A Study In Nonsense; Or, My Experience With Florida’s Wack Medicaid System
It should not be this bizarrely complicated, and yet…
I can only speak to how Medicaid is done in Florida. Let’s get that out of the way up front: other states implement it differently, and I don’t know all the ins and outs of that.
When I became aware of the nonsense of which I speak, it was largely because of Republicans being so adamantly against the Affordable Care Act. ACA, also called Obamacare, was supposed to work in part by expanding Medicaid. The federal government would provide funding; the states could choose to accept or decline.
Well, if you had a state leadership dominated by Republicans in those days, the Medicaid expansion probably didn’t happen. Republicans were very explicit in their position: if Obama wanted it, they were against it, even if it would benefit them and their constituents to agree.
This had the added bonus of convincing constituents that Obamacare was trash. “See!” They would say. “It doesn’t work! Obama is a liar!”
I can’t rightly predict what would have happened if the Medicaid expansion had been enforced as intended, but I probably wouldn’t have had to go so many years without any healthcare at all. So, you might say I’m a bit bitter.
In 2014, I applied for disability benefits on the grounds of my mental health; I have lengthy histories of eating disorders, PTSD, anxiety, and bipolar disorder. It was eventually granted — three years later. Then I was able to get Medicare and Medicaid, both, along with SNAP benefits.
This was 2017. At some point in 2018, I received a letter suggesting that I should sign up for a Dual Complete plan, where my Medicare and Medicaid benefits would be managed by a single company. That made sense at the time.
What I didn’t realize was that I’d have to find doctors that accept both Medicare and Medicaid in order to use that plan. Consequently, finding care that meets my needs and that is also in-network has been a nightmare.
There is also the added complication of my transness. Half my government presence is under my deadname, including my SSDI and SSI, even though my Social Security card has my chosen, legal name. My insurance company has me as my deadname, because that’s what Medicare has me as, because that’s what Social Security has me as, even though my Social Security card has long been updated. I want to say my Medicaid is under my current legal name, because the Florida Department of Children and Families (DCF) runs it, but that’s questionable, too: my DCF account doesn’t list Medicaid as a benefit I receive, even though I definitely do receive it.
All of this is hampered by the fact that I can’t get into my Social Security account online. I need to wait to receive a letter in the mail with a code that will allow me to reset my password. I’ve physically gone to a Social Security office, twice, to have my name updated. That’s why it’s on my card, so why would the change not ripple out to all of Social Security?
Social Security and Medicare could sync up their info. Medicare would sync with the insurance company. At least then they’d have my correct name. That would be a start.
It wouldn’t be nearly enough, though. For an example of the abject ridiculousness of the current Florida Medicaid system, check out this actual screenshot I took earlier today:
The supported browsers are Firefox 26 — the current version is 77 — and Internet Explorer, which is just silly. But I did download IE 11, and nothing changed. At some point, I was able to find what appeared to be an updated version of the web portal at flmedicaidmanagedcare.com, which was not where Benefits.gov directed me.
That site indicates that I’m eligible for full Medicaid, but all it says is that I “can’t enroll,” in anything. Good bet, since it’s not open enrollment time, but it doesn’t have me with any coverage at this point. And it still lists me as living in another county.
When I called Florida Medicaid on the phone, I was told they had an old address and that I needed to update that with DCF. When I logged into my DCF account, I was shown my current, correct address and asked to confirm it was still valid. It makes me think that Florida has two profiles on me in the system, which shouldn’t happen, but the same is true of my health insurance provider. The “two names,” problem wouldn’t be an issue if they used a unique identifier, like, I don’t know… a Social Security number?
This is a complete mess, is my point.
It’s a mess that’s further complicated by currently being on the brink of relapse in my eating disorder, a ton of stress, and the fact that June is a hard month for me. In June 2017, I helped my mom pass, staying with her damn near 24/7 in the hospital and then in hospice, over several weeks. She died on the summer solstice, the longest day of the year (and it really was). In June 2018, I had my first real breakup, got my heart smashed, had way too much risky sex, got gonorrhea, and got assaulted by one of those hookups.
My birthday is also tomorrow, so that’s fun. June is a hard month, and I don’t want to be dealing with this medical nonsense while I deal with all the other nonsense in my head. And yet it’s precisely the latter nonsense that’s making dealing with the former that much more pressing.
The mind reels. If you’re confused at this point, welcome to the party.