy groups. Thresholds seemed to say they could help, but I’d need to go through an intake or something, and oh, that was generally billed to Medicaid. Huh? There also see to be some other way of them getting reimbursed through other sources. I’ve tried to call the intake department, but again, got voicemails. I left messages anyway.

Today, my husband went back to the hospital as the wound wasn’t looking very good and his original surgeon’s instructions didn’t seem to make sense. I figure that medical bills or not, a serious infection would be worse. After seeing the new surgeon and getting instructions that made more sense, he checked with the billing department. Low and behold, he was told that we are covered by Medicaid until the end of the month, and our coverage ends November 1st. Oy. This of course comes after many missed doctor’s visits that we now have to hope we can reschedule and get resolved before we lose Medicaid.

In the end, we’ll still have to appeal and my husband’s research says that most appeals are denied the first time around, and you’ll have to try again. There’s also been the suggestion that you lose Medicaid when they see that you’re using it. *shakes head*

At least for medication refills, I’m hoping we can go back to the Fantus Clinic at Stroger and get them refilled. However, we’re going to have to go through the walk-in clinic all over again because that’s the only way to get a PCP. The PCP will then decide whether or not he wants to prescribe the medications we’re already on. Since none of our doctors are with Cook County Hospital, they won’t accept prescriptions from them or let us transfer prescriptions from our current pharmacy. There’s no way to we can afford to pay even the generic prices for our medications so I guess it’s back to spending 12+ hours at Stroger after getting no sleep. Fuck Medicaid.

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Why can’t Congress pass that damn health care bill already. The public option is already dead and that was one of the issues that conservatives had the most trouble with. Why must something so important take so long?! Most everyone says they agree that the health insurance system in America is vastly inadequate, and yet they’re still fighting about it. Call your Senators and Representatives and complain! You the voter elected them. You the taxpayer pay their salaries. Call them!