Edited For Clarity

When I was in the hospital, I was asked if I had insurance. I said I didn’t because my employer has a 6 month waiting period for medical benefits. So they processed me to apply for MediCal. Turns out, I already had an active case as I had applied in the summer when I lost my previous job.

Since the 29th of December, I have been dealing with the MediCal folks to get my coverage fully activated. When I originally applied, my income level was based on my unemployment payments. This, as it turned out, meant that I would have a $1200 “share of cost”. What that boils down to is that I would have to pay $1200 out of pocket first, and MediCal would pick up the rest for the year.

I contacted them because my income situation had changed. I can’t work for an indefinite period of time. First estimate is 2-3 months, but depending on tests of my heart function, may go much further. The only income I have now is my disability payments, which are based on what I made this time last year.

They have been “working” on my case for weeks. I have been paying for medications our of pocket for the last few weeks. Total cost of my medications is about $450 per month. The most important one, Plavix, runs $220 per month. I’ve applied for assistance but haven’t heard anything yet. But cash has run out. And so are my meds. I have two days of Plavix left. I called the MediCal office every day for the last week and a half to see what the status of my case was.

Today, when I called, I explained that I was running out of meds, and that the share of cost reflected my having been on unemployment. They suggested that bring my disability paperwork in so they could process it. So I did.

Here’s the upshot – they gave me a zero share of cost for January – but raised my share of cost to $1531 starting February. This means, before they pay a dime of my charges, I have to put out over $1500. That’s right, my share of cost increased.

Why? Because of how much I get in disability payments.

How does this make sense? I CAN’T work right now. My expenses have gone up because of medications, doctor visits, etc. Between the meds and my rent alone, 2/3 of what I get in disability is gone.

But here’s the part that really doesn’t make sense: I have been paying for “disability insurance” since my first job at age 13. That’s 34 years. I’ve been paying the state for those MediCal funds too. But when I need it, it turns out it’s not insurance. It’s a trust account. I have a limit on disability from the state of $26,000. How did I pay in for 34 years to what is touted as an “insurance” policy and yet that’s all there is?

Luckily, I will likely be able to pick up one more month of medications before I have to start paying into the share of cost. then, it gets very difficult. The idea of public assistance is to help those who are having trouble. I’m now in that group. Apparently, I have to figure out how to pay for my life saving drugs first.

Yeah. I’m pissed. And worried.

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