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medicaid (Read 5108 times)
katieSD
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medicaid
Jul 22nd, 2010 at 11:29pm
 
I am newly diagnoised with moyamoya.  My surgen (Dr Nussbam in st Paul) said it's extremly important I have my bypass sugery in the next month.  I don't have insurance, so I filled out my medicade application a little under a month ago.  I'm wondering if anyone has had luck with medicade covering sugery?  I'm slightly worried becuase in SD we have to prove disabled to qaulify.  I've had four small strokes but the only thing it's seems to affected so far is my spelling.  Has anyone had luck getting declared handicap without a "catastrophic" storke?  I am hoping a lack of blood and oxygen is enough to qulify me.  I'm also hoping my EEG results that show "low brain wave activity on the left side" will also help?  I can't be outside for more than an hour in the heat and things like that.  But the state worker said she thought it would be a strech to qulify becuase I'm walking and talking.
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amy
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Re: medicaid
Reply #1 - Jul 23rd, 2010 at 7:16pm
 
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
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Meg
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Re: medicaid
Reply #2 - Jul 26th, 2010 at 12:24am
 
I was able to be on Medicaid disability, without ever having had a stroke. I think you should try & talk to a different worker. Hopefully a different worker would realize how much of a risk MM is. Yes you are walking and talking, but I was once told that having MM is like having a ticking bomb in your head. The fact that you have had 4 strokes should prove to them just how disabling this disease can be. It's a miracle that none of them were catastrophic.
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yunnanababy
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Indianapolis, IN USA
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Re: medicaid
Reply #3 - Jul 26th, 2010 at 1:46pm
 
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

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Mom to an 9.5 y/o ballerina/guitar player with MMD & an 11.5 y/o gymnast/cross country runner/swimmer!
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amy
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Re: medicaid
Reply #4 - Jul 26th, 2010 at 3:23pm
 
thanks
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katieSD
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Re: medicaid
Reply #5 - Jul 26th, 2010 at 8:31pm
 
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 Smiley  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.
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katieSD
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Aberdeen, SD
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Re: medicaid
Reply #6 - Jul 30th, 2010 at 12:16am
 
Just an update!  I've been approved Smiley  thanks to the help of my U.S. Senetor who's eye I caught with a newspaper article the local paper had written up about my story.
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Little Luca
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Re: medicaid
Reply #7 - Jul 30th, 2010 at 2:15am
 
Great news Katie.

Mark (Luca's Dad)
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1st stroke in September 2008
Bi-lateral mm diagnosis
2nd stroke in November 2008
Left side surgery in December 2008
Doing just great!
 
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