TennCare drama

You know when things are just so complicated that when you try to explain it to someone you just want to say "oh nevermind!"  That's about how I feel.  However, in the name of historical preservation, I will do my best to give a brief yet accurate description of what's going on with our TennCare coverage, or lack there of.

Since 5 days after the girls were born, we have had the blessing of having medical  coverage by our state funded insurance.  I've made it a habit to thank people who work in Tennessee for their part of paying for the care of our girls.  There is no doubt in my mind that the bill has been over 2 million dollars and rising.  TennCare covers Penny's 24 hour a day nursing, ventilator rental and service, suction machine, nebulizer, food pump, her formula, all her supplies, and all of her therapies and doctors appointments.  Just the nursing care is almost $10,000 a week.  We have our primary private insurance as well which covers some of the expenses too but does not cover any of the nursing.

Needless to say, Tenncare is a necessity for us.  Jonathan and I both work full time at jobs that are, shall we say, fulfilling but less than lucrative.  We are not below the poverty line at this point but would get there quickly if we had to carry the burden of paying for Penny's medical needs.

About 2 months ago we got some paperwork from TennCare to see if we qualify for a different kind of Medicaid.  Well, seeing as I was totally happy with what we had, I didn't hurry to send it back in.  In the hustle and bustle of a twin toddler household, the papers got to the bottom of a stack of mail and were forgotten.  Until one day we got a call from our pharmacist, also known as Yeh Yeh (Jonathan's dad), that our TennCare had been terminated.  I didn't worry too much because obviously it was some kind of mistake and I would call in the morning to get it straightened out.  Oh if only it were that simple.

If I were to go into all of the calls, hold times, "I'm sorry ma'am but you'll have to call _____", and "all you have to do is this and you'll be fine" it would take you all day to read it.  I will summarize it to say that the system, to me, seems to be a big everchanging maze that no one has a complete map of and even the people working in it aren't sure of the way out!  I have said it before and mean no insult, but as an intelligent person dealing with this and coming to my wits end, I really don't know how anyone working with fewer faculties could succeed!

Well, just like anything else that seems impossible, it's not impossible with God.  

On Wednesday we got a letter saying that both our appeal and our reapplication had been denied, and that will just not do.  So, I took the day off of work on Thursday and Penny, Nurse Kim, and I headed down to 170 N Main street to get this straightened out and not take "no" for an answer!  We found a reasonably priced place to park, took a lovely mile long walk down Main Street, got through security, and up to the office to which we had been directed.  It was not the right place.  This was the administrative offices not the office where the case workers were.  I was less than please.  Because it's never good to make an enemy of someone whose help you may need, I smiled and thanked the lady at the desk and Penny waved bye bye and we went back down stairs.

When we got off of the elevator there was a man laying on the floor, with a crowd of people around him, obviously in pain.  I encouraged Nurse Kim to go see if she could help.  When I looked a little closer to see if I could tell what was going on, there were people signing to him.  He was Deaf and there were a couple other Deaf employees of the state there with him along with hearing people who had no clue what was going on.  Being a sign language interpreter, I stepped in and was able to help him communicate what had happened, give the EMTs the information they needed, as well as to interpret a call to the man's  grandmother.  So the Lord was making it abundantly clear to me that although it seemed my plans were failing, His plans never fail.  I did ask Him if He could have provided the man an interpreter without canceling Penny's TennCare. I think He laughed.

So, off we went with renewed faith and increased blood pressure (from the excitement and the walk back to the car) to find this other Department of Human Services office.  I knew it wasn't in the best of neighborhoods, but I wasn't quite prepared for the office to be sharing space in a strip mall with a skating rink and the Probation and Parole office.  Quite convenient for anyone who might be in need of all three services, but just unnerving for my suburbian self.  It's tricky for two tall white girls and a baby on a beeping ventilator to be inconspicuous in a place like that.  We did our best.

I signed my name, and sat and waited to be called.  It looked like it was going to take forever and that we would all catch every airborne disease there is, and then I noticed I had missed a call.  It was from our case worker who we were there to see.  It's impossible to reach someone in the DHS office if you call back because they are on to the next person they have to call, so I hopped up and ran to the counter asking the nice lady to let our worker know that I was in the waiting area.  She came out to get us, most likely hours before we would have been called otherwise, and we began the process of begging for help.  Penny did her part and needed suctioning so her machine beeped, the vent made the high pitched noise it makes when it's disconnected, then there's that suctioning sound that evades description.  People were peeking over their cubicles trying to figure out what that terrible racket was.  I snuck Penny a high five.  She took it one step further, desatted, and then threw up.  That's my girl!  The poor case worker never knew what hit her.

In all honesty, our case worker was very kind and willing to do more than she had to to make sure Penny got what she needed.  We got her all of the information that she needed to process the application and technically she has 45 days to do it.  She said she would take care of it today.  Apparently we have to apply, be denied, then subtract the cost of treatment from our income and apply again.  Since just the nursing would deplete our household income in a matter of weeks, I'm pretty sure we will be able to get back on track sooner than later.

As I was telling Nurse Kim, it seems silly for me not to trust that the Lord has this under control and that it is all under His sovereign hand.  He's brought us this far, I just don't see Him saying "see ya...best of luck!"  So we wait, and trust, and offer to make brownies for nice case workers.