Medicaid is amazing. We’ve been on Medicaid since April of 2020, just after I was laid-off due to the pandemic. Until I was on it, it was really just something I heard about in news stories — I had no idea of the actual experience of it.
On “Full Medicaid,” our family has paid zero dollars for medical treatments and prescription drugs, of which there have been quite a few. While finding a private practice that accepts Medicaid is tricky, especially in the “nicer” areas of town, the major hospital systems all accept it and for our purposes, it works. We just made sure our pediatrician and PCP all took the coverage and all is well.
Until this sore throat hit. When Dr. A, my PCP for years now, saw me for my initial visit back in May, the office made it clear that they did not take Medicaid patients. Dr. A made an exception for me since I had been a patient for so long, and I was only on Medicaid temporarily thanks to Covid. I believe he saw me pro-bono.
The real snag came when he said I should see an ENT for this nagging throat issue. My Medicaid plan requires a referral to see a specialist, and because he was not “in-network” with them, they would not accept his referral. I had to find a new primary care doctor. This was back in June of 2021, as the world was re-opening, and the Delta variant was wringing its hands in anticipation. Getting an appointment was going to take a while.
I could not get into my new PCP’s office until late September. Meanwhile I had been to urgent care three times for this throat and ear pain, hoping against hope that it was a simple infection.
Dr. B, as I’ll call her, finally saw me in September and gave me a referral to see an ENT right away. A few more weeks later, and I began seeing the ENT, who did not accept Medicaid. The nearest ENT I could find that took Medicaid was over an hour away, and I live in a major metropolitan area.
At the same time, I had returned to full-time employment, and reported my change in income/status to the state. Thinking they would drop my coverage since I was no longer in need, I purchased private insurance through the Obamacare marketplace. It would be another month and a half after that initial ENT visit before I could get the biopsy done to confirm my diagnosis.
All in all, it took over six months to finally figure out what was causing this literal pain in my neck. And since October the insurance mess has only gotten more tangled.
Let’s hope the next six months are far more productive and effective.