FL Medicaid: I'M PISSED OFF (and that's putting it NICELY!)!!!

I am SO fed up with these Florida Medicaid crack-heads at the Department of Children and Family "Services" (unfortunately, they "service you" in ways you'd rather avoid). Here's what's going on (I'm leaving out the exact numbers for obvious reasons, but will give you more than enough to go on).

First, a bit of background. For those who don't know, I'm a cancer patient (according to my records, at least, it's terminal—but in my opinion, that just means that cancer is what will eventually get me, when I'm ready to give up...which I don't see happening in the next 20–30 years, at least). I'm not currently able to work, and am living on disability. My only health insurance coverage is from Medicaid.

Late-Nov06: It Begins....

It's late November. I've got family visiting, and all is well (except that I've run out of one of my prescriptions—for anti-stress meds—that the doctor won't fill until later, so I'm completely stressed out). I get mail stating that, due to my excessively high income (i.e., my disability check), my Medicaid coverage will end as of the end of the month. Gee...wonderful. Morons....

So anyways, "one" phone call later (after countless other calls where I got directed to the "right number"), I've been informed about the "medically needy" program...except that it appears to be a cancer patient's worst nightmare (aside from the cancer itself, that is). For those not familiar with the program, here's how it works: They take the total household income (including the value of anything you own) per month, subtract about $200 from it, and call that your "share of cost" (i.e., the amount they expect you to pay). Absolutely no consideration whatsoever is given for your monthly bills, living expenses, etc..... After that share of cost is met, Medicaid kicks in for the remainder of the month (but wait...there's more to it than that...and some of what I was original told was wrong, but we'll get back to that in a bit).

In other words, if:

  1. Your monthly income is (let's pick a nice round number): $1,500
  2. Your monthly share of cost is (again, nice round number: $1,300 (they normally figure it based on income minus $200...in my case, my share of cost was actually $250 HIGHER than my monthly income).

If you have seven treatments, each costing $200, they expect (important key word there) you to be able to pay for the first six. But, after the seventh, you've exceeded your share of cost for the month, and Medicaid will kick in pay for it all, and you're good for the month (bzzzzt...the crack-head told me wrong...more later).

While on the phone, I repeatedly asked where that first bit of money was supposed to come from (if the share of cost wasn't met before the end of the month), but the crack-head on the other end of the line didn't have an answer, nor did he show even the slightest hint of caring (we're talking stone cold here, folks...a robot, at least, wouldn't have shown emotion; this guy was COLD-BLOODED).

So next, I make some more calls, asking for help, and the best I'm told from anyone is, "sorry, that's how it works...anything else?".

At this point, I'm so angry I'm shaking (i.e., REALLY mad!). Several hours later, I'm slightly (barely noticeable) calmer. After that, I go back and forth between being too angry to do anything and feeling too deeply "snowed under" to do anything. That last bit remains true even today, as I write this page.

Early-Feb07: The Plot Thickens...

Ok, remember that example above? Well, it's wrong. Let's say those seven treatments are on consecutive days. The seventh breaks past the share of cost, and from that point forward, Medicaid will cover you...but not for the first six. Sorry, but you'll have to skip paying bills (you know, unimportant things like rent, electricity, phone, etc.), eating, and such for the rest of the month. Oh, wait, there's an alternative: skip the doctor's appointments.

It gets worse, though. Let's say, given the same income/share of cost numbers from above, you get two labs done on the first of the month, each of which costs $2500 or more (i.e., your share of cost is blown right out of the water). On the second, after reviewing the results from the two tests, your doctor prescribes medication. Ok, so you go to the pharmacy and expect to be covered, right? WRONG. Medicaid doesn't even start to consider the bills until they receive a final bill from the hospital, and the hospital may not get that finalized bill out for weeks. When the final bill does go to Medicaid, it takes them a day just to see it, and then up to ten days to do anything with it. During that time, you either pay for your medications, seek help from charity (if it's something they'll pay for, and if you don't mind abusing said charity like that—getting them to pay for something that will be covered by Medicaid eventually), or you wait...and wait...and wait....

Final Thoughts (what, were you expecting a happy ending?)

I'm getting overly stressed and tired from writing this (yeah, it works that way...when the energy level drops, it drops very suddenly and completely), so I'll end here. But there is one concluding point I'd like to make: the Medicaid system may be the best we have, but it's desperately in need of an overhaul by someone who actually gives a rat's backside about the patients (i.e., not the people running it now). I'm not qualified to do that, and I don't know who is, but I do know that someone who is qualified needs to do so rather urgently.

(Shhhhh...don't tell anyone, but I have figured it out, though.... What they're really trying to do is, by causing people to not be able to get treatment or medications, weed out the medically needy from the population.... Ok, so that's not actually true...but sometimes it certainly does seem that way...e.g., right now, when I've got two prescriptions and some labs, all of which I should have had last week, that are still on-hold, waiting for Medicaid....)

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