If you’ve never experienced what it’s like to live on Medicaid as your only source of health coverage, you probably think it’s bad. Or perhaps you have Medicaid (or you qualify for it) but you’re confused as to what your benefits would cover. Maybe you think that it’s very minimal, and perhaps you’re worried that it doesn’t cover the care you need. You may feel like it can’t help you.
Well, as a woman who has lived with Medicaid coverage my entire life, let me fill you in on my experiences:
I live in California, so here, it’s referred to as “Medi-Cal.” I grew up pretty poor, so I had it as a child, then transitioned into foster care and had it throughout that time as well.
Obviously, as with all forms of health insurance, you do have to ensure that you seek out providers in your area that accept your specific plan, but once you do that, it’s really not so bad.
You get set up with a primary care physician who is responsible for your yearly check-ups, testing, and exams. If you need any specialty care, they can refer you out to clinics with specialists, as with any HMO.
So I’ve been asked before: What are the out of pocket costs for all of this?
What if I told you there aren’t any?
I’m not kidding. (About the question that I’ve been asked before, several times, and my counter question!)
Annual Physicals = Free
Lab Work = Free
Exams = Free
Medications = Free
Visits to Specialists = Free
Hospitalizations = Free
Surgeries = Free
So because all of the above things are completely covered, you’re probably thinking that there are hidden fees or some sort of annual cost.
What if I told you there are no co-pays, deductibles, or premiums?
Again, I’m not kidding!
I actually didn’t even know what a co-pay was until I emancipated out of foster care at the age of 18 years old, went to college, and signed onto my university’s student health insurance plan, which was Anthem Blue Cross. Then, for the first time, I had co-pays on almost all doctor’s visits and certain medications. They were mostly affordable, but still awful!
Luckily, the Affordable Care Act made it possible for all child welfare system alumni (including former foster, adopted, kinship, and institutionalized youth) to receive Medicaid worry-free until the age of 26! So after graduation, my Medi-Cal was still active upon the termination of my student health insurance, and I was still able to receive all of the wonderful benefits.
As I continued my journey through higher education, I did start to become diagnosed with several conditions over time, including both physical and mental health disorders. My Medi-Cal made it possible to treat everything I was going through, whether it was an acute illness/injury that would go away over time or a chronic health condition that was a more permanent part of my daily life.
When I turned 26 years old, I was terrified to lose my Medi-Cal coverage. Luckily, I didn’t have to, because I was still considered low-income and remained eligible.
They renewed my coverage, and sure enough, I still got to enjoy all of the services I depended on.
In 2018, I had my first official surgery, a tonsillectomy/adenoidectomy. Though I had to jump through many hoops to get it approved because of complications, it was all covered at no cost to me!
As a woman who lives with chronic mental health conditions, I utilize my Medi-Cal to attend therapy weekly, visit my psychiatrist regularly, and to cover the cost of all the medications that are necessary for my stability. I am grateful for my Medi-Cal every day!
Aside from the questions I mentioned earlier, I’ve also been asked if the quality of care I receive is mediocre or subpar because it’s covered by Medicaid.
The answer is no! Many of the medical and mental health providers assigned to me are excellent! They hold degrees from respectable universities, such as UCLA and USC. They are kind, knowledgeable, and compassionate when it comes to my care. That’s not to say there aren’t a few bad apples here and there, but I can always get a second opinion or ask to be referred to a different practitioner if I choose to.
I’ve actually spoken to several friends who transferred over to Medi-Cal after losing their primary insurance, and they all told me they liked it so much better.
Recently, I learned about two additional benefits that are available to me: 1) transportation services and 2) a mobile nurse unit. I can get rides to all medical appointments and they’re completely free. They usually send me in a Lyft, and they even have an app, so I get text reminders and alerts. I have saved so much time and money on commuting because of this. With the mobile nurse unit, I was assigned a physician and nurse aside from my primary care clinic that can make house calls or refill my prescriptions as needed. This has also made my life tremendously easier.
I will admit that it’s a little different for dentistry and non-medical necessity services, such as alternative forms of therapy (i.e. massage, acupuncture, chiropractic, etc.) With dental work, many essential treatments are covered (i.e. annual check-ups, teeth cleanings, cavity fillings, etc.), but some of the more intensive treatments aren’t fully covered, or you may have to pay out of pocket for permanent crowns or cosmetic procedures. And with the more homeopathic types of medicine, those aren’t covered at all. So it’s not perfect.
And sometimes, it can take weeks to months to get appointments with certain specialists or for authorizations to be processed. You definitely have to learn how to stay on top of everything and advocate for yourself, but that’s true of any health insurance.
However, I write this all to say that it’s a pretty amazing system, and it can only get better with future improvements. Medicaid is basically our nation’s version of “universal health care.” It just isn’t quite “universal” yet.
It is crucial that you get out there and vote during this election season. We need reform to the healthcare industry in many ways, but we can’t afford to lose what we currently have in place. Several Americans, such as myself, depend on it for survival. Many of us with mental health conditions in particular depend on it for our very sanity. And many more Americans who don’t currently possess Medicaid or Medicare don’t know what they’re missing.
If you feel like you may qualify for the Medicaid plan in your area, don’t be afraid to seek out organizations that can consult with you and help you apply.
Here’s to staying healthy and well!