I Want Her to Be Cared for Properly . . .

I have taken care of my mom all my life as she has had debilitating Rheumatoid Arthritis since she was 6 years old. She went through an experimental treatment about 20 years ago, hoping to put the arthritis into remission. The treatment not only didn’t help the arthritis, but she contracted Chemical Hepatitis as well.  I’m afraid that treatment along with the medications she has had to take for so many years has worn out her liver . . . due to all the pain and cortisone treatments she has had to take through the years, she is now suffering from non-alcohol related cirrhosis of the liver. She was diagnosed 4 years ago with this.

In December 2012, she got to the point where she could no longer care for herself. We moved her in with our family, my husband, my step-son and myself. I now care for her full time. I worked in accounting for 15 years but I am no longer able to work outside the home due to her many needs.

The Medicaid/Medicare issues alone have been a nightmare. My mom was originally only on Medicaid due to her indigent financial status and then in June of this year, she “Qualified” for Medicare. She was transitioned over to Medicare from Medicaid but had Medicaid as a backup. Thankfully, her medical needs are covered this way but her medications became a huge problem. Medicaid uses a company called Amerigroup and StarPlus as their insurance providers and processors for both medical and medication needs. Medicare uses Aetna to process their prescriptions.  If the medication a person is taking is not on Aetna’s Formulary, then it is no longer covered by Medicare. When my mom was switched to Medicare from Medicaid, FIVE of her prescriptions were not on Aetna’s list.  I spent hours and hours on the phone until I was finally able to find the right “Department” to help me. I had to ask her doctor to fill out multiple forms for EACH prescription and each one had to be submitted for review and approval to be added to the Formulary.  There is actually a “hamster wheel” process that happens between Medicare, Medicaid, Social Security and Aetna. I was finally able to get her medications approved but it took me several months and many, many days and hours on the phone.

I help my mom with meals, meds, doc appointments, medicare and medicaid issues (LOTS!), bathing, cleaning―pretty much everything . . . but  I love my mom and want her to be cared for properly.