Adventures in Obamacare

I knew that one day Obamacare would show up and bite me. Today was the day.

I am in the process of transferring my medical care to another state. So far, the only thing I could possibly blame on the Affordable Care Act was that it took me three months to get a medical appointment with a primary care physician once I applied. And yes, I had to apply to the medical practice to even be accepted as a patient.

My first appointment was with a nice young fellow in his last year as an intern. I explained all my little medical history and we discussed my referral and prescription needs. I was particularly concerned with continuing to receive a certain medicine crucial to my health, one which I have been receiving at no cost from Novartis, a large pharmaceutical company. My previous doctor set me up with them and I have been getting these pills each month for several years.

My current prescription from the last doctor expires in about three weeks, and it appears that getting  a new one would not be a problem. Thus, I figured my place with Novartis was secure. I was wrong.

Today  I called Novartis to order my monthly supply and was told that my account had been suspended because I now had to apply for coverage with Medicaid under the rules of the Affordable Care Act. The woman I spoke with initially told me that the current state I live in has expanded its Medicaid coverage and thus was considered the primary provider of my meds.

What complicates my case is that I technically am not a resident of the state I live in. I moved here for work. My permanent domicile is in my previous state, which does not have this “expanded” coverage. This is noted on my pay statements from my employer. Even so, I was told I needed to apply for Medicaid in my current state and get a rejection letter. End of story. “No meds for you”, ala Seinfeld’s Soup Nazi, was the message I got. I even pulled the “lawyer” card, but to no avail. “If you are going to ‘chapter and verse’ me on the law, and this is YOUR interpretation, I guess I need a lawyer to come after you guys.” Didn’t work. I also complained that Novartis suspended me and didn’t even tell me about it.

Since I have a short supply left and this medicine is very necessary, I decided that I was not going to go away quietly. I asked to speak with a boss. I got the same story, except after some mild ranting about Obamacare and my short supply of meds, the woman agreed to give me another 30 day supply. I wasn’t satisfied. “I want to speak to YOUR boss,” I said.

Knowing I would get nowhere speaking to a higher up, I took my current antagonists’ advice and just took what I could get and allowed myself to be transferred to some place called “Inventive.” Before the transfer I asked who these people are. “‘They’ll help you apply for Medicaid,” said Amber, my polite supervisor at Novartis. “Fine,” I said. “But WHO are they?,” I repeated. Amber told me they were a “part of Novartis.”

After arranging for final delivery of meds, I was transferred to a very nice man named Jason at “Inventive”. He asked me how he could help me and I gave him the background.  After some communicating back and forth I learned that Novartis could not just cut me off while my case was pending. We agreed that I should apply both to my health insurer and my current state Medicaid for coverage and procure denial letters to prove if necessary to Novartis that I had to pay for my pills out of pocket if they did not do so.

“But that first woman at Novartis was just going to let me go without my meds and didn’t tell me any of this,” I said to Jason.

“She didn’t take ownership of the call,” he said. Jason also expressed annoyance at how Novartis was treating me. He told me to call him if I needed anything on my case. In the end, other the console me, the only thing Jason did for me, however, was to provide me toll free numbers to the two states’ Medicaid offices.

So now I have to probably spend a bunch of time at the social services office applying for Medicaid I am sure I am not even eligible for. The supply of my extremely necessary medicine is at risk, and thus potentially also my health.

Many thanks to the American people for voting the current administration into office–twice. I also want to thank Congress for their support of the Affordable Care Act, also. You like me. You really like me.















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