Wednesday, August 24, 2011

My baby has health care!

Being a mom you want the best for your kid. You want to see them thrive and you want them to have medical coverage that will take care of all their needs. You want it to be top notch, what one might expect of healthcare in the USA and western society. This has not happened for my daughter in the state of Texas until very recently. We moved here when Sweetpea was 5 1/2 months old, she was on Medicaid in WA and we thought transferring it over to TX would be fairly easy. Oh boy, were we wrong, it has been one of the biggest red tape headaches I have ever experienced to date.



I don't actually blame this on Texas, like any other state Texas is working within the guidelines of a F#%&ed system. Unlike WA their are two kinds of freeish healthcare here, what I like to call healthcare for the poor, Medicaid, and health care for the kind of poor, CHIP. When we first moved here with our income, we were considered part of the poor, after an unexpected job change and supposedly making more money, (supposed because a lot of daddy's income goes to all the benefits for working for the city so we actually get less each month), we are now a part of the kind of poor. With keeping the class system in its solid place we had to switch over our babies healthcare.


At the beginning I thought CHIP was a part of Medicaid. I filled out a CHIP application and got Medicaid info in the mail. 3 conversations later with various operators, all nice people that I waited for 20 min. to talk too, I found out CHIP was a different program and Sweetpea would not be eligible because of the before mentioned income requirement and also because she was under age. No where did it say on the website you can only get CHIP after you are 1. The unfortunate part is in the meantime when I thought CHIP was Medicaid I found a doctor I liked who only takes CHIP. Feeling defeated I tried in vain to find a good doctor that takes Medicaid. Moving to a new state, not knowing any other moms on Medicaid, my options were slim. I even consulted the Internet to find a good doctor. There were reviews but most of them were for specialty pediatricians and were hard to get in touch with. Finally after holding off for too long, Medicaid assigned me a pediatrician and health plan. They also told me I could change it at anytime, great, still not the doctor I wanted.


With the advent of daddy's new job my CHIP dreams looked like they might come true after all. This is also around the same time I got a renewal notice from Medicaid saying if I did not fill it out in 5 days time I would not have Medicaid coverage. Perfect, I thought I want CHIP. I filled out the application once again, this time giving it to daddy to fax into the requested office. 2 weeks pass, again we are denied, Sweetpea is too young still.



I think, I am screwed, no CHIP and now no Medicaid, we still have yet to use Medicaid, but knowing it is there in case of emergency had been helpful. I call Medicaid. They explain to me they actually “just say 5 days to scare people into filling it out,” we got this form 2 months after my daughter got Medicaid, so only a two month break from paperwork, grrrrr. They tell me I have to fill it out again to have them officially deny me, then sign me up for CHIP. I fill out the form I think for the 4th time in the 5 months we have lived here. We wait; we get a letter saying our Medicaid will end. More waiting, then the letter today, a day of waiting to hear from a job after a second interview, my baby has CHIP!


My fingers tremble as I pay the fee online to get things started up and finally choose the plan I want and the doctor we picked out, the doctor we are aligned with in values, who has a small practice and is a mother herself. I am crying, things are finally working out in my favor, the stress of the last 5 months and not having the healthcare we want for Sweetpea is melting away. After getting her all signed up they tell me on the phone her coverage will not begin until October. A letter should come in the next week telling us the exact date. Sweetpea will be 13 months old and will be having her first check up sense we moved here. 5 1/2 months to 13months with no check ups, no updated vaccines and thankfully very little sickness.


To those of you who are used to having regular healthcare you may be appalled by this, why didn't we just go with a Medicaid doctor and get her all up to date? Well, we have tried, recently and we will continue to try until CHIP comes through. With the possibility of me working full time, childcare outside our home is in our eminent future. In order for Sweetpea to attend day care she needs everything to be up to date with her healthcare. The incentive is there, it’s just that the doctor they assigned us has been out of his office for a week now. This is a man we have never met, who doesn't seem to keep any regular office hours, school just started here it would be odd for him to be on vacation. I have called twice and still not even a call back.


The doctor we chose gave us a free half hour consultation; her practice is small and has a special room for sick kids. She is open to a longer vaccination schedule, she answered all of our questions and looked us directly in the eye. Her office said, I want you here. Isn't that what we all want for our kids? This is also why we were holding out. We had had a bad experience in Olympia when Sweetpea was sick and we had to see a substitute. We knew how bad it could be to have a doctor taking care of your baby that you don't trust.


The fact is most of these doctors for the poor are overworked, and run huge practices that look more like factory farms. I don't know the back ground story of why so few good doctors seem to accept CHIP and Medicaid but I do know it really sucks that I can't get my Medicaid doctor to answer the phone when I need my baby to have a wellness check up before she starts daycare.


This is not meant to just be a rant, although it could be. This is the state of healthcare in the USA. This is what makes me want to be a healthcare activist. I was put off my parents insurance when I turned 18; I have had health insurance for 3 years of my adult life. Once when I had a full time job that actually paid for it and once when I was pregnant and for 4 months of my post partum. Thankfully there were great cheap clinics in Seattle for all the times I got the flu or needed something checked out. What about now? I am a mother without health insurance because my family can't afford it until I get steady work outside the home, which will hopefully cover my babies childcare, groceries and then maybe health insurance? We shall see.....

For now Sweetpea has her doctor, we just need to hold out till October.

1 comment:

  1. Thanks for sharing your experience. Have you checked out Central Family Practice? (http://www.centralfamily.com/)

    I don't have any experience with them but they seem to be a cool integrative health clinic.

    From the first line of their mission statement:

    "Central Family Practice began in 1998, right here in Austin. We're a local, practitioner-owned clinic determined to provide low cost health care to all, particularly those with little or no insurance."

    Might be a good fit for you and the papa, if nothing else.

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