When you have Medicaid and an eating disorder

When you have Medicaid and an eating disorder, it is next to impossible to find treatment if treatment is not available in your state. What the people at Medicaid either don’t realize or don’t care about is that 20% of anorexics will die. My insurance company told me that sometimes people died because they don’t cover the services they need when I told them this fact. So I am taking things day by day keeping an eye on my heart rate as sometimes when I walk it goes as low as 46 or even 43 bpm which is not normal for someone who is walking around the store. I just pray every day that my body does not decide to give out before I can be helped to get the treatment I so desperately need. I go to my providers who are scrambling and telling me to go to each other with no result because no one knows what to do to fight the monster that is Medicaid. All I hear from the emergency room is either go out of state for treatment or stay home and die. What is this world coming to? All I know are money hungry insurance companies who don’t care about the person but all they care about is the profit and the money they will save by not paying for someone’s much needed treatment. Actually, they are spending more money on crisis stabilization programs that I keep going in and out of when it would be far cheaper for them to pay for the treatment I need that would also be the most effective. Instead, they are constantly telling me that I need this or that for their appeal process and so we have been waiting for over a year languishing and suffering because they want to find a lower cost medically necessary alternative. I find it interesting that there a denial letter says the services that we are requesting are a non-emergent when in the appeal itself it says if we do not get treatment I am at risk of death. How is that not emergent? And the person who reviews the appeal is a psychiatrist, but do they specialize in eating disorders? The short answer is no. They also say that we need to find treatment at a lower cost medically necessary alternative which by the way is breaking state and federal parity laws. They cannot impose a fail first policy meaning they cannot tell us that we need to complete treatment at a lower level of care and fail first before they will approve a higher level of care. They are hoping that by drawing out this appeals process, we will give up trying, and even though there are some days that yes, we want to do just that, we will not. I just hope our body can hold out. Also, they say if we need immediate treatment to go to the local emergency room, but that is a dangerous thing to say because the local emergency room knows nothing about eating disorder treatment and will give a liter of fluid in one hour which for someone with an eating disorder can kill them. I do not nor will I ever understand the logic of a government insurance, and I almost wonder if this insurance company that is run by the government isn’t put in place to continue ritualistic abuse whose goal was for the person to die which is exactly what will happen if we do not get treatment. Coincidence? I think not. The only thing I wanted for Christmas this year was to get into treatment, but that is not going to happen. At least I will be around people I love. We have a long battle ahead of us, and we just hope that physically we can hold out to see it through.

Ray

denied appeal

So they denied the appeal. We are taking them to court. Hope we win. This is rediculous.

They said we didn’t meet medical necessity criteria. To hell with them!!!

Ray