Zebra Files 37) Accessing Care

Accessing Care-Is anybody out there?

Deciding to seek answers, to research, to advocate for yourself, and relentlessly seek the better health I deserve is only part of the equation. In reality, those are only the things I can control, and there are plenty of things that I cannot.

I was successful in getting my hours reduced so my body isn’t being maxed out every day. The calming of my system, and lessening of demands has been incredible. The scariest of my symptoms have subsided significantly.

For example, sometimes when I walk up stairs, I’m just experiencing pain, rather than pain along with a variety of electrical symptoms compounded by a loss of functional control of my legs. This is a dramatic improvement.

The reduction in days I work will only last until the beginning of January. So getting the care that I need to enable me to go back to work full-time is urgent.

In reducing my hours, I also lost my private insurance, (which is actually for the best because it was costing me $260/month, and wasn’t paying for much of anything. As a matter of fact, having private insurance was preventing me from accessing care. Many places didn’t take my insurance, and the system will not allow me to use my Medicaid without billing the private insurance first.

So, my private insurance was gone- and that barrier no longer existed, except that it still did. Every system that I was in, my PCP, my physical therapy, ALL of it had to be changed.

Curious why everyone keeps going through the motions?
Break Free!

I recertified my Medicaid, and they assured me over the phone that they would remove the imperative to bill the other insurance first. That message didn’t do anything.

I couldn’t get my meds, because the pharmacy’s computer system instructed them to bill Cigna first, never mind that I no longer had it.

I couldn’t make Physical Therapy appointments for about a month, because they needed a new referral to use Medicaid, and it took several calls per week to get the referral sent.

This referral only covers my lower back. I’m on my own for the electrical symptoms in my arm.

Cigna required 6 weeks of PT before they would allow the MRI on my lower back. It took a lot of back and forth, but I was able to get the MRI before PT was even reestablished.

The MRI found that I have spinal stenosis and facet arthropathy. This is finally enough to get a referral to a pain center and a spine center.

After hours of trying to get through, I finally got an appointment with the Spine Center. The earliest available appointment is in July 2024. The pain center assured me that my referral is in the pile, but they just haven’t gotten to it yet- too bad for me.

I will keep calling.

And it’s a race. The deadline is looming. I have to have all of this handled before that beginning of January date, when they will expect my full-time return to work. I just don’t see any way that it’s possible.

But I keep trying. What else can I do?

These ideas are so much better Shared!!