Why I Had To Apply For Medicaid

Why I Had To Apply For Medicaid

Medicaid. Not an option I had ever thought I would consider or need to consider, but here I was. Not for myself but for my two and half year old son, Amos. Amos had been slow to meet developmental milestones and his speech still had yet to come even though we had “been patient” and done intensive therapy since he was ten months old. We plugged along and hauled him to eight to ten theories per week, both private and through our state’s early intervention program. This time of year brought the dreaded letters though, the ones warning us that we would soon be out of therapy visits. How could I possibly forget that we had thirty for speech and another thirty for physical and occupational therapy combined? I knew better than anyone and was reminded again, there were no appeals available, not one thing I could do except pay out of pocket.

My husband is a successful attorney in a small firm and we buy our own health insurance. Our choices for insurance are the same for anyone else in the state of North Carolina and yet, there is no policy available to purchase that offers therapy services based on need. All BCBS plans offer thirty speech visits and thirty combined occupational and/or physical therapy visits. No exceptions. No appeals. No additional coverage, like that is offered for dental or eyes. In the coming weeks, we will be out of private services for Amos. At $400 an hour, 4-6 times per week, it is not a possibility for our family of six. I sure there are millions of people like us that fall in the cracks of needing benefits, certainly we can’t be the only ones that don’t have $150,000 to devote for their Amos’ each year.

The last few months I have asked some very hard questions regarding my two year old son, Amos. Would he ever say “dada”? Would he ever be able to jump? Would he learn to read? I was left to ask, “Should we apply for Medicaid?” to my son’s developmental pediatrician. He paused and I waited,with baited breath, a nervous smile, downcast eyes, clenching thumbs, on the verge of tears. His jovial manner was a natural icebreaker to my self, anxious and hesitant, a guarded question that would unlock a Pandora’s Box. “I would”, he said as he explained it would take months and that if we were denied, we would likely hit the appeal process after his third birthday and then we would be guaranteed. As much as I hate not knowing, nor do I like being guaranteed for something that would be so helpful yet something I grossly do not want, yet I have no choice.

We will apply for Medicaid. We will take advantage of the system that I never knew I would need. Do I feel like society is responsible for the care of Amos? No, I don’t but I am at a loss of what to do to make sure we do our best for him. I will beg and plead his case so that we join a club of which we don’t want to be a member. Begrudgingly, I am hopeful it may work. I will not have to spend hours on the phone with our insurance company, explaining and gathering information and doctors’ letters. The dissemination of information that uses up priceless time in the development of a little boy’s brain, time that is ticking by and at some point, the clock will stop.

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