Wednesday, August 25, 2004

Spoke to my State Senator last night. He is going to assist me in my fight with Medicaid. Actually, he is wife is an old friend from Memphis. I had no idea she lived here (or was married to a State Senator for that matter). It's amazing how small this world is. (Thanks EK)

I can not, for the life of me, figure out how I can get around this problem with Medicaid. Because of my income, which is through Social Security Disability, and the small amount Renee earns, we don't qualify for Medicaid. However, due to my disability, I qualify alone.

But, because of the income, I have a rather enormous spend-down. Meaning, in order to have coverage with Illinois Medicaid, I have to spend $1339 a month - out of pocket - in order to qualify each month. After I meet the spend-down, Medicaid pays the bills (minus the $1,339) at 100%.

If I fail to pay the $1,339, for three consecutive months, I will lose the coverage entirely.

I'm not concerned that I won't have $1,339 in medical bills each month. My prescriptions cost about $2,200. But apparently, Medicaid will only pay $861 of it.

I'm stuck between a hard place and a rock. I would love to go back to work, but I can't find someone who is willing to take on my insurance needs. If I work without coverage, I lose because by working full-time, I lose my disability benefits, which in turn means I lose Medicaid.

Besides the issue of finding a company who will take me on, I no longer have the skills I had before - due to my stroke - and basically don't have the abilities I once had.

So, I'm damned if I do and damned if I don't. One thing is for sure - Between rent, insurance (life and car), tuition, food, electric, phone and gas bills and everything else, there is no possible way I can pay $1,339 every month to Medicaid. That amounts to close to 50% of my current income. If it was me alone, I'd be able to handle it, but I have a family of 6!

I didn't ask for this condition. As far as I knew, there wasn't even a hint of heart disease in my family. In fact, my cholesterol level was never particularly high. I had back surgery just two years earlier and during my pre-op, I was given a clean bill of health.

I truly believe G-d works in mysterious ways and I know there is a reason that I have been thrown into this mess. I just wish he would let me know what his plan was. This too, shall work out. Struggling is just another obstacle in life. But, I think I've had my share.

It's time for some good things to happen for a change.

No comments: