The Daily Minutiae: Medical Assistance Denial

Earlier this week, we received a letter of denial for medical assistance.

We hit our primary insurance out of pocket maximum at the end of March. In that regard, we’re pretty lucky to have the insurance we have. However, our insurance will only cover 30 sessions of occupational therapy, which Love Bug attends once a week on her doctor’s recommendation. Seeing as there are 52 weeks in a year, well…you do the math. We applied for supplemental insurance to get us those extra sessions, and to see that status say DENIED with no explanation whatsoever…it kind of temporarily broke me.

scarcam

I’m not too proud to admit I spent the better part of 20 minutes sobbing on the bathroom floor once everyone was asleep later that night. I’ve been pretty good at rolling with multiple punches coming my way (oh, our dishwasher is not only broken, but has been leaking into the kitchen subfloor/basement ceiling for who knows how long, and we have a $1000 deductible? Meh, it happens. Oh, we’re going to be weed-whacking on the front lawn, and randomly kick up the smallest pebble in such a way that it hits and subsequently shatters the entirety of our glass storm door? OK, well, it could have been worse) but when those punches directly impact my little girl, I tend to lose my mind.

On any given day, as parents, we have to stay strong in the face of a myriad of adversities, but we all have our breaking points, and this was mine.

The following day, I called and called and called our local Department of Human Services, only to be told “All our representatives are busy helping other callers. Your call is important to us. Please call back at another time” (what. even.) 38 times (yes, really) over the course of an hour and a half, crying softly out of sheer helplessness and desperation in the corner on our dining room floor. Love Bug, who was watching Sesame Street in the other room, checked on me periodically, asking “What’s goin’ on, Momma? What’s goin’ on?”

Eventually, she figured out that if she climbed on top of me (as I’m crying on the phone to an automated service) she could see out our dining room window, and boy did she love that view. As she described to me the people walking and the trash trucks and the school buses and the dogs and bunnies and squirrels she saw, I finally got through to someone.

It turns out, our case was mishandled (which, frankly, I find unsurprising) and shouldn’t have been denied in the first place. So, they’re reviewing it again, and hopefully we’ll have better results this time around. I think the reason the denial was so world-shattering was because all along the way, as we’ve slogged through this process, we’ve been told that it’s a given that we’d be approved for medical assistance. Our social worker, our therapist, and the representative who helped me at the state level when I discovered the county level was completely inept all agreed immediately that we absolutely should not have been denied. So there’s some reassurance in that solidarity, but I won’t be relieved until we get the actual approval notice.

we three

Even in this blindingly stressful situation (as I’m hyperventilating to myself about how on earth we could possibly continue to pay for her therapy out of pocket at $459 a pop) I can take away a moment of light: I have the memory of a two-and-a-half-year-old yelling at me to “Go sit in the corner!” once everything was resolved, so she could continue to climb on top of me and see out the window.

The kid is alright. And most of the time, so am I.

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