Thursday, February 26, 2015

Preparing To Be A Foster Parent: Medicaid


Does that one little word make you want to scrunch up into a ball and hide?  Me too.  I didn’t want to deal with it.  I didn't want to admit it.  I didn't want anyone to know that my boys are on it.  However, it was and is a fact of our lives.  We must deal with it.  I do need to talk about it because our boys are on Medicaid and will be until they are at least eighteen years old.  

Going into our training to become a foster family we knew nothing about Medicaid and the other benefits that wards of the State of Indiana are allowed.  Not much information was offered to us about it, other than the knowledge that our foster children would have it and children adopted from foster care frequently are awarded it post adoption.  (There are other benefits too!)

When the boys were placed with us we received a ‘permission to treat’ card that had their names and Medicaid numbers written on it along with our information and their Family Case Manager’s.  This was to go into my wallet and be used anytime we had any type of doctor appointment.  (Medical, dental, eye doctor, specialists.) Approximately 2 weeks post placement we received new Medicaid cards for them in the mail.  This was their insurance card.  

The Good

I can still remember vividly on my first trip to the pharmacy standing there with my mouth hanging agape as the pharmacy tech explained to me that the boys’ prescription medications were FREE.  As in No Charge.  $0.00.  I don’t know what I expected exactly, but I had no idea their meds would be free.  Wow.  That is amazing.  Each of the boys is on four medications.  That is EIGHT prescriptions and we pay nothing out of pocket.  I was floored. 

The Hard Part

What I was unprepared for was that sometimes people judge you.  And you can tell.  You can feel their judgment boiling over and raining down on your head.  Sometimes you are innocently standing at the pharmacy window and a tech will ask “Do you want name brand or generic?” and you quietly answer “They are on Medicaid we have to have generic.”.  Only to have someone look at you standing there in a dress/skirt with all five of your chicks gathered around your grocery cart with a look that would peel paper clean off a wall. 
In the moment I want to explain that:

I’m a foster Mom.  This is a foster child.  This is my pre-adoptive foster child.  This is my adopted child that is formerly a foster child…that my husband has a good job, we have money to pay for these children... I’m not a baby mill living off the system.  But then I realize that nothing I say will matter to that judging person.

Do you know who it will matter to?  The kid.  Yep, pre-adoptive or not.  Adopted or foster.  If I say any of those things it will mean something to that child in that moment even if they don’t understand the words being said.  So I say nothing.

Sometimes it is at a doctor’s office.  Sometimes it is calling a new eye doctor to get eye exams.  Sometimes it is imagined…other times you know it is not.  Be prepared.  Steel yourself for it.  Sometimes you won’t even notice but other times those looks will hurt. When we changed pharmacies back last summer after we moved I made a point of telling my pharmacist that our boys were pre-adoptive fosters because sometimes even the pharmacy team members give attitude.  Not all of them, but some at some stores.  Target (several different ones) has been great to me in that regard.  When we had our name change in November (post adoption) and got new cards they quickly took care of the situation and there was very little discussion about it.  They know me, see me coming.  I’m there so often.  

Oh yeah.  You will be there so often!  We are pretty much at the pharmacy counter on a weekly basis between the boys meds and D and I.  That is okay.  I’ve learned to track our pill count and put it on the calendar so that I know which Rxs need to be filled each week.  I almost always go to the pharmacy on the same day of the week now.  I have a Post It Velcro pocket that holds all our paper scripts.  It fits nicely in my purse or planner or in my desk drawer depending on my need.  Nothing gets lost that way. (affiliate link)

Question Everything

I’ve learned also to ask lots of questions, particularly with new practitioners.  Last fall I was calling around to get E and N in to see an eye doctor.  E needed new glasses badly.  His were so scratched and the elastic in the strap was nearly shot.  When I called an office I had been referred to I asked first thing “Do you accept Medicaid?”. I was assured that they did.  The appointments were made.  Two weeks later I had picked the boys up from school and was approximately 5 minutes away from the office when I got a phone call.  N’s Medicaid had been denied.  No reason…it just didn’t go through.  I knew full well it had been over a year since he had been seen but what could I do?  We continued on to E’s appointment.  When we arrived it was ALL of us.  We even had one foster child with us.  We filled up the office waiting area.  I felt horrible…but you do what you have to do.  We waited to be taken back.  The doctor made an appearance at one point and had BIG eyes and wanted to know HOW MANY of us were getting eye exams that day?  Sadly, just the one!  

Finally they called us back.  The appointment was rather lengthy because of E’s issues.  He and N both have trouble letting doctors examine them.  It also took a long time because his vision is so bad.  At the conclusion of his appointment his doctor proceeded to tell me that he needed vision therapy and how he just happened to be working at the university doing just that…and that Medicaid would not pay for a minute of it.  I explained to him as kindly as I could that we could not afford that right then.  I then asked about the new glasses.  As it turns out his office did not offer even ONE frame that was covered by Medicaid.  Not even one.  They did have a lovely alternative to what he had been wearing (goggle style) that was atrociously ugly and expensive.  I sweetly asked for E's new prescription and I left as quickly as I could. 

As I was scooting out one of the sweet girls working there gave me the names of the only two places that offer a frame covered by Medicaid in our town.  (This would have been great information when I originally called!)  One of them was just up the street.  I walked into this other office with the new prescription and asked if I could order glasses?  (Sure!)  Which ones are covered by Medicaid?  (This whole shelf.)  I ended up not picking any of the frames covered by Medicaid anyway.  I wanted something similar to what he had been wearing so we chose to pay out of pocket for what would be the best choice but I am not a bit sorry that I left that doctor’s office without ordering glasses.  I just felt so silly for not thinking to ask specifically if they had frames that were covered.  Lesson learned.

My very best advice to those who are moving into this season of life is to take the steps to educate your self.  You are about to become this child’s best advocate.  If you do not know what services are due them and fight for them very few other people are going to be vested enough to do so either.  Google is your best friend.  Look for more information and if you cannot find what you are looking for enlist your child’s Family Case Manager, CASA or Guardian ad Litem.  Also, seek out other foster parents and make friends!  They can be a wealth of information.

Up until this point in our experience with E & N and their doctors I had been well pleased.  They saw every specialist they needed to at Riley at regular intervals and we had very little trouble before then.  Of course at the time we lived in Greenwood and had every conceivable specialist within minutes of us in Indianapolis.  That isn’t necessarily the case in smaller towns.  However, I think you will be pleasantly surprised to find that it isn’t as bad as the nightmare you may have previously imagined.  Just be ready, think ahead.  Plan for the worst and hope for the best.

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