Showing posts with label Primary Children's Medical Center (PCMC). Show all posts
Showing posts with label Primary Children's Medical Center (PCMC). Show all posts

Monday, July 2, 2012

Medicaid and other Financial programs

update: 7/12/12- just found this website that goes into great detail about assistance programs.  Check it out. 

Like the saying goes..."It is easier to give than to receive" and that saying can't be any truer than to my husband and I.  It is hard to sit down and admit that no matter how hard you work or save there comes a time when you have to just push your pride aside and search for help.

We live a good life.  We have loving family and friends that are our biggest source for strength and support.  We have a loving marriage, a place to call home, a two year old pup that lets us know daily how much she loves us with her many wet kisses....and then just shy of 8 months ago we were given the biggest gift of all...a little boy to call our own....our Noah.  We both work full time at steady jobs, we have two working cars to get us to those jobs, and are fortunate enough to have a health insurance policy provided by our jobs.

Unfortunately,  sometimes all the hard work and blessings just are not enough.  Having a special needs child is costly even with insurance.  As soon as we get one bill paid a few others come in the mail with their empty return envelopes asking for us to fill them up and send them back to pay for this clinic visit or that test or this therapy session.  At first we thought we could totally handle it.  We had insurance and a tiny bit set aside for such reasons but 7 months later and we soon realized just how fast and how costly things truly are.  Juggling insurance claims and co-pays and deposits and prescriptions and whatever else insurance does not cover becomes down right expensive. 

We started to look into any and all programs we could find that could help Noah with his therapy or future costs.  We are not sure if he will need special medical equipment or not but the way things are looking it is a pretty good possibility. Our insurance denied all genetics testing and we have one chance to appeal the denial and so we plan on doing so but have to wait for another four months before we meet with the geneticist and have him write the letter of appeal.  Crossing our fingers and praying that our insurance will accept the appeal and we can get genetics testing for Noah.  We know and understand that it will not change the outcome of his future.  It would just be really nice to know if he does have a specific genetic reason behind all of his diagnosis.  It would be invaluable to find out if we should start looking into other areas of his body if he does have a specific genetic diagnosis that may cause heart problems or liver failure.  It would also be really comforting to know if his diagnosis is inherited and if we could pass along the same diagnosis to any future children we might have.  If the appeal is not accepted then we will have to come up with the funds to pay for these tests on our own (aside from all the other medical bills).  One test can be around $4000.  Yikes! 

These are the programs we have found so far and are trying our hardest to get accepted into. 

Early Intervention Program:  see your specific state or local EIP program
Application Process: One phone call and they had a therapist sent out to our house to evaluate Noah's abilities and go over his medical diagnosis to see if he had qualifying diagnosis's. It was very informal and more of a play date for Noah than an application process.  We filled out the few pages of paperwork, turned in medical documents and financial documents and that was it. 
Outcome: Accepted. We were accepted into the program and set up with three different therapists.  A physical therapist, and occupational/speech therapist, and a vision therapist. 
Thoughts: We have been set up with Utah's Early Intervention Program now for the past five months and that program is wonderful.  It is based off of our annual income and not off insurance so we are billed a set amount once a month for as many therapy visits we can get that month.  (because of recent program funding cuts Noah's visits have been cut down to about 3-4 a month now-----heartbreaking news for us and Noah's development but we will take what we can get).

Medicaid: http://www.medicaid.gov/
Application Process: This was a very lengthy application that took me a couple days to fill out and gather all the specific medical documentation and records requested.  We had to submit three months worth of banks statements and pay stubs.  They asked us all kinds of personal questions like the make and model of our cars, if we rented or owned our home, if we had a retirement plan, savings...ect.  I then had to personally drop off all the paperwork (an entire binder full) to the medicaid office to have them flip through it all and make sure I was not leaving any T uncrossed.
Outcome: Denied.  We were told we own too many "liquid assets" because we do not carry loans on the two vehicles we own.
Thoughts: This seriously made me irate.  Just because we worked out butts off to pay our cars off so that we didn't have so many bills coming in and we get denied for being responsible adults.  ***you can see I am still a bit fumed by this.  According to the disability medicaid rules you are allowed to own one car but not two.  We were also denied because both of us put a few $$$ into a savings plan each month (obviously to help pay all the medical bills but I guess being responsible doesn't matter once again)
Warning:
If you are planning to apply for Medicaid, be sure that your finances are in order so that you can qualify.  Also, you may want to speak with a Medicaid case worker (our Primary Children’s Hospital has one designated to specifically help parents with their questions and to build a plan – so check out your hospital resources).

Social Security Supplemental Security Income: http://www.ssa.gov/pgm/ssi.htm
Note:  Because we were denied Medicaid we were told we would also be denied SSI for the same reasons so we decided not to waste time by filling out all the application pages knowing we were going to be denied. 

Shriner's Hospital for Children: http://www.shrinershospitalsforchildren.org/
Application Process: A two page application that you print from their website and comes with a detailed instruction manual so you know exactly what they are requesting.  Very easy and took me about an hour to fill out and print.  You will want to include medical information.  I got a signed letter from Noah's doctor outlining all of his conditions and diagnosis to make it easy for them to read instead of having to go through every single record. 
Outcome: Pending.
Thoughts: Because I am a type A personality I went ahead and called to make sure I was sending my application to the correct address (your local Shriner's Hospital).  You will want to make sure you live near a Shriner's hospital because it would be hard to get accepted and then have to fly to another state to get the services.  We are fortunate to live within 30 minutes from a Shriner's hospital in Utah.  If accepted we are hoping they could help pay for therapies and/or medical equipments costs (walkers or wheelchairs..ect). The woman I was speaking with on the phone was extremely friendly and that made my day a whole lot better.

Utah Division of Services for People with Disabilities: http://www.dspd.utah.gov/
Application Process:  This was by far the biggest application to date.  Many pages asking many questions regarding Noah's condition, diagnosis's, doctors, tests, current abilities, ect.  I had to once again submit medical records, signed letters, a copy of Noah's SS card and birth certificate, and all of the paperwork from his Early Intervention Therapists.  They also asked for copies of his xrays.  It cost me $3.00 to mail the large envelope with all of his information in it to them.  It was that heavy.
Outcome: Pending
Thoughts:  I am not sure if this program is called something different in each state. I attached Utah's website in case you wanted to research something similar in your own state.  This program is primarily a long waiting list that we hope to be put on.  If we are accepted that is.  If accepted and then chosen from the extremely long list it could help pay for respite care, Noah's thickener for his food, expensive formulas, diapers when he has outgrown baby diapers, ect.  Basically each state is given a certain amount of money each year.   When they get the money they go to the list and decide who from the list is in the most need and pay for the services needed for that individual.  They go down the list and try to hit as many people as possible until the funds run out.  The funds are usually allocated within a couple months.  When the money is gone...it's gone!  Everyone else just sits on the lost until the next year and hope that their needs are great enough to hold their spot on the list.  If a person applies and their needs are greater your name gets bumped down the list.  I have heard to plan on anywhere from 3-5 years before your name gets picked from the list.
****knowing the history of this list we decided to get Noah on it now as an infant in hopes that when he is older we might get picked and they might help us with the costs of caring for a special needs growing child (adult diapers, wheelchairs, respite care, other special needs costs, ect)

United Healthcare Children's Foundation (medical grants):  http://www.uhccf.org/
Note:  This program helps pay for costs AFTER insurance has covered their portion.  You must have insurance to qualify and you must be a US citizen. You must turn in your most recent IRS tax form to see if you fall within their Adjusted Gross Income level (depending on size of family).  We do not qualify because we do not fit within their criteria but I wanted to list this service so others who do qualify may apply.  They actually pay your medical bills once you get them so you do not actually get money sent to you personally.  You submit your medical bill and they pay them (if you are chosen for the grant).  The amount awarded to an individual within a 12-month period is limited to either $5,000 or 85% of the fund balance, whichever amount is less. Awards to any one individual are limited to a lifetime maximum of $10,000. Grant recipients who are awarded less than $5,000 may re-apply for another grant once the current grant funds have been completely exhausted. The 12-month $5,000 limit (or 85% of the fund balance) and $10,000 lifetime maximum limits apply. An application must be submitted prior to the child's 17th birthday.

I would love to add to this list so please email me if you know of any other programs out there for people to seek assistance.  

Suggested subjects or phrases to google in searching for medical assistance
1.      Medical assistance J  (also add your state or counties name in there as well)
2.      Health Care Costs, Help
3. "insert states name" waivers
4.      Financial medical assistance
5.      Respite care, costs
6.      Medical grants (and then enter “for patient” or “children” or “medical bills” or “for single mothers” ect)
7.      Pennies by the Inch : Primary Childrens Medical Center PCMC Pennies

Wednesday, June 20, 2012

Newly Diagnosed: What to do Now

http://instantautotrade.com/wp-content/uploads/2012/04/Check-List1.jpg
I keep telling my family "I wish there was a document that was handed to us when Noah was first diagnosed with Agenesis of the Corpus Callosum that listed all of the stuff we (should know or question or look for) then went into detail about other closely related diagnosis or possibilities."

Well my friends I have decided to go ahead and make one big fat list of links that will guide you to everything I have found regarding Noah's diagnosis's. If I were to create a document myself it would be way too many pages for people to want to read so I am just listing links so you can pick and chose what you would like to read.  I have listed them by diagnosis so you can get where you want to get faster :)

****keeping in mind I still am just learning about stuff myself and may not have everything listed that I should. But I would love to add to this list so please let me know what I am missing and can learn for myself too).

What to do right now:
  1.  For ANY disability your child may have please look up your local "Early Intervention Program (EIP)" and if you qualify get started with this program as soon as possible. This program only goes up until age three and then there are other programs for older children.(this is a federal program (in the states) and does not work off of insurance but rather your family income amount to see how much you have to pay each month).
  2. If you are fortunate to have insurance or unfortunate to have to deal with insurance...Contact your provider and see what your plan covers, what facilities they cover, and what doctors they cover.  Doctors will not know or care what your plan is so many of them refer you to places or specialists that may not be covered by your insurance so be on top of this at all times. You may also want to find out what your out of pocket costs are with your plan and if co-payments count towards this out of pocket amount.  Every insurance provider is different than the others so every plan is different.  Get to know the ins and outs of your specific plan. 
  3. Find a FANTASTIC pediatrician who has experience working with special needs children.  They will be your best resource and support in taking care of your child and getting you in to see specialists. 
  4. Start to make appointments for your child to see "Specialists" as soon as possible because the waiting list for such doctors can be months away. 
    • Neurologists (seizure disorders, MRI's, EEG's, ect)
    • Endocrinologists (diabetes, hormone's, adrenal gland, monitoring growth ect)
    • Geneticists (chromosome or hereditary abnormalities, ect)
    • Special Needs Clinics (Utah has one up at PCMC but not sure about other states)
    • Ophthalmologists (eye to brain connections)
    • Optometrists (vision and degree of eye sight)
    • Therapy Facilities (Physical, Speech, Occupational, Vision)
    • ***most facilities have a "quick list" you can get on once your child is starting to show  signs of certain disorders (seizures symptoms, abrupt weight loss/gain, dehydration, choking, ect).  Have your pediatrician call the specialist themselves so you can be seen much sooner.  
Caregiving 101, by: Kris Hansen
 I found this resource on the internet at www.caregiving101.org with some ideas on how to prevent “Caregiving Burnout”.
  1. Choose to take charge of your life, and don’t let your loved one’s illness or disability always take center stage.
  2. Remember to be good to yourself.  Love, honor and value yourself.  You’re doing a very hard job, and you deserve some quality time, just for you.
  3. Watch out for signs of depression, and don’t delay in getting professional help when you need it.
  4. When people offer to help, accept the offer and suggest specific things that they can do.
  5. Educate yourself about your loved one’s condition.  Information is empowering.
  6. There’s a difference between caring and doing.  Be open to technologies and ideas that promote your loved one’s independence.
  7. Trust your instincts.  Most of the time they’ll lead you in the right direction.
  8. Grieve for your losses, and then allow yourself to dream new dreams.
  9. Stand up for your rights as a caregiver and a citizen.
  10. Seek support from other caregivers.  There is great strength in knowing you are not alone.


Agenesis of the Corpus Callosum - Description


Septo-Optic Dysplasia Description / Optic Nerve Hypoplasia Description
Epilepsy Description


Infantile Spasms (aka West's Syndrome) Description


  • This a an article we came across that scared us to death but then I found out that the data is really old and according to our neurologist is not longer "catastrophic".I only list it because you will come across this in your search and I want you to know that Infantile Spasm treatments have changed dramatically and my neurologist has not had a single child die from it.  Here
Sandifer's Syndrome (aka Acid Reflux Disease) Description


Dysphagia (feeding tube stuff) Description

Hypotonia Description


 


Other links I found that I found helpful (even just for DIY ideas)

Thursday, June 14, 2012

Optic Nerve Hypoplasia Diagnosis

We sat down in the Ophthalmology department waiting to be called in to see why Noah's eye was having problems.  We were both tired being only five days since Noah's birth.  We went in, the doctor did all kinds of crazy tests, some that made all of us cry because we could see how uncomfortable it was for our newborn baby. The doctor then sat in front of us and told us the diagnosis.  "Noah has what is called Optic Nerve Hypoplasia in his left eye.  This is when the optic nerve does not grow fully and your son will never have sight in his left eye."  We thought the world had crashed down on us.  We sat there wiping away the tears and fear creeping up for the unknown future for our son.  We seriously thought this was the worse news ever.  Our son only has one working eye.  He will have to go through life with only half of his vision.  We were devastated.  The doctor then told us that he wanted us to do an MRI that Wednesday (two days) just to make sure he was correct in his diagnosis.  He also wanted some other electromagnetic tests done to test if Noah's right eye (the one working eye) was actually sending and receiving signals from the eye to the brain. 

We had two full days of worry and sadness and me just recovering from labor.  But all the while enjoying our new little bundle of cuteness wrapped in swaddling blankets.  We were deeply in love with Noah and even if he only had one working eye...who cared really.  He was our son and we love him. 

Wednesday came much too fast.  We were once again up at PCMC for the MRI.  They brought us back into a room filled with hospital beds as other children were recovering from sedation.  They then proceeded to give Noah his sedation so that he would not move while getting the MRI.  Everything seemed routine and smooth.  We ended up having to stay a full night there because Noah's little body would not wake up from sedation so he had to have around the clock supervision.  It was a long night for my husband and I trading the chair for the padded bench seat to get even a minutes worth of shut eye.

We went home the next morning and waited for the phone to ring to tell us the news.....

Helpful Links for Optic Nerve Hypoplasia/ Septo Optic Dysplasia:

Los Angeles Optic Nerve Hypoplasia Center

Facebook Optic-Nerve-Hypoplasia-ONH-Research-at-Childrens-Hospital

Magic Foundation

Tuesday, June 12, 2012

Delivery

Noah was born on Friday, November 10, 2011.  It was a pretty uneventful labor with no real complications.  I had to be induced because I was 6 days over my due date and my fluid levels were really low.  All of my ultrasounds had looked great and I had even had a few extra ultrasounds done because we were chosen for a new study where they were just monitoring my pregnancy and stats.  I had a touch of morning sickness, no cravings that I can recall, I only lost my cookies a few times while flying on an airplane.  I did however have a scare when I was 6 weeks pregnant where I thought I had lost the baby.  However, everything looked okay and the bleeding only lasted a few hours.  Nobody was really sure what it was but tossed out the possibility of maybe a bursting cyst.  The full nine months went smooth and my husband and I went through all of the first time parent motions getting things ready.  My due date came and went and 6 days later were were sent to Labor and Delivery to be induced.  I went natural for most of the labor but no matter how much medication they gave me to start my induction my body would just not dilate.  At that point I opted for an epidural and both my husband and I fell asleep within minutes.  Two hours later the nurse came in, woke me up because my monitor had fallen off my belly, decided to do a quick check, and Noah came out 15 minutes and three pushes later.  He was stuck in my pelvis and the chord was wrapped around his neck twice.  He was born not breathing with an Apgar of 3.  I started to panic.  Literally a few minutes later and he was crying with a new Apgar of 8.  All was good.  He was breathing and beautiful with a full head of dark hair.  He did experience some bruising on the left side of his face from being stuck in my pelvis but we were told not to worry.  The next day we kept calling him our little Pirate because he would not open his left eye.  Finally when his pediatrician came to do the initial evaluation we asked him to check out his eye.  He did so and told us that his left eye was not responding to the light and called in an appointment for us to see a pediatric ophthalmologist that Monday up at Primary Children's Medical Center (PCMC) in Utah.  We had no idea at that point just how many visits to PCMC we would eventually have.....and this is where Noah's Noggin story begins.