A Day at the Medicaid Office

On Monday I had to leave work early to see about getting my mother re-certified for Medicaid. She’s in a rehab center while her broken ankle heals. Medicare covers 20 days in rehab but she’s in some insurance HMO plan that sucks out the Medicare money and doles it out the way they want to. For some things it’s better than Medicare. But for others it’s not. This, for instance. Instead of covering 20 days in rehab, it covers ten. She’s on day seven. After that I have to start shelling out one hundred bucks a day to keep my mother there. That’s why I’m driving to the Medicaid office instead of sitting in yet another meeting at my school.

During my lunch break I had called the SSI office. A message told me I was “caller number twenty in queue.” I finally got to a human, but he managed to cut me off. So I dialed again and in only fifteen minutes I had another human.

“Please don’t cut me off,” I said to him. “It takes way too long to get to a human.” He promised he wouldn’t.

I told him my story: my mom had been on Medicaid 18 months ago, the last time she was in the rehab center. I explained that when she got better we put her in a private pay facility because there were no long-term Medicaid beds available. But now she was back in rehab and we needed the Medicaid again.

He transferred me to someone else and I got a voicemail. She didn’t call me back. So a few hours later I leave work and call her again. Lo and behold, she answers. In my utter naivete I was sure that this was something that could be done by phone or online. Wrong. I am required to go to the office and fill out an application in person.

As I drive to the office, I wonder how this would get done if I were not here to do it – or if I had the kind of job where I couldn’t leave to go take care of my mother’s medical problems. Or what if I was sick myself, or disabled? This is how people’s live spiral out of control, how they go bankrupt, how they die forgotten and alone.

The Social Security Administration building in Charlotte is an imposing brick building not far from uptown. As you approach the entrance, you join the huddled masses yearning for healthcare. Most of the people milling about are minorities. According to a Healthcare Forum I went to recently, 35 percent of African Americans are without health insurance. I don't know what the figures are for Hispanics. For whites, it's 6 percent. But I've been part of that 6 percent. I know what it feels like to simply decide you can't get sick. Many of the people here are women. They have children or they are pregnant or both. I wonder why so many Americans are poor. Why aren’t there enough jobs for us? What happened to the idea of affordable childcare?

I go inside and a woman at the information desk gives me some form to fill out. No pen, but I’ve got my own. I find a little desk and fill out the form, then I go stand in a line. When I get to the front of the line I have to sign a piece of paper. Then go sit in another area and wait. Hmm, I think. Okay, maybe this is what the crazy “keep your government hands off my healthcare” screamers are picturing. I know it doesn’t have to be this way. Government manages to do a lot of things pretty damn well. Education, road building, libraries, policing, fire fighting. But maybe this sucks because it’s for poor people. Maybe if it was for everybody they’d get more efficient. Then again, maybe it would be like the DMV. Whatever. No one should die or go broke so that Insurance CEOs can wipe their butts with hundred dollar bills.

This place has kind of a festive air about it. I watch a preteen girl herding her younger siblings; a dad and his severely disabled son; a lean, athletic young black man in a wheelchair with his hands in bandages. Everyone has a story. After an hour of sitting I’m still wondering what about this whole experience couldn’t be done online or by phone. A couple minutes before five, just before the place closes, a case worker leads me back into the warren of cubicles for an interview. The cubicles are small; the walls brown. I sit down in a plastic chair and stare at a line of screws sticking out of the wall.

The case worker, a strapping bald man, seems like a really nice guy but I’m remembering a guy I knew who worked for social security in another town and who had a predilection for smoking pot and exposing himself to teenage girls. Whatever this particular guy does in his spare time, he seems perfectly willing to approve my mother’s application.

There’s just one problem. I’d forgotten that when you get on Medicaid, they take your social security check and leave you thirty bucks a month for spending money.

“But . . .but . . .how will we pay for her room at the assisted living place?” I ask. “Her social security check pays for a good chunk of the rent. Then my brothers and I make up the difference.”

“My hands are tied,” he says with a shrug.

Tears start marching down my tear ducts for a general meeting just under my eyelids. Words of doom and desperation swirl around my brain pan.

“But . . . but . . .” I begin again. “She’s only supposed to need rehab for a couple of weeks and if she loses her place, then where will she go?”

“I understand,” he says. “Some people have mortgages and they have to choose between their homes and their healthcare.”

This makes me feel so much better.

“It’s not going to work,” I tell him, trying to keep the whine out of my voice. We continue with the application.

Like a rat backed into a corner, my brain begins scurrying around the problem as I wait for him to print out the forms. What can I do? Will I need to yank her out of rehab? Surely the assisted living place won’t take her back in this shape. She can’t put any weight on her right foot. She needs so much help getting off and on the toilet, getting in and out of the bed. Will I need to go over to her place and move all her stuff out? Money for movers, money for storage. What will I do about that albatross of a bed she has? Is it time for her to move in with me? Will my new roommate be willing to help me out with her? Is she moves in with me, will I ever get any work done again? Will I ever be able to travel? What about sleeping? She needs a lot of care. A lot. And how can I get her in and out of my house without a ramp? What about bathing her with no shower downstairs?

Finally, I stop. I realize I can’t make any decisions without more information. Tomorrow, Scarlett. We’ll figure this out tomorrow.