Over the last 3 years I have had to deal with many struggles and I wrote about them here.
Having a disability and being in a wheelchair requires extra
medical attention and care. There are
many things that are needed out of necessity on a daily basis that include, but
are not limited to, my wheelchair, a shower bench, and other assistive devices
for day to day living.
I was born with Spina Bifida and have been fortunate enough
to do a lot in my life because of my disability from trying out for the
Paralympic sled hockey team, traveling to Ireland with the New York State games
for the physically challenged, being able to meet several celebrities and even
getting to go on rides as many times as I wanted as a child.
I enjoy life as much as possible, but it isn’t always fun
and games. Having endured 21 surgeries, and over the past three years have been dealing with a significant medical
issue that has left me unable to work.
Recently, I have had to deal with the not so pleasant side
of private insurance, Medicaid and Medicare.
Over the past five weeks I started a new treatment for a
pressure ulcer. This specific treatment involves platelet rich plasma. My
insurance company did not cover these treatments and I am paying out thousands
of dollars out of pocket. I still have private insurance to cover things that
are necessary for everyday living through cobra coverage from a previous
employer which is $300 a month and I have also had Medicaid and Medicare
coverage due to my disability.
Over the last couple of months I had to renew my Medicaid
coverage and the process has become a tiresome, stressful process. Medicaid is necessary
to those who are disabled and need help with prescription coverage, medical
supplies and durable medical equipment.
Medicaid is a secondary insurance and covers those things that my
primary insurance has not covered. The applications for Medicaid had been
approved in the past, but this year it has been increasingly difficult. I
received the basic Medicaid application returned and then a few weeks later I
received more forms to fill out including for my primary doctor to fill out
verify my disability. All of those forms were then sent back and I then
received what seemed to be an approval letter stating my coverage would then
resume as it was but with a slight change because I am now eligible for
Medicare prescription coverage. This past week I contacted Medicaid again
because there had been denials from doctors' offices and for other services
that are needed. Upon speaking with them, I was told that I make too much money
on Social Security disability and will now have a co-pay of $117. This was astounding
because previous to being on disability over the past year I had worked for
several years and could still keep my Medicaid at no cost.
Social Security disability is based on poverty levels and
those that need it are hurt because you are penalized for attempting to save
money for emergencies down the road.
I have recently also
been enrolled in Medicare because of my date of “disability” from my last day
of work. In looking over the coverage and ordering my necessary supplies it was
sad to realize things that have always been a necessary part of my daily living
and some that are necessary during my health problems were not covered or a
medical supply facility not wanting to use my insurance because they lose money
on a product. Medicare is also deducting over $100 from the disability check.
My total insurance cost is over $500 or more than half of what I get on
disability per month.
While I agree that Medicaid, Medicare and even social
security need to be more stringent in their policies. I was born with a
disability and am permanently disabled and that has not changed in the last 35
years. Those of us who need these programs are being hurt by those who abuse
the system, making it much harder to get what is needed to have a better
quality of life. There needs to be changes made for the better so that the disabled,
the elderly and anyone who needs these programs can keep their head above
water. This is something that needs to be investigated at local and national
levels. It is unfortunate that the
political climate is and always has been involved in medical care instead of
focusing on helping people in need.
