With all the last-minute travel for family over the past few months and Dan being ineligible for financial aid for the spring semester, we have needed to conserve our cash since our arrival in the U.S. As such, we have been dabbling in our country's wonderful government aid programs. As soon as I arrived in Ohio, I researched Medicaid and the application process for Ohio. I was pretty pleased that they made the application form and many other great resources available on the web. This allowed me to gather the appropriate documentation, construct a good application and get approved almost immediately. Penny took the regular amount of time. I made sure to see a doctor that took both our medical insurance (which wouldn't have covered the full cost of a pregnancy and delivery) and Medicaid. These folks happened to be the medical practice linked to the book distribution company my mom worked for. They were awesome and didn't even begin billing until I had my Medicaid card in hand.
The Medicaid folks referred me to WIC as well. I learned that WIC is not food stamps. WIC is a program that provides coupons for food to supplement the diets of kids under age 5 and pregnant women, so Penny and I qualified. The goal is to reach people at risk of having bad nutrition if they don't have help. After four hours in a waiting room filled with children and signs saying "No food or drink permitted" (and guards enforcing the rule), I walked away with a little fistful of coupons. The coupons are REALLY specific - certain brands of whole grain breads, certain names of cereals (not brands, specific boxes), a certain size of formula can, certain brands of juice, etc. The specificity of the coupons made grocery shopping a bit tedious and tricky. You don't get "change" on a WIC coupon. If I buy a 32oz bottle of juice and the coupon was for 64oz, then I just don't get as much juice this month. The store was tricky and would stick little "WIC approved" stickers on the smaller bottles of juice and always the cheapest approved brand (so they're losing $2.50 on Juicy Juice instead of $3.50 on Welch's). Once on WIC, you are required to go in for periodic check-ups where they weigh everyone, check blood iron levels and generally see how you are doing. Goody, more multi-hour starvation fests for the purpose of paperwork.
Then we moved to New York. Each state runs their own Medicaid and WIC, so I had to apply all over again. I researched while in Ohio, but could find no NY Medicaid application online. I called the NYC Medicaid hotline (1-877-472-8411) to have the application mailed to me in December. It never arrived. Things were a little hairy when we first arrived in NYC in January with Augustine's death, so I put off applying until I could handle the headache. In Ohio, Medicaid will cover pregnancy costs up to three months prior to the application date, so I figured I might have some leeway here as well. I called the Staten Island Medicaid office, but the number wouldn't connect, the answering machine filled and eventually it just rang indefinitely. After a week or two of that silliness, I decided it was time to suck it up and head down to the Medicaid office in person to apply.

I gathered all the documents I had used in Ohio, plus some extras that seemed to be mentioned on the NY
Medicaid website. By 10am or so I arrived to find a line for the info desk where I would find out where to get the form. I got the form, completed it as best and fast as I could and put it in the wire basket to await the "interview" where I actually got share every detail of our identities, income and medical expenses. Now I was in the actual line. Numbers were called (I didn't have a number), names were called, hours passed and the room emptied. I found myself in a room where the staff had all gone to lunch, none of the folks there when I arrived were left. I checked with the one guy left to cover while everyone else was on break - my application had disappeared into the abyss "behind the door" so it was impossible to tell how much longer the wait would be. That was 2pm and I hadn't brought a lunch for Penny or myself. She had eaten all her goldfish, put a good dent in the grape supply (she looks cute with grapes in her cheeks, doesn't she?), and wow she loves dried cranberries and raisins! She had been really patient and playful with the other kids who went in and out, but she wanted an actual meal and we were starting to infringe upon her nap time.
By 2:45pm, I was getting ready to give up and just reapply another time when I could have Mom babysit Penny. At long last, our name was called and we went through the infamous doors for our interview. The case worker started her checklist of forms she wanted to see. When we got to the income section, I explained we didn't have any, showed her what documentation I had, and she began to make notes on what additional proof I'd need to show. I'm sitting there as she's writing notes (I'm writing them too because sometimes people's handwriting is tough to read and it's always good to have a backup) and she glances over and sees Augustine's death certificate. She asked why I hadn't given her that birth certificate earlier and I explained that I was applying because I had pregnancy expenses related to the loss of my baby. "You should have mentioned that earlier. That changes what you need to bring. Let me have that to copy." I was somewhat taken aback by the sudden lack of monotone the death certificate had elicited, so complied immediately. I must have just made her job more complicated or something.
When we were finally released at 3:30pm, my application was woefully incomplete (only one pound of documentation had been presented and I needed quite a few more forms and supporting letters). I had a checklist that stated I must be back with the missing documentation by March 22 or else my application would be assessed using solely what I had provided in this meeting. Great: some of the items requested would have to be mailed to me, which might take a while. Thankfully, I've procured most of what I was told I needed since the horrible first visit. Now that Mom's back in town, I think I'll head to the office again on my own.
Having gone to the office and filled out the form...I later discovered that it IS available online. It's just called an
application for Family Health Plus. It has a more complete picture of the documentation required for the application than the NYC Medicaid website as well. When you apply for NYC Medicaid, you are also required to apply for a specific
Managed Care Provider (essentially the same as a brand of insurance). To do that, you check to see what MCP your doctor takes. A bit of a challenge when none of the MCPs listed on the Medicaid site have links to provider lists and some doctor's office staff are too lazy to list for you which MCPs they accept. They do have a HELPFUL list of phone numbers you can call, though - egad!! Only phone numbers on the WWW? Ohio had all that info available online so I could compare policies, find my doctors, etc. Here, they had a guy in the waiting room with a laptop who could look up your doctors and tell you which plans they accept. You then find the plan that all your doctors accept from a list and play eenie, meenie, miney, mo. You have to choose before you leave the office, so hope you choose well. There is a short window in which you can switch, but what is going to happen in that time period that will inspire you to switch? Do you think they'd get policy info to you within a month? Do you have anything to compare that info to?

You might be able to tell from the tone that I did not enjoy my experiences applying for public health care and supplemental food aid. You might think that means I don't like public health care. Exactly the opposite. I think having health care available for people is important, especially with so many people who used to be middle class having financial problems these days. Medicaid has helped fill in the gaps our insurance doesn't cover at a time when we just don't have the money to cover those costs. I spent much of last week trying to figure out whether my insurance would cover $4,000 worth of genetic testing to determine whether I have a genetic clotting disorder that could have caused Augustine's death. I wanted to know BEFORE I took the tests if I could AFFORD to know the answer. The doctor recommended I take baby aspirin until I know the answer, so it's not a purely academic question. People shouldn't have to make those kinds of choices.
The take home message here is that the system needs fixing. How on earth can someone who is just making ends meet by working one or more jobs going to be able to spend days prepping and then an entire work day or more in an office on an application? Seriously?! Sadly, I seriously doubt that the folks in the room discussing how to reform health care have ever applied for public health care. Each state has a different system, different levels of info available: heaven help those who manage to move while in the system! I sincerely hope that whatever Congress comes up with is actually helpful and capable of being implemented. This is too important to rush, yet too important to wait forever on.