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LEHIGH VALLEY WEATHER

M is for mess

It’s amusing most of our healthcare options start with the letter M. And appropriately so, because much of it is a convoluted mess!

It has been this way for at least as long as I’ve been alive, or at least since I was in preschool. That is when my adopted father died, leaving his wife a new single mother with two young children.

In college, I took a class in human resources. One of the units covered healthcare. I had no idea the mess this would uncover. One day in class, my professor was going over Medicaid benefits. He explained that the minor children of widows and widowers who receive Social Security are eligible for Medicaid.

My mouth dropped open. My widowed mother paid out of pocket for Blue Cross coverage for me and my sister. For over 20 years!

Before I could recover from the shock and speak, a woman at the front of the room burst out of her seat. She was irate. She had been widowed a few years earlier and had a young son. Like my mother, she paid out of pocket for their healthcare.

It seems when you applied for Social Security for yourself and your kids after the death of a spouse, no one at the Social Security office bothered to explain Medicaid eligibility. This is a complete failure. Who expects someone who has just lost a spouse to understand all the options?

Further complicating matters, Medicaid, aka Medical Assistance, is managed at a state and county level. Social Security is managed at a federal level. This is akin to getting three people who speak different languages to communicate with each other.

Recently, I had to reapply for medical assistance. Since our income changed, I had not renewed, thinking James’ coverage was intact because of his ADHD diagnosis. I was unpleasantly surprised to discover that information was missing from our file. Once everything was resubmitted, Erick, my oldest son, was denied. Try explaining formulas to a 20-year-old who didn’t study human resources.

Even as I worked on this column, I received another notice that now the county wants more confirmation of James’ needs. And from what a state worker told me, every parent of a child with special needs, regardless of income, must go through this process. Multiple times. Conventional healthcare, be it major medical or marketplace, will not cover these services. Even so, each year I have fill out forms that go to my health insurance, knowing it is strictly a formality, and they will be rejected.

Someone must be making a fortune on all this paperwork.

Back when I was in college, I thought about going for a master’s degree in economics and planned to start with further exploring the cost of not insuring those children of widows through omission. Now I think this is merely going to be one chapter in a larger book.

By the way, Medicaid, you owe my mother a lot of money. Single motherhood is tough, and no one should be making it more difficult than it already is.

Lani Goins