The Saga Continues
Continuing the updates provided by my previous post, Mrs. AP now has her prescription for her UTI — thank you Lily Lloyd for the offer to help! — and is scheduled for a D and C this morning. The number of complex maneuvers required to make this happen would make the Navy Blue Angels blanch. As I’ve not the time to draw the diagrams required for a proper demonstration I trust my list-making skills will suffice.
- Medicaid eligibility is determined in Florida by The Department of Children and Families (DCF)
- Medicaid coverage includes multiple sub-providers or plan names
- Medical service providers may accept one Medicaid plan to the exclusion of others
Follow me so far? Here’s what Mrs. AP did — while growing increasingly frustrated, suffering increasing pain, and fighting the fatigue her anemia triggers — to overcome the ridiculous failings of the current system.
- Call the pharmacy where we tried to fill her prescription Sunday night, learn the (not accepted) Medicaid plan was still in effect.
- Call Medicaid, sit on hold for 20 minutes before talking with 1 representative and then 1 manager to learn that the Pregnancy plan we need is active on the account but that the unaccepted sub-plan is still attached until November 1. Furthermore, the account is now marked for all benefits to expire October 31.
- Call the sub-plan provider to obtain a list of Obstetricians who will accept said sub-plan. Try not to yell at the representative who is surprised to find not a single office in the county. Obtain a list of the 3 closest offices, a respective 24, 33, and 56 miles from our house. Also be told that “most everybody accepts the prescription coverage, just not Walgreens.”
- Call the closest office to learn they only have Doctors and Mid-Wives available on Wednesdays.
- Call the next closest office, get an appointment scheduled at their closer office for mid-afternoon yesterday (Tuesday now).
- Call the closest non-Walgreens Pharmacy. Be told they no long accept the particular sub-plan.
- Call the next-closest Pharmacy, arrange for a transfer of prescription, to be available for pickup around noon.
- Call DCF to determine why coverage now expires on Halloween. Sit on hold for 30 minutes. Give up and give in to exhaustion; take a short nap.
Sadly, the affair does not end there. Our ex-roommate took Mrs. AP to pick up her prescription and to the appointment, where she was subjected to yet another vaginal ultrasound and a bevy of tests all to be told what we already knew; that she was pregnant, fetal growth stopped weeks ago, the pain and bleeding will only get worse, and that a D and C is needed — at a different hospital tomorrow (now today).
Mrs. AP walked in the door on the phone with a representative from the scheduling hospital. 30 minutes later the pre-surgery interview and instructions were complete, and Mrs. AP was on the phone leaving a message for her estranged and separated soon-to-be ex-husband to get him to commit to signing away Power of Attorney to Mrs. AP’s mother or myself during the course of the surgery. None of us want him having any influence on these proceedings.
Our concern, of course, is that Mrs. AP has a history of low hemoglobin levels due to her anemia. During her first and third deliveries she needed transfusions afterwards. During her second delivery she had transfusions before and after. While a D and C is considered a relatively routine procedure in the medical community, the fact remains that Mrs. AP is not a routine woman and must be handled with care. Yes, I’m worried, and feeling rather helpless because they’re naught I can do to help.
This entire ordeal has only served to elevate that feeling of helplessness. We have been failed by the inefficiencies present within the American Medical System. This entire business of hospitals and insurance companies operating to maximize profits instead of universal elevated levels of care is ridiculous. The fact that the same hospital that saw us Sunday night for Emergency Care cannot provide the necessary aftercare is a sad failing. The fact that the competent doctors with whom Mrs. AP has established histories are unavailable because of a dispute over acceptance of a sub-plan provider is absurd. The system is collapsing under it’s own weight, and those who don’t have the private equity means to evacuate will be trapped under the rubble. There is absolutely no reason that the most densely populated county in the state of Florida has a zero acceptance rate among Obstetricians for the most-issued Medicaid sub-plan. None. Anybody who has to rely on public transit in a situation such as ours would have no way to reach the necessary care prior to life-threatening situations.
It’s ironic that the same day we reached some semblance of a workable solution we heard Mitt Romney state during the Presidential Debate that under his medical plan he would eliminate Medicaid. Were that the case right how we would have no recourse but to let Mrs. AP start to bleed out, go into shock, and then call for an ambulance in the hopes that she could reach proper care in time. Such a situation seems absolutely inexcusable to me.
But enough soapbox preaching. In one hour I’ll be swapping out the last hour of my shift with my ex-roommate so that I can help Mrs. AP prep and we can make her appointment. We’re both going to be emotional wrecks throughout, and we’ll both be suffering physically. I’ll be exhausted from working all night, she’ll be hurting from the surgery and the aftereffects.
If you pray, work spells, work with energy, or ask for help from the universe, I ask you do so for us now. We’re going to need it.
I’ll keep you posted.
Stay SINful, friends.