Participant’s name has been changed to uphold anonymity of personal identity.
A mother of seven, Lauren shares how important Medicaid health coverage has been for her family. Three of her children receive Medicaid benefits, one of who has autism.
“It has allowed us to not worry about the additional financial responsibilities of having a child with special needs with outrageous medical bills. They aren’t the easiest to work with, but the program itself has relieved the stress of extensive medical bills and been a blessing to our family.”
Lauren has found the paperwork process to be slow and difficult. She explains it is “just frustrating the red tape parents have to work through to keep their services, rates correct, etc.”
Lauren also notes that there are some therapies that are beneficial to her son with special needs that are not covered by Medicaid. Chiropractor services and alternative therapies, for example, do not tend to be covered under Medicaid.
When asked about the hopes Lauren has for her family she shares, “That they would be a contributing member to our community serving and using their talents and resources to better our community. To be as healthy as possible.”
Her oldest, 18, is a budding entrepreneur. “He’s putting himself through college right now. If there’s a way to make money doing something, he’ll find a way to do it.” The rest of her children play sports, do ballet, babysit kids in the community, and serve in their church. They are a busy family who is grateful for the services they receive through Medicaid, albeit a less than flawless process.
Sudip is an international graduate student currently pursuing a Ph.D. He and his family receive health insurance through Medicaid. He shares “it’s been really helpful, everything has been almost free of cost. This year I took my son to his first dental visit and that was really helpful.”
Sudip’s wife had experienced some health issues over the last few years. When she became pregnant, she was able to apply and was approved for Medicaid. “My wife didn’t have insurance for a while. It was very difficult for her, with Medicaid it’s a peace of mind. We were able to get some financial assistance, didn’t have to pay that much [out of pocket], and they encouraged us to get other insurance.”
When asked what he would like to see improved in the system, Sudip shares he had some difficulties with the renewal process.
“In the beginning, I was approved right away. For the second time I was denied a couple times, but other than that [I’ve had] positive experiences.”
Sudip plans to finish his Ph.D. in northwest Arkansas. Upon graduation, he hopes to be able to spend more time with his family and to continue educating the next generation of academia.
Amy, the mother of a 14-year-old autistic son, has had a far from perfect experience since her son’s transition from Medicaid-TEFRA to Summit Medicaid-PASSE. “ When he switched to Summit, they denied all my son’s medication, and I have to pay out of pocket to provide continuity of care.” In addition, due to Amy’s son’s aggressive behavior, he has been on vital and costly antipsychotic mood-stabilizing medication such as Geodon for the past five years. Amy stated, “ Summit does not want to cover his medication; however, he can not go to school without it. As a result, I have to fight every six months with health insurance to get prescriptions through Summit on time and to prevent my son from running out of medication.”
Previously, Amy had TEFRA-Medicaid for her son. Amy stated that she was paying 108.00 dollars monthly and about 50 dollars when he needed to see a specialist. The problem, Amy said, “ Is that most providers and doctors are refusing to take her 6ft and 180-pound child that slaps people when he does not get his way.” As a result, services have decided to no longer treat him based on his behaviors. Amy says, “ I don’t understand when he is there for aggressive behaviors.” Unfortunately, her son’s therapy has been impacted due to the insurance discrepancies and his aggressive behavior. “All PASSEs should be able to have enough ABA, SPEECH, PT providers under their umbrella and be able to provide for children that struggle with behavioral issues.” Due to this, her son has not had any therapeutic services in over four years. As a result, Amy has attempted to submit and gain a spot for a DDS waiver.
Amy placed her son on the waiting list for the DDS waiver when he was three years old. “Recently, legislation approved 600 slots for the waiver, which helped us move from number 3,800 to 2,860 but, that doesn’t help because it seems that you get more help from providers with a DDS waiver because the providers will get paid.”
However, Amy stated, “by the time we found out about the open slots, he no longer qualified for the DDS Waiver anymore.”
Amy voiced that she chose Summit because someone referred her by saying they were the best PASSE option. However, during the individual assessment, individuals are tiered into different categories based on behavior. For example, individuals assigned to Tier 3 receive more intensive services than those assigned to Tier 1 and Tier 2. “I understand the rationale, but I don’t think the PASSE system works.” Although she likes her care coordinator, Amy stated that she believes they are used as a middle man and make it more difficult to get services for family members.
Medicaid has been extremely helpful for BW who is a current undergraduate social work student and a new mother. BW became eligible for Medicaid services when she found out she was pregnant with her son. “It has helped us tremendously as far as paying all medical costs and providing transportation when I was pregnant. I absolutely love it.” Medicaid has been a saving grace for BW and her son when they’ve needed to receive medical attention. “I have always went to the doctors when needed… They have taken care of me and my baby.”
BW says there have been some administrative difficulties with Medicaid “The hardest part was applying for it. It was a lot of paperwork.” Also, sometimes Medicaid doesn’t pay for her family’s bills in full, causing BW to incur charges and fees.
“I have received a few bills that Medicaid did not cover.”
BW is thankful for Medicaid coverage for her family. She will be completing her undergraduate degree in May of next year. BW’s hopes are to continue on in the field of social work and attain her master’s degree.
KT is currently on Medicaid and is seven months pregnant with her second child. Her first child is on Medicaid and has developmental issues due to being born exceptionally early and weighing one pound. KT remembers being on Medicaid all of her life and has never had private insurance. KT states, “I like being on Medicaid if I need anything like medicine. It’s free or a dollar. They help me out with my records and make sure that I am okay.” While she is pregnant, KT admits that Medicaid has been good because she feels that she receives the adequate attention needed during her pregnancy.
KT states, “while on Medicaid, they do more check-ups and run more tests on me. They let me know what I need to do or if I need more water. They tell me what’s going on.” Her daughter is also able to receive therapy and other treatment through her daycare and pediatric appointments.
“Medicaid has been good with my daughter and her development. When she was little she was in the NICU, and her lungs and stuff got better. Medicaid covered while she was in the NICU and I don’t have to pay for the doctors’ bills,”
Due to her having a past and present high-risk pregnancy and currently having outpatient counseling services, KT feels that the physicians and therapists care and look out for her more while under Medicaid insurance.
Maria has had Medicaid coverage for her daughter since she was born. Medicaid has covered her daughter’s check-ups, eye exams, and other preventative care. It has also been helpful when her daughter required intensive emergency care.
“In 2015, we had an accident and she had to have several surgeries.”
Maria shares that Medicaid paid for her daughter’s surgeries and medications. The out-of-pocket cost for her daughter’s care would have been unrealistic for her family. “I paid the minimum, I think it was $10 for the visits.”
A catastrophic event like a car accident can put any family in a financial crisis. Maria says “we have been lucky.” Her daughter is now fully recovered and living a full and happy life. Maria is grateful for the support her family received during their moment of crisis and hopes that others in similar situations are able to have the peace of mind Medicaid afforded to her family.
MD previously received Medicaid coverage. She utilized the program before and after she was enrolled in trade school for carpentry. Medicaid helped her to make sure her children had the medical care they needed. “I had no employment or money after finishing trade school and if one of my children became ill, I would not have been able to pay out of pocket expenses.” Medicaid ensured that MD did not have any medical bills when her family needed medical services. The expenses saved were used for other necessities for her household. MD is now working and able to provide for herself without the use of Medicaid.
MD does believe that there is a stigma associated with Medicaid use which has resulted in being treated differently by the health system.
“I have been treated unfairly because I feel doctors treat you differently if you have Medicaid, especially if you are Black. I feel you are seen as uneducated.”
Thaddeus is grateful for the services he has received through Medicaid over the past 3 years. “It actually helped save my life, me and my daughter.” Recently, Thaddeus and his 11-year-old daughter were hit by a distracted driver and taken to the ER. They were able to get every health service they needed through Medicaid. Today they are both healthy and well.
Thaddeus shares that getting medication for his family has never been a problem once he enrolled in Medicaid.
“There’s not a whole lot of hassle. You’re in and out. I have custody of my daughter and it makes it easy for me.”
Medicaid insurance has covered health services that his private insurance did not and Thaddeus is grateful to have this extra support for his family.
DD is a 68-year-old single grandmother with legal guardianship of an 11-year-old grandson and 9-year-old granddaughter. Medicaid has been a blessing due to having limited retirement funds. DD thankfully has Medicaid and Medicare coverage for herself and her grandchildren have ArKids Medicaid.
Recently DD’s grandson suffered from a traumatic brain injury due to a car accident. “Medicaid paid everything for the six weeks he was at Arkansas Children’s Hospital, including surgeries and after-care therapies.” Also, DD’s granddaughter broke her thumb at school this year and received immediate and quality health. DD also has metastatic breast cancer, and her treatments are possible with no out-of-pocket expense thanks to Medicaid.
“We are so thankful to be able to get medical care with Medicaid’s assistance.”