Yesterday I kind of lost it, and it all started Friday when the mail came.
Let me back up a few weeks back first...

A few weeks back, my husband and I finally had the chance to make the official change of address on our identifications and our insurance. Somewhere in that process, the state, county, insurance company, I don't really know who, realized that we do not make enough money to be able to afford our own health insurance, so my husband, and only my husband, was put on Medicaid without ever applying for it. Friday he received his notice and Saturday, his card.

We both believe in earning the things that we have, but in this past year plus, I have not been able to work due to recovering from surgery which led to CRPS going out of control, and so our savings is pretty much gone. Right now I am at the point that if the state decided that they wanted to step in and help us at a time that we really need it, I would. After all, that is why it is there and one of the reasons why a certain percentage has been taken out of our paychecks every week for our entire working lives.

Here is where I have a problem. Our insurance is in my husbands name. According to the person I spoke with yesterday, I would have to apply for my own policy, a policy separate from the one that I am on now. Until then, I will continue on the policy I am on. She was not sure how co-pays and such would carry over. She did not know if I would have to get new referrals, or if old ones would seamlessly carry on to the new policy. She could not tell me if there would be any more delays in the process of getting ready to go in for the SCS trial... Basically, she didn't have many answers for too many of my questions.

We are both fed up and frustrated. I am tired of not being able to do much of anything and being in constant unbearable pain every day. My husband is tired of seeing me in that much pain every day and having to take over doing the things that I can no longer do. We have been looking for a doctor that we can work with and very recently found one that has a treatment plan that we are agreeing on. We really do not want any further delays in a treatment that may lower the pain to bearable levels and get me back on my feet again, but it seems like we were given yet another obstacle in the way of that. An obstacle that I can not find any answers on getting around. I don't want to see an opportunity pass by that would help my husband out immensely, but neither of us want any more delays.

So, what do we do? Do we decline my husband's chance at Medicaid. Do we pass up on perhaps one of his only chances at getting a hearing aid, a chance at getting his teeth fixed which needed to be done years ago? Pass up on those opportunities because of our desperate desire to possibly lower my pain levels earlier instead of later?

Wow. What a great couple you two are! And I mean that sincerely. The fact that you desire the best for each of you as individuals says a great deal about your character. It is absolutely beautiful to see two people equally concerned about the needs of the other! Here are some thoughts that immediately come to mind:

1. There is an 80% chance that your pain levels will go down with a SCS. The percentages for your husband's teeth and hearing improving with his procedures are probably at least that. So playing the percentage game here may not be helpful.

2. Can Medicaid be applied for after your procedures are completed? Probably not (Am I correct), since your husband has already received his card. So, what are the options concerning the current insurance? Is it able to be kept as a secondary insurance?

3. What is the earliest time that you could get your SCS trial started? That way you would have two coverages for a short period of time, if the current insurance can't be kept long term..

4. Thinking long term--Maybe you could be on insurance and Medicaid at the same time with the Future insurance that you would apply for being a secondary insurance to Medicaid. Many people have a secondary insurance, since Medicaid only covers 80% of an individuals needs. Without a secondary insurance those costs come out of pocket.

5. Is it possible to keep your current insurance until your procedure is over and then get the insurance under your name afterward?

In my very unprofessional opinion there are questions to be answered which may ultimately lead you in the direction that you and your husband will go. I'm sure that there are other thoughts as well that I haven't come up with. Members of this site have exceptional insight. It will be interesting to read what they have to say.

PurpleFoot, beyond a doubt, you and your husband have a great relationship. That is a fact. I hope and pray that as the answers to this dilemma unfold that it draws you even closer together. I wish you well.

-Spike-

Hi Alaina,

Boy this does complicate things. Medicaid issues can be complex. You can't have two primary insurances at the same time so whatever you do the companies will coordinate stop/start dates.

I'm wondering if the premium assistance marketplace option might be a possibility. It looks like something that could work. I'm assuming all choice is not lost in the matter and if your husband chooses to go with that he could.

I'm attaching two articles that my be helpful.

http://kff.org/medicaid/fact-sheet/m...n-in-michigan/

https://www.macpac.gov/wp-content/up...nce-Market.pdf

Sorry you're having to deal with this right when you got settled on a plan. That is terribly frustrating. I hope the solution makes itself clear soon and both of you are able to get what you need.

Insurance issues have become so complicated lately and I can barely wrap my head around the complex nature of your current situation. Sounds like there are still a bunch of unanswered questions too that I hope you can get the answers to. At the end of the day...if you end up having to choose between his medical needs and yours (which is just a horrible situation to be in) you are going to have to make hard choices about what can be put off and delayed...and what cannot. If you cannot risk delaying the SCS trial and messing with that treatment plan after finally finding a dr you can work with then that may be a priority. If you feel you can wait and that your husband's needs are more pressing...then go ahead with the medicaid. Not a choice you should have to make and I hope that you are able to get it all sorted. Thinking of you.

Alaina,
I'm not sure I understand. Your husband is now on Medicaid. Are you still covered by your old policy? If so can you keep that coverage or do you have to change right now?

You are correct that you two have paid into the system and the purpose of that is if someone becomes disabled. You have evey right to take advantage of a benefit that you and your husband have basically purchased.

I don't feel that I have enough info to figure out the next step, but there must be a way that you can both get your needs met. If you want write bach with more info. ~mac

After spending the entire day on the phone, researching, and eventually just feeling completely defeated, we apparently have one of a few choices. We have been on a plan from the Marketplace since my husband is self-employed, and the company I work for only has 4 employees so we let our insurance program go back in 2008. My husband's company still has not fully recovered from the economic problems a few years back, but with my income, we have been able to get by.

We have a few options, of which, none of them are really all that good. We can both go on Medicaid, where I will have a tough time getting the care that is needed. It's not that I can not receive the care, I will just have to fight a lot harder for it. We can pay the full price for a plan without any tax credits applied, which unfortunately is not an option due to our finances. The last option is that my husband will go on Medicaid, and I will re-apply for a plan at full price. If that last choice is actually an option will take a few more phone calls later on tomorrow. The way things were explained to me earlier today were a little confusing and need some more clarification before we can make a choice as to what we will do. It was explained to me that because our taxes are filed jointly, we both would have to purchase a plan, or both go on Medicaid. That doesn't make a lot of sense to me, so tomorrow I will call the marketplace to see if I can get some real answers.

I know so little when it comes to insurance. It can be so frustrating trying to figure all of this out when it was thrown at us out of no-where.

PurpleFoot
Okay so it deleted my entire statement....nice
I just wanted to let you know we are well here for you!!! I started with no insurance for the entire first year having Crps....then finally qualified for state insurance.....and they Wil cover all the narcotics I need but the Lidocaine patches that are NON narcotic and worked so well weren't covered because I didn't have "Post Herpatic Neuropathy" which is what the "package recommendations"......grrrrrrrr
We, unfortunately, I think all having our ludicrously convoluted and insanity provoking insurance nightmares in our dealings with Crps! I'm sorry it happened to you too! Try and stay calm and breathe deeply. I had to seriously retrain myself in how I react to stressful situations because whenever I get really stressed or emotional it makes my crps worse!
And remember....we are here whenever you need to vent!!

I would make calls to insurance companies, there should be someone to help u figure this out, we did this and didn't pay anything, marketplace pays them. A licensed insurance agent for health insurance is best plan of action I do believe. Good luck

Geez, Purplefoot that's like running a marathon for us! You must be worn out.

I know that was taxing but it sounds like a very productive couple of days. It's great to have all that behind you and be moving forward. You're making good progress. That alone can really give one a lot of hope. I always feel better myself when there is a plan and movement being made.

Be extra good to yourself this weekend and let that foot warm back up. That was quite a bit to go through. I hope you recover soon and the momentum keeps going.

Sending warm hugs,

Oh Purple
....
I do know your frustrations!! It's always lovely when no one can assist you with questions or problems AFTER you've paid and been on a policy that could be changing..... I qualify for 100% free medical from the "state" BUT they have control over what medications and treatments you're able to have access to. Like how they'll cover Narcotic meds but not Lidocaine Patches since I don't have "post-herpatic neuropathy...or how I can't get the compound pill only made by one pharmacy in town that isn't covered but IS only about $40 a month......but if I pay for it myself I'll lose my insurance.....ugh
HOWEVER...it's still better than being without any insurance at all with Crps which I had to do almost the entire first year I was dealing with Crps.....
Try to breathe deeply and let go for now. Unless you get a supervisor or something else to figure out what you need....
I had to SERIOUSLY change my reaction to stressful things because it would only serve to worsen my Crps.....ugh it is honestly "getting in my nerves"" ..grr
There are a LOT of more knowledgeable people here who might be able to help you more but I am here for you too! We all are! Let us know if you need support!!