i had my surgeries in 2000 and 2001 and i have applied for disability in 2007 because i just cant work and i have been denied 3 times right now my case is in the appeals and i just hope i get a good answer it is b=very frustrating

Hi Katie,

I am sorry that on top of the concerns for your health, you have to battle for insurance coverage to get the care you need.  Many of us have faced similar struggles and know first-hand how daunting it can be.

I googled Dr. Nussbaum & see that he practices at St. Joseph Hospital in St. Paul, so I assume this is where your surgery would take place.  This hospital has a Customer Advocacy Department.  I would encourage you to contact them and tell your story.  Solicit their assistance in helping you obtain Medicaid coverage.  Be prepared to tell your story many times, to as many people as will listen.  Though it sounds tritie, often times in these cases, the old saying "it's the squeaky wheel that gets the grease" is very true.
Here is the link for St. Joe's advocacy dept:
http://www.healtheast.org/contact-healtheast/customer-advocacy.html

I also briefly looked at the SD Medicaid website and see that there is a division called "Constituent Liaison Services".  I would encourage you to also contact this department (if you haven't already) to learn if they can provide any services to expedite your approval for Medicaid.  Here is their email addy:
DSSConstituentLiaison@state.sd.us

You may also need to contact an attorney - google Medicaid attorneys.

In my daughter's case, the key to eventually getting the insurance we needed for her to have the surgery with the only qualified surgeon in the city was to find someone at the insurance company who "got" the urgent nature of her condition.  There were many who "got" it but thought we should just wait a few months until open enrollment, so basically just sit around for 5 months & wait for her to have another stroke(s).  This was unacceptable, so I just kept making a nuisance of myself until they allowed me to change plans mid-year so my daughter didn't have to wait the 5 months for the surgeries.  I was not dealing with Medicaid however, so imagine that adding government bureaucracy to the mix would have only further complicated matters. 

I think the same will be key for you - finding someone who "gets" the urgent need of your situation, so I would also 2nd an earlier poster's recommendation to ask to speak to another social worker.  Don't be afraid to keep asking for the person next up the chain of command until you get someone who will listen to your story and is moved to help you. 

Best of luck to you as you navigate the often confusing maze of government-funded health care.  I will keep you in my prayers for swift resolution to these financial matters so you can get the care you need to live a healthy life!

Best regards,

Jennifer

Thanks for all the help!  I recently started working with a social worker from St joseph hospital which I think is helping the situation a lot.  She said that the Surgeon wrote a very strong letter stating the urgency of the surgery.  She also said that she will be contacting the department of social services on my behalf now and checking to see if they can move a little faster, but I will deffedntly be using the email you looked up for me!  Thanks so much.  It's so hard to figure things out on my own right now, just so much on my mind as I'm sure everyone knows.  I agree that having another stroke is not an option for me either, not when i know I can be helped   I know I'm very fortunate to have been diagnosed so fast after my strokes and have a good surgeon.  I just hate pushing my luck like this waiting.

Great news Katie.

Mark (Luca's Dad)