Medical Insurance and College





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Discus: Parents Forum: 2004 Archive - Part 2: Medical Insurance and College
By Candi1657 (Candi1657) on Sunday, September 19, 2004 - 08:53 pm: Edit

(Posted this in the Cafe, but figured the parents would probably be more knowledgeable.)

Isn't a sort of requirement that major medical centers have to accept Medicaid? I mean, it's not like Medicaid recipients can switch health plans. Haven't seen a specialist since I've gotten here, and I'm trying to get hooked up with orthopedics and rheumatology, at the very least.

Just writing this because Yale's UHS says that they don't accept Medicaid (in a letter they wrote to my mom). Which means that I'm up a creek without a paddle.

What major medical center won't accept Medicaid????

By Marite (Marite) on Sunday, September 19, 2004 - 10:14 pm: Edit

Candi:

I believe that Yale UHS is correct. Find out what the Yale health insurance plan, which should be mandatory, does cover. Then talk to the financial officer and explain your situation: you need more than the standard emergency care normally provided under college's health plans (flu shots and the like). I am sure your situation can be resolved.

By Candi1657 (Candi1657) on Sunday, September 19, 2004 - 10:41 pm: Edit

Marite,

From what I've gleaned from the literature, there is a basic coverage offered to all undergraduates enrolled on a full-basis. This is basically (as you said) standard emergency care. There is a comprehensive health insurance plan offered by Yale (that one has to pay for), but if you have alternate insurance (which for me, I believed, was Medicaid) you can subsequently waive said health plan.
My mother was actually happy that I would be going to CT, because of the new Medicaid rules. Now (at least in NY) you have to get an HMO that Medicaid sub-contracts. It allows you to see better specialists, but comes with a lot of extra paperwork. And it can be difficult to get the sub-contracted HMO to fully pay for certain things. For example, Mom was upset because she got a bill for my ambulette leaving the hospital (after first hip surgery) and also for the yearly echocardiogram that I must have done. That's what HMO's do to you! However, if you leave the state, Medicaid waives the sub-contracted HMO and you are fully Medicaid again. I just hope I can get UHS to work with us. It simply sucks that Yale waited for months to tell us this.

By Marite (Marite) on Sunday, September 19, 2004 - 10:57 pm: Edit

Candi:

You may want to get the finaid office involved in the conversation as well. My understanding is that UHS are not equipped to deal with complex financial issues. I don't think they get many students on Medicaid! You may have to send them copy of whatever regulations you are aware of. Good luck! What hassle!

By Candi1657 (Candi1657) on Monday, September 20, 2004 - 09:14 am: Edit

Thanks, Marite!

By Candi1657 (Candi1657) on Monday, September 20, 2004 - 07:02 pm: Edit

Update:

I went to UHS Member Services today. I spoke to a woman at a desk that was initially pretty rude to me. She said, "We don't accept Medicaid...We can't trust Medicaid or Medicare", in a rather abrupt manner. She referred to someone that was over her. This woman was pretty nice, but she wasn't much more helpful. She said the only alternative I had was to purchase Yale's health plan. At this point I got so aggravated that I started to cry (yes, very embarrassing) and had an asthma attack (even more embarrassing).

I was then referred to SFS (Student Financial Services). I had calmed down by then. There they told me what I had to do was use the rest of the financial aid money left on my account to pay for the Yale Health Plan. I refused. I need that money, since I'm basically self-supported. They then referred me to a patient advocate at UHS, who I'm supposed to see tomorrow.

It was difficult dealing with all these people, because, shockingly, most of them didn't fully understand what Medicaid is. One person asked me how much I paid a month for Medicaid (not knowing it's free)...Another person asked me if I meant Medicare, and then inquired why would I be enrolled if I wasn't elderly. I had to explain several times to several people what constituted eligibility for Medicaid. I don't believe I'm the only person here on Medicaid, so I don't see why this is such a huge deal.

I hope things go better tomorrow. There has to be a Medicaid provider in New Haven offering comprehensive services (including specialty services). I tried looking at Medicaid's website, but it is so large and confusing that I gave up.

By Texas137 (Texas137) on Monday, September 20, 2004 - 07:16 pm: Edit

Skip the Yale student health service (I assume that's what we are talking about here). I would imagine that very few Yale students are on Medicaid. Unless a provider has a lot of Medicaid patients, it is cheaper to give away care for free than it is to take on the administrative burden of taking an occasional Medicaid patient.

Medicaid involves so many hassles before the doctor or hospital can collect anything that the the only way it is economical to accept any Medicaid at all is if you accept so many Medicaid patients than you can have staff who are experienced with Medicaid and do nothing but deal with the claims.

Call the social worker at the hospital associated with Yale and find out how Medicaid patients in the community access medical care.

By Thumper1 (Thumper1) on Monday, September 20, 2004 - 08:14 pm: Edit

The university health service does not have to accept Medicaid. I think you should be looking for private physicians who will accept Medicaid. Perhaps a referral to a community clinic in New Haven would be appropriate....they might be able to point you in the right direction. AT DS's university, the university health insurance plan can only be waived if the student provides evidence that they have a similar plan with the same type of coverage. To be honest, Medicaid does not provide the same types of coverage than private health insurance plans (but you already know that) and the provider list is sometimes limited. Also, you may need to check about your out of state status with regards to using Medicaid in CT. Call Medicaid and see what they say. You can't be the first person with this problem.

By Blossom (Blossom) on Monday, September 20, 2004 - 08:32 pm: Edit

Candi, your college has a Dean and a Master, both of whom are adults and university insiders. I would suggest making an appointment with either/or, explaining your situation, let them know that right now your job is to be a Yale student, and you need adult intervention to help you navigate the bureaucracy. They may have dealt with this in year's past, and may know which physicians in the community will work with you regardless of the party line is at UHS. Even if they haven't dealt with this themselves, surely one of the Masters at another college has-- so tap into the institutional support and let them help you.

It is not a good use of your time to be waiting around for appointments with social workers in hospitals, and it is definitely not a good use of your time to be arguing with Financial Aid about this late-in-the-game curve ball. You have specific medical needs and unless they are addressed, you will not be successful at Yale.

Go find one of the grownups who get paid to worry about you and let them help you.

By Candi1657 (Candi1657) on Monday, September 20, 2004 - 08:56 pm: Edit

I've already communicated with Medicaid about my status as a student in CT in my waiver of the sub-contracted HMO form.

Thumper1,

I know that there are private physicians and community clinics in the area that accept Medicaid. However, from going that route in NY (especially with the "free" clinics, well at least that's what we call them), I know that I can't do it again. They offer very limited services and since I needed a lot of specialty referrals, they winded up giving me a bunch of different doctors affiliated with a bunch of different health centers. None of them communicate on a significant level (this is the true disaster). And they tend to be of varying quality. I was stuck in this system for years. I was so happy when I found Columbia-Presbyterian Hospital in NY, and had everything transferred there (orthopedics, rheumatology, genetics, cardiology, allergy/asthma, etc.). Having everything in one major hospital system took away much of the hassle and I began to attend all my appointments on a regular basis. By the way, Columbia-Presbyterian rocks (and they have decent hospital food, too:)).

Blossom,

When my Mom first received the letter. I immediately e-mailed my dean. He is the one who referred me to the fourth floor of UHS (which is Member Services). I'm sort of tempted to e-mail him again (but don't like to feel that I'm harassing him), because the people at UHS act as if I have an unlimited amount of time with which to sort this out. I really don't, as I've said, I've gone a while without seeing anyone.

By Dmd77 (Dmd77) on Monday, September 20, 2004 - 09:10 pm: Edit

I don't know what kind of doctors you have to see, or how often, and certainly it would be easiest to see doctors on the Yale campus, but...
I can't help wondering if it might simply be easier to take the train into NYC and go to your regular doctors?

(I'm used to driving 45 minutes to see my gyn... so an hour's train ride doesn't seem impossible.)

By Candi1657 (Candi1657) on Monday, September 20, 2004 - 09:14 pm: Edit

Dmd77,

That's what I originally planned on doing, when I realized that it is truly impossible with my schedule (would have to miss a lot of school if I kept the appointment schedule that I kept in NY) and ridiculously cost-prohibitive. To be perfectly honest, I'd rather see Columbia-Presbyterian physicians more than anyone else, but now I'm realizing it's not feasible.

I know that I must not be the first person to deal with this, but you would never know that from the people I talked to! I felt like I was speaking in a different language to these people. It's times like these when I wish my Mom was here (yeah, I know, I'm being a big baby, but Moms are great in a pinch)...dealing with things is so much easier when she is around.

By Achat (Achat) on Monday, September 20, 2004 - 10:04 pm: Edit

Candi, I would suggest not only sending an email to the Dean but also making an appointment and seeing him/her. This is NOT a trivial matter and you will not be bothering him with this. I donot think you will be harassing him.

I know someone who is on Medicaid here. You are right about finding appropriate resources to help with your particular ailment takes a long time (which you probably don't have).

By Robyrm (Robyrm) on Monday, September 20, 2004 - 10:10 pm: Edit

Candi,
If the UHS does not accept medicaid, does it also mean that the University Hospital does not accept Medicaid? This would be hard to imagine. Why don't you bypass the established "student health service" program and go directly to the subspecialty clinics that you need at the hospital itself. These are likely 2 very different entities.

By Achat (Achat) on Monday, September 20, 2004 - 10:17 pm: Edit

Candi, is it possible the Yale School of Medicine's hospital provides the same comprehensive one-stop services that you got from Columbia Presbyterian? Would that be too hard to find out?

By Candi1657 (Candi1657) on Monday, September 20, 2004 - 10:19 pm: Edit

Robyrm,

That certainly seems very likely and Cleveland mentioned that on the Cafe. But what bewilders me is that I spoke to several people at UHS and two at SFS and not a single one told me that I had that option. I'd be quite angry if they ran me around if all I needed to do was contact the hospital. Then again, I would be relieved, too.:) They made it seem very clear-cut: either I get their health insurance or...well they really didn't offer any other alternative.

By Marite (Marite) on Monday, September 20, 2004 - 10:30 pm: Edit

Candi:
Truly, I think they just are not used to dealing with students on Medicaid and it is also correct that it is very hard to collect from Medicaid. Again, I suspect your Dean is not necessarily the best person to deal with this. If UHS has no or little experience, your Dean probably has even less.
Ask finaid to help you sort this out; and if not, can your finaid be extended to provide the coverage that you would have gotten under a regular health plan? This might mean signing you up on the group health plan that Yale provides for its employees and could cost about $2k. Surely the finaid office could spring for that amount and give you peace of mind?
Good luck. You have better things to do with your time than wait around in UHS.

By Candi1657 (Candi1657) on Monday, September 20, 2004 - 10:36 pm: Edit

Thanks. I just got off the phone with Yale-NH Hospital. I spoke to a woman who told me that they are affiliated with various private physicians that accept Medicaid, but she couldn't tell me if the Hospital accepts Medicaid. She says that these are two different things.

And I'm beginning to worry, because as I just now recall, I couldn't fully utilize Columbia-Presbyterian services under full Medicaid, I was only allowed to do that when I went under Medicaid's sub-contracted HMO. Now I have to be full Medicaid because I'm out-of-state. Yale-NH might be the same way. I think I might be in trouble...I may have to go the "free" clinic route.

By Achat (Achat) on Monday, September 20, 2004 - 10:41 pm: Edit

But aren't you in-state in CT now since you are a CT resident?

By Candi1657 (Candi1657) on Monday, September 20, 2004 - 10:43 pm: Edit

"Surely the finaid office could spring for that amount and give you peace of mind?"

I wish...that would be nice. However, they just seem bent on subtracting the money from my financial aid account. I guess they think they've already invested too much money in me.:)

By Marite (Marite) on Monday, September 20, 2004 - 10:44 pm: Edit

Candi:

I think you are better off asking the finaid office to cough up an extra $2k to provide the same kind of health coverage Yale provides for its faculty and staff. Really.

By Candi1657 (Candi1657) on Monday, September 20, 2004 - 10:45 pm: Edit

Achat,

No, I don't qualify as a CT resident, for some reason. I am NY resident studying in CT in Medicaid's eyes.

By Marite (Marite) on Monday, September 20, 2004 - 10:46 pm: Edit

Candi:

Our posts crossed. If necessary, ask your dean to support you in a letter to the president or the provost. I'm serious.

By Candi1657 (Candi1657) on Monday, September 20, 2004 - 10:58 pm: Edit

Marite,

I am going to seriously consider that if all else fails. I don't think the options that they've given me are fair. The "free" clinic or specific physician route is okay if you only see a primary care physician on a regular basis and only rarely see a specialist. Otherwise, it becomes a nightmare.

By Achat (Achat) on Monday, September 20, 2004 - 10:59 pm: Edit

Let us know how it went. I would go with Marite's suggestion which would give you peace of mind.

But I also know hospitals that accept Medicaid (such as St. Peter's in NJ and from about 10 years ago, Danbury Hospital in CT) but I don't know specifically about Yale-NH.

By Massdad (Massdad) on Monday, September 20, 2004 - 11:04 pm: Edit

And to think elite schools talk about enrolling more low income students! This just goes to show that the gap between rhetoric and reality at elite colleges is a chasm.

Candi, what BS you're putting up with. If I were you, I'd start some political pressure, and be sure to take a copy of today's USA Today issue with you.

No one deserves such a run around.

By Marite (Marite) on Monday, September 20, 2004 - 11:05 pm: Edit

Candi:

Do talk again to your Dean. You have some chronic medical problems and it is not wise to wait until they flare up to try to sort this out, nor is it a good use of your time as a brand new freshman. Let your Dean know that you have already spent a frustratingly long time trying to sort this out, that the financial aid office wants to include health coverage in the package it has already offered you, but that would mean cutting down on some other essential needs, and ask the dean to support you in an appeal for additional aid so that you can afford health coverage. You simply do not have the money. Yale does.
If you must use emergency services, it will be far more expensive-- probably for Yale University Hospital. Xiggi recently spent six days in hospital, which cost $20k, according to his Dad, and not all bills have been submitted.

By Achat (Achat) on Monday, September 20, 2004 - 11:12 pm: Edit

Marite, some were suggesting looking into Yale-NH hospital the same way she used Columbia-Presbyterian, as a one-stop for all kinds of services, not emergency.

By Marite (Marite) on Monday, September 20, 2004 - 11:16 pm: Edit

Achat:

Yes, I realize that. I was also taking into account her reluctance to do so, as per this passage:

>>And I'm beginning to worry, because as I just now recall, I couldn't fully utilize Columbia-Presbyterian services under full Medicaid, I was only allowed to do that when I went under Medicaid's sub-contracted HMO. Now I have to be full Medicaid because I'm out-of-state. Yale-NH might be the same way. I think I might be in trouble...I may have to go the "free" clinic route. >>

Frankly, I think that for Yale, $2k per year should be chump change. As Massdad says, when it comes to enrolling low income students, there is quite a gap between rhetoric and reality.

By Candi1657 (Candi1657) on Monday, September 20, 2004 - 11:30 pm: Edit

I read that USA Today article and it truly is disheartening. Especially if they define low-income as $49,000!

Thinking of all the hassle that I went through to get here, how I had to scrape up the money to pay my relatives to help me move, how my Mom put clothes and furniture on her credit card that she really can't afford by any means, and this current issue, I have this to say: If one is very low-income...You MUST be in love with a $40K+ college in order to attend it. If you're not passionate about school or about learning save yourself and your parents the hassle, by all means. And don't be dazzled by that piece of paper that says $0 in parental contribution.

That said, I don't regret my decision one bit. I just hope things will be better tomorrow (currently my favorite saying).

I hope Xiggi is okay. I know that extended stays can pile up ridiculous figures. I remember once when I was PICU (for asthma) five days, the sub-contracted HMO called the hospital and asked them to give a list of reasons why I should stay there one day more. I was promptly transferred to a regular ward the next day. The dollar speaks.:)

By Candi1657 (Candi1657) on Monday, September 20, 2004 - 11:45 pm: Edit

Thanks for clearing that up, Marite.

I fear that Yale-NH may be the same as Columbia, because of the woman's reluctance to say that the Hospital itself accepted full Medicaid. And my understanding (from what I've read online), is that they really don't have to because CT Medicaid recipients are sub-contracted just like us NY'ers are. It's terribly complex and hard to follow.

By Ellemenope (Ellemenope) on Monday, September 20, 2004 - 11:52 pm: Edit

A quote from the USA Today article:

"But it's not enough just to get low-income students to enroll. Once they're on campus, a new challenge kicks in. Studies show that low-income kids who meet admissions requirements perform well academically. Still, some students say there are cultural hurdles. 'It's important ... that the university creates an infrastructure for (students) to survive and thrive here,' Craig says. 'That class divide is going to hinder their experience if they're not welcomed.'"

Part of that infrastructure has got to be someone who is well versed in the ins and outs of things like Medicaid. Maybe the letter to the dean should include a copy of the USA Today article.

By Marite (Marite) on Tuesday, September 21, 2004 - 06:52 am: Edit

That USA article is so accurate. Especially at elite universities, there are expenses that do not figure in financial aid packages but that can make it impossible for low income students to join in fully in the life of the community. One example is the assumption that orchestra or choir members will have black suits (or even tuxedos) if they are men, black of white dresses if they are women; or that they will have a place to stay if the college closes down between sessions (and sometimes just because of a one-week break), or that they have adequate health coverage, which, as Candi shows, is not always the case.

By Achat (Achat) on Tuesday, September 21, 2004 - 10:35 am: Edit

The medicaid website is indeed a huge mess and hard to follow. The FAQs only cover simple cases. But I notice there is a provision that says a NY Medicaid recipient is entitled to as much support out-of-state as in-state. Not that it means anything.

By Blossom (Blossom) on Tuesday, September 21, 2004 - 10:37 am: Edit

Candi-- one of many differences between you and one of your upper income classmates, besides the obvious, is that he or she has a lot of experience making a situation like this someone else's headache. You are to be applauded for taking responsibility for your own medical care, but believe me... nobody "in charge" at Yale wants this to become a hurdle for you.

You have three options as I see it--1) continue to invest time and get aggravated and "follow the rules" as laid out by UHS and Financial Aid; 2)Give up and chew up time commuting back and forth to your care providers in NY; 3) make this someone else's problem so you can get back to business of being a college Freshman.

If you had the benefit of entitlement in addition to your obvious intellect and work ethic, you'd choose number 3. You can either write a quick letter to the Yale Daily News explaining why Yale has no interest in supporting low income students, using your experience with UHS and FinAid as Exhibit A. You can explain that you will either have to withdraw from the university and head back to NY to have access to your care providors OR use the balance of your FinAid on insurance which will leave you indigent for the rest of the year. You can also write the same quick letter to your Dean, Master, and the President of the University, letting them know how sad you are by the choice you need to make.

Then, sit back and go to classes and do your work. This is their problem to fix. Make sure your tone is neutral in the letter.

There have been Medicaid students at Yale before, but it is possible that since most 18 year olds are healthy (my kids have never seen a specialist... ever... other than the pediatrician who was their primary care physician) so I don't fault your Dean for not realizing that your situation is more complex than most. Now that you're there, you have an opportunity to let the institution come up with a solution for you and all the other Candi's who will come after you.

Candi, this is how the rich and powerful play the game.... and believe me, they are not sitting in a waiting room in St. Raphael's hospital to talk to a Social Worker about which Dr.s in the neighborhood would waive the private insurance co-pay or work w/Medicaid. Nor would they be missing class to sit on a train for a Dr's appointment, especially when coming from a place like New Haven which has a world class Med school and teaching hospital, which is a magnet for the top minds in medicine from all over the world.

By Mom2003 (Mom2003) on Tuesday, September 21, 2004 - 10:42 am: Edit

Blossom ... I hate to say it but I share your cynical outlook on this issue. Candi, talk to the dean and I bet you can get more finaid to cover the Yale insurance. You know you have a huge fan club in the parents forum right? We all need something to do now that many of our kids have left for college and are happy to write a letter your dean expressing shock that such a thing could happen at a place like Yale.

By Aparent4 (Aparent4) on Tuesday, September 21, 2004 - 10:42 am: Edit

I say walk into the financial aid office and get them to pay for your student health insurance. It is ludicrous that a student at a school like Yale should be on Medicaid. At my kids' school you are not allowed to be exempt from the student health insurance unless you can prove that your policy is equal to or better than theirs. It sounds as though the same is true at Yale. I don't see how Medicaid could meet that criterion. As Blossom says, make it their problem. Look how all of us are exorcised over this here; Yale officials should certainly see the problem and respond appropriately.

By Marite (Marite) on Tuesday, September 21, 2004 - 10:42 am: Edit

Candi:

Blossom said exactly what I wanted to say. Make it Yale's problem, not yours. As a courtesy, write to the dean, finaid office, etc.. and wait a few days for them to react before sending the letter to the Yale Daily News (don't aggravate people unless you absolutely have to!). But definitely ask Yale to fix the problem without making you pay out of your finaid package.

By Justanothermom (Justanothermom) on Tuesday, September 21, 2004 - 11:04 am: Edit

Candi:

In that letter to the Dean & financial aid office (I agree that you should allow them some time to respond to your situation before taking further action), I would explain in excruciating detail all of your health problems as well as your concern that they might resurface again due to lack of medical attention. (Don't forget to keep a copy of that letter for your records!)

I can guarantee you that Yale will scramble to ensure that you'll receive adequate medical attention while in their care!

Donít despair and lots of luck

By Cangel (Cangel) on Tuesday, September 21, 2004 - 12:42 pm: Edit

>Part of that infrastructure has got to be someone who is well versed in the ins and outs of things like Medicaid. Maybe the letter to the dean should include a copy of the USA Today article.<

There is no more than one individual (if that) alive in this country that is "versed in the ins and outs" of Medicaid in all 50 states. I bet this problem doesn't come up at Yale more than once or twice every 5-10 YEARS.

Candi, I agree that getting coverage should be the problem of the school, they are the ones who want to be so darn supportive, and open up to low income students, blah de blah, but the reality is YOU are between a rock and a hard place.

Do you have a good rapport with an ATTENDING at Columbia/Pres, preferably your rheumatologist (I'vwe deduced from your hints that you have some sort of connective tissue disease or collagen vascular, lupus, scleroderma, etc)? Call this doctor, not the clinic, his office. If he's not there, say politely, I'm a student at Yale Univ now, and I need to talk to him about getting a referral to someone who can see me at Yale Univ Hospital, when would be a convenient time to call back? The FELLOW on service might also be able to help with this, residents are probably too far down the totem pole.
Whether or not the insurance is resolved quickly, it is in your best interests to have your records sent to someone at Yale Hospital that specializes in rheum (in case you have an acute exacerbation), That's what you want to talk about. If you are 18 years old, you are the only person who can sign the papers (have a fax number handy when you call, you will have to fax a release back to COl/Pres). Once the records get sent, schedule a routine visit with this physician that the Col/Pres doc recommended. Show up with your NY Medicaid card all smiles, it is now their problem (and if worst comes to worst, you are only out one office visit, don't let them take X-rays or draw blood until the insurance is resolved). You will not be the first Medicaid patient from NYC that THEY have seen. My guess is that when the Yale doc meets you he will be impressed with your tenacity and guts to be at Yale that he will become an advocate for you. At least, someone will have access to your history, and know your name if you become ill.
Best of luck.

By Texas137 (Texas137) on Tuesday, September 21, 2004 - 12:49 pm: Edit

If you need to be seen on a regular basis by medical specialists, that may or may not be available at the University Health Center, even if they were willing to accept Medicaid (or treat you for free). Most school health centers are only set up for pretty basic, primary care sort of stuff. Find out what specialties they offer at the Yale center and see if that will meet your needs before you go out of your way to try to access the health center.

The vast majority of hospitals, including all teaching hospitals (like Yale's) are required by federal law to accept Medicaid because they receive federal funding. But that only applies to inpatient and emergency room care. It does not necessarily apply to the hospital's outpatient specialty clinics.

By Cangel (Cangel) on Tuesday, September 21, 2004 - 12:50 pm: Edit

Oh Candi, obviously, get the name of the doc they are sending rcords to, you may well talk to the Col/PRes doc's nurse, that's OK, she may handle all of this, even down to the doc's signature. They may not send all the records, it may be a summary letter. They also may ask you to come down and pick them up, your Mom can probably do this with the proper release instructions, it's not an emergency, it just needs to be done, Then you take them to the Yale office or clinic and make the appointment in person. Once you are into the specialty office or clinic, that will get you hooked into the system, they should have to see you and bill Medicaid.
I'm worried that Medicaid won't let you get routine out of state care, I'm not sure ours does.

By Nedad (Nedad) on Tuesday, September 21, 2004 - 01:11 pm: Edit

If you need to be seen on a regular basis by medical specialists, that may or may not be available at the University Health Center, even if they were willing to accept Medicaid (or treat you for free).

Very true. At four top schools I am personally acquainted with, the papers parents get from health services make it VERY clear that there are no specialists available, and although referrals will be provided, the student needs his own OR university medical insurance.

This is a terrible problem, and I am on Candi's side and hope she solves it, but it should be a lesson to others: FIND OUT IN ADVANCE how you will deal with severe or chronic illnesses once at college. This is something that NEVER should have slipped through the cracks in the first place. This should have been settled well before the first day of school!

I could never imagine letting my niece, for example, who is a cancer survivor, waltz off to college in another state until we were 100% sure we had set up in advance who her medical caretakers would be. (That's NOT a dig at Candi's parents - but someone, her doctors probably, should have warned her about getting her medical records and access straight).

If financial aid needs to go to university medical insurance, it should. Students at the university where I volunteer (and they are ALL very low-income) include it in their budget when considering their aid packages. You can't ask the university to pay for it after the fact; it must be considered ahead of time as an expense. Nor can you say you want to keep your financial aid for other things. As far as this university is concerned, medicaid is simply another insurance program, the way others of their students have free insurance through the parents' business. This is the wrong way to look at it, and unfortunate, but that is what they do.

If she got highly specialized care from UHS at Yale, she would be getting a lot more than normal students get. But they certainly should be able to hook her up, and the manner in which she has been treated is disgusting.

By Blossom (Blossom) on Tuesday, September 21, 2004 - 01:53 pm: Edit

NeDad, we're all on Candi's side but just a quick aside... my college kids have private insurance from my employer but it is most definitely not free, and the portion that I shoulder vs. the subsidy from my employer is increasing every year. It is reasonable coverage in case of a medical catastrophe, but has high out of pocket costs for the kind of specialist visits Candi is talking about, in addition to very high premiums. Thank God my kids are healthy.

I'm not sure I agree with your calculus of Candi's financial aid... I'm willing to bet a latte that the Fin Aid officer who put together Candi's package did not consider her medical needs when the numbers were run. I think she's wasting her time trying to appeal the award now, but a quick phone call from the Dean or Master from her college to the head of Financial Aid ought to be enough to resolve the issue.

As I stated earlier, most kids are healthy.... and so UHS is set up to handle coughs and colds, sprains and flu, STD's and counseling/psych services. Outside insurance is required to handle traumatic injury, a prolonged psychiatric event involving hospitalization, chronic disease management, etc. Just because Candi's case is different from the norm doesn't mean she has to sit back and "follow the rules". The rules weren't written for kids like her, and I believe that the Administration of Yale would be horrified to learn of her situation. (I don't mean the paper-shufflers she's met so far.... the top Administration.)

To your point about your niece... you may be new to the party here but this situtation is not analagous.

By Cangel (Cangel) on Tuesday, September 21, 2004 - 02:19 pm: Edit

Texas137 is probably exactly right, the physicians of the University Hosp may well be organized as a separate entity that is not mandated to take Medicaid, or they may choose to do so (the University group in my town does).As someone pointed out, it is very difficult to break even at Medicaid rates, and one way to do it, is to see a lot of Medicaid patients, and get very familiar with the bureaucracy.
I had another thought, does NY Medicaid have a patient advocate that you could call? If the state does, they may be helpful.

The more I think about this, it is not Yale's responsibility to provide Candi with financial aid to cover the in-house insurance, no more than they should cover renter's insurance for her dorm room's contents, or a middle class child's health insurance whether parent loses a job. They could probably do it if they want to, but I'm not sure about that with the state and Feds involved (Pell Grant), the rules become byzantine. After all, we wouldn't consider it CUNY's or SUNY's responsibility to give her more generous health insurance in her financial aid package, we're just talking about this because it is Yale.
It is Yale's responsibility to help her navigate the current murky situation, and get coverage now.
This also bleakly illustrates the difficulties poor children have in going to college, even with what seems to be full monetary support.
As NEDad said, it also illustrates the importance for all of us to clarify health insurance coverage for our kids before they go out of state.
All the best, Candi, you've overcome big obstacles before, you'll figure this one out.

By Mini (Mini) on Tuesday, September 21, 2004 - 02:36 pm: Edit

Candi - if you put together a letter that outlines your problem and what you need, addressed to the President of Yale, I'm sure we would all be happy to download it, personalize it, and send our own copies. The university hates to have a black eye, and the squeaky wheel gets the grease.

Make it THEIR responsibility to get it fixed - not because they HAVE to - but because they don't like the consequences of not doing so. I mean, from Yale's point of view, we are talking "budget dust" here - and one visit to the ER at the Yale hospital wipes out whatever savings they thought they might otherwise have.

By Marite (Marite) on Tuesday, September 21, 2004 - 02:49 pm: Edit

>>It is Yale's responsibility to help her navigate the current murky situation, and get coverage now.>>

That really is the crux of the matter. Legally, Yale is not obligated. But morally, it is.
When the finaid office made her an offer, it did not take into account her medical condition (and probably had not been made aware of it). I doubt very much that the package has any slack in it that could allow funds to be shifted into health care coverage. So I find the finaid office's proposal that health care coverage be taken out of her finaid package unrealistic.

Colleges can be extraordinarily flexible when they wish to be. The best case in point is accommodating students with disabilities. But it is no use dealing with low level assistants who do not have the authority to exercise any kind of flexibility, merely to implement whatever policy is on the books.

There are two issues involved: how insure that Candi has continuous specialist care as needed and how to pay for it. The idea of having all her records transferred to to Yale-NH and to have her NYC doctors get in touch with doctors at Yale-NH is a good one. For how to pay for the care, she should take up the suggestion of a detailed letter to the dean and the president or provost outlining her medical concerns and asking to pay for it.

By Candi1657 (Candi1657) on Tuesday, September 21, 2004 - 02:51 pm: Edit

Update:

So the plan today was to go to the patient advocate at UHS and if offered no satisfactory options, to go to the dean's office. I went to UHS and met the patient advocate. This woman was very sweet and personable. Didn't know a lot about Medicaid, but knew more than anyone else that I spoke to. Initially, she appeared utterly clueless as to what to do. Then she started making phone calls. And more phone calls. I was there for a very long time. Then she hung up the phone, took a deep breath and started asking more questions. One thing that I was very glad of was that she didn't mention purchasing the Yale Health Plan as an option whatsoever. She realized that traveling back and forth from NYC would not be an option and that UHS billing me and having me then petition Medicaid per bill would not be a satisfactory option either. So she formulated a tentative plan. See, there are individual physicians at Yale-NH that accept full Medicaid. The problem would then be coordinating my care and making sure that they communicated. So, she proposed that UHS serve as an external coordinator for my care by the various physicians. Meaning that they collect and store my records from various physicians and update them as to my care from other physicians. The physicians would do the actual treatment and handle billing Medicaid. I would be the one initially searching out the specific physicians, however.

I am tentatively optimistic about this plan. I say tentatively because she sounded as if she was making at it up as she went along, as if she were foraging into unknown territory. It sounds like a good idea theoretically to me, and UHS wouldn't be billing me for serving as an external coordinator. I just pray this works out!

Thanks to all for your support. I mean that from the bottom of my heart. I wish I could give you all hugs!

By Cangel (Cangel) on Tuesday, September 21, 2004 - 02:52 pm: Edit

My bad, her out of pocket health coverage might be considered personal expenses, somehow finagled into financial aid, but probably next year. Marite's right, there are definitely 2 issues, I was trying to point out that she needs to establish continuity of care, simultaneously or before figuring out the paying piece.

By Achat (Achat) on Tuesday, September 21, 2004 - 02:58 pm: Edit

Candi, soooo very glad at least something is working out. Now finding doctors is the next step. Look at what Cangel said about getting your previous doctor(s) at Columbia Presbyterian recommend someone. They all seem to know each other.

By Cangel (Cangel) on Tuesday, September 21, 2004 - 03:00 pm: Edit

Candi, that will probably work, mostly because I think you've found someone (the advocate) who will want to make it work - you may still have things to take care of, but it should be much easier now.

By Alongfortheride (Alongfortheride) on Tuesday, September 21, 2004 - 03:07 pm: Edit

I have just a couple of basic questions here and I'm sure there is someone that has already posted that can answer them. Before the question, though, I have a point. Our insurance also is not free. It is paid pre-tax through a flexcomp system. We have a point of service health care plan. The doctors who are part of the plan are all in our area. My son is attending school out of the area. Since the insurance provider does not contract with university clinics, office visits are on us. Son's school, however, charges a $360 clinic fee designed to cover office visits, so we're covered anyway. I realize that not one medical test is covered under the $360, but if something like that was in place for Candi at Yale, wouldn't it cover coughs, colds and injuries, just leaving the testing for Medicaid? I do realize that office visits are just a drop in the bucket for Candi's medical needs.

My main question is this, given the picky nature of insurance companies in this day and age, isn't there a possibility that she could be denied coverage under a private plan because of pre-existing conditions? If that is the case, it would seem to me that fixing the Medicaid issue is the route to go.

Thanks for imput. I really don't know all there is about the ins and outs of medical insurance. I just know about how our personal claims have been handled.

By Candi1657 (Candi1657) on Tuesday, September 21, 2004 - 03:08 pm: Edit

Oh, sorry if I haven't been clear. I have a connective tissue disorder (currently a bone of contention between my geneticist, my orthopedist, and my rheumatologist). The geneticist believes that it's Ehlers'-Danlos and the orthopedist and the rheumatologist believe that it is some other undifferentiated congenital connective tissue disorder. Which means that my joints are quite lax, they are very painful. I have had dysplasia in my hips that I had surgery for twice over. I have scoliosis from it as well. I have numerous X-rays taken throughout the year on my spine, knees and hips. I've also had two MRI's and a CT scan. I'm also supposed to be wearing an big, ugly brace on my knee (they threatened that I would have to have knee replacement surgery if I didn't wear it, but wearing it doesn't fix the knee, it just delays the inevitable) that I gave up wearing after three months. My skin scars easily. I was also supposed to have an endoscopy (?) because they believe that it may have been causing the lining of my stomach to bleed, but I refused (they say I'm difficult). I have to get my blood drawn frequently because often secondary connective tissue disorders develop over primary ones. I also have to get a yearly echocardiogram to make sure that it isn't affecting the blood vessels around my heart (it slowly dilates them, but there is dilation that is within range, and dilation that something needs to be done about). I also have to get my eyes checked twice a year because they believe that it is why I am so photophobic (don't know how they come up with that?). My ankles routinely swell up with fluid. I did physical therapy three times a week in NY but dropped out of doing that as well (did I mention I can be a difficult patient?). Unexplainably, as well, I keep being referred to a neurologist because I have poor balance (why can't they just chalk it up to me being a klutz???). I'm sure I'm leaving something out, but that's the major part of what the connective tissue disorder does.

I also have severe chronic asthma, which I've been hospitalized three times for (in ICU twice). And I also get severe, anaphylactic reactions from eating peanuts (asthma/allergy thing goes in hand). I also have atopic dermatitis (which has, thankfully been getting better with age).

By Alongfortheride (Alongfortheride) on Tuesday, September 21, 2004 - 03:10 pm: Edit

Candi, I was typing and answering the phone when you posted. So glad you have an advocate now, and I hope that she can get the medicaid angle straightened out for you.

By Marite (Marite) on Tuesday, September 21, 2004 - 03:24 pm: Edit

Candi:

Big hugs to you! Sometimes, somebody who does not know much about an issue makes it a point of pride to learn as much as possible about it. I hope the advocate does exactly that for you and finds out how on your behalf how to get you the best treatment possible with the minimum of effort on your part and at no cost to you. Good luck!

By Dadofsam (Dadofsam) on Tuesday, September 21, 2004 - 08:15 pm: Edit

Candi: what a couple of days you've had!! Really hope that the work of the patient advocate will result in a system being set up for taking care of your needs.

However --- I'm with those posters who advocated contacting the higher-ups in the administration in order to flag the problem. My 2 cents, for what they're worth, is that even if this system is set up, you still should do that. For one thing, you're going to be there for a few years, but the patient advocate may change jobs and there you may be all over again.

Also, seems to me that someone at Yale, whether in the finaid office or the admissions office, should have been aware at least that you had some unusual medical conditions when you were accepted. As I remember, you are a star coming out of a low income situation, and (I forget) maybe a URM as well. Even though the admissions process is over for you, the admissions office ought to have an interest in how you're doing once you're on campus, at least for attracting future applicants from backgrounds like yours.

So if you still have some time, once the system has been set up, think about sending a letter to the Dean or whomever in the administration is the proper person, summarizing the situation. Thank the patient advocate and copy her and her boss. Copy the Dean of Admissions and perhaps find a way to make sure that the letter is actually brought to his/her attention.

Meanwhile, all the best.

By Momofthree (Momofthree) on Tuesday, September 21, 2004 - 09:10 pm: Edit

Candi, my heart goes out to you. I know that you would so much rather be doing your college thing than making all of the medical connections. I can sympathize so much as my D, who just graduated, also has a chronic illness which required two fairly lengthy hospitalizations while she was in college. It is so tough to keep it all going when you don't feel well anyway, and then to have to deal with such a complicated bureaucracy! I am very sorry, and will keep you in my prayers. One thing useful I learned in our many trials is that communication with everyone in the system, from profs to administrators to supportive friends is the key to making this work. Many blessings.

By Candi1657 (Candi1657) on Wednesday, September 22, 2004 - 12:33 pm: Edit

Thanks to everyone!

As to the school's prior knowledge of my medical conditions, well, I believe they know from many avenues. First, I sent University Health Services a form my doctor filled out detailing my medical conditions. For my housing (in order to get a suite on a low floor), I had to put a note from my primary-care physician on my residential college's permanent record detailing my medical conditions. I also registered with the Yale Resource Office for Disabilities.

I did all these things prior to coming to Yale.

I must also mention that my connection to the Yale Resource Office for Disabilities has been very helpful. There is a truly wonderful woman that works there and she offered to help from a variety of sources, including a free taxi that I can summon to take me anywhere on campus! Unbelievable. Haven't used it however. I don't wish to use anything that would make me in any way conspicuous.

By Achat (Achat) on Wednesday, September 22, 2004 - 12:38 pm: Edit

Candi, how is your search for doctors in New Haven coming along? You could look at what Cangel said earlier about how to find doctors in the specialties that you need. Get Columbia Presbyterian doctors to recommend someone here.

By Xdad (Xdad) on Wednesday, September 22, 2004 - 02:34 pm: Edit

Oh my God, Candi! I just read this thread and I cannot believe everything you have to go through in your first weeks at Yale. I've said it before, but it is worth repeating: you are a truly exceptional person. I hope that many will find inspiration in your past trials and in your future development in school.

I was talking to Xiggi -who is doing much, much better now- this morning, and his comments were: "Gee, someone ought to be able to do a lot more for Candi. She should not have to climb so many obstacles. You and I ought to do something". I'm not sure what he has in mind, but I'll contribute to any efforts.

Please continue to let us know about your situation.

By Candi1657 (Candi1657) on Wednesday, September 22, 2004 - 02:52 pm: Edit

Thanks, Xdad, for the update on Xiggi and the support from you both.:)

I started calling different offices yesterday, but as soon as I say "full Medicaid" I start to get the run around. I called the patient advocate last night, a bit frustrated, and left a message on her voicemail to help me find one place through which I can get various physician referrals at once. She should be calling me back today.

By Mini (Mini) on Wednesday, September 22, 2004 - 04:40 pm: Edit

Candi - this is a ridiculous way to be spending your freshman year at Yale, instead of making friends, enjoying your classes, reading, going to plays and concerts, pledging for Skull & Bones (nix the last one), you are desperately dealing with the American health care system!

I think you should force Yale to deal with you, and I think you can.

BUT until that happens, I (as among the poorer - but happiest! - posters on this board) would be pleased and honored and privileged to make a contribution to get you on the Yale student medical plan ASAP. If you tell us how much it is, I'm positive we can make this happen (but only on your permission.)

And I'll go one better - I'm even willing to serve as the collection point, and I'm even set up to take credit card contributions. Now, let me make this clear - this will NOT be a loan, if we decide to go ahead. We will be investing in you. You will pay us all back by becoming the most amazing person you can possibly be, and we'll all benefit as a result. It will simply be a matter of passing it on.

I will understand fully if this makes you uncomfortable. But let's make sure you get what you need, and then we can all storm the office of Yale's President so he can sprinkle some budget dust.

By Marite (Marite) on Wednesday, September 22, 2004 - 04:56 pm: Edit

Candi:

Please, please write to the dean and director of finaid office, and stop trying to deal with this on your own. This is not the best use of your time.

And Mini, I would join in, too 9not poor, but quite happy). I can't believe the amount of time a brand new freshman is having to spend on non-academic issues!

By Sybbie719 (Sybbie719) on Wednesday, September 22, 2004 - 04:56 pm: Edit

Mini,

Count me in

By Achat (Achat) on Wednesday, September 22, 2004 - 04:58 pm: Edit

Count me in too. Let us know where we can contribute.

By Xiggi (Xiggi) on Wednesday, September 22, 2004 - 05:16 pm: Edit

Mini, thank you for writing what I was thinking. I did not dare to suggest such a plan without Candi's approval. I am far from being flush with cash, but I'll find a way to send in my regular contributions to your collection account. Regardless of the monetary part, I will start writing a few letters and find additional support sources. There are too many talented and generous people on this board for failing to find a workable and long-term solution.

By Candi1657 (Candi1657) on Wednesday, September 22, 2004 - 05:37 pm: Edit

Thank so much for your offer, but I could never dream of soliciting monetary donations from you all.

Believe me, the emotional support and advice that you all offer is more than enough! It means so much to me I can't even express it in words.

As much as I appreciate the gesture, I cannot accept!

By Xiggi (Xiggi) on Wednesday, September 22, 2004 - 05:39 pm: Edit

Candi, you may have exhausted all avenues but you may want to check the Medicaid page of the Yale Medical Group. Their website says that Yale doctors and providers participate in most Medicaid managed care plans in Connecticut. They list several numbers to verify eligibility.

YMG is comprised of (sic) the practicing physicians of the Yale School of Medicine, and is affiliated with Yale-New Haven Hospital, its primary teaching hospital. With over 100 specialties and subspecialties, YMG is one of the largest multi-specialty group practices in the United States.

In addition to compassionate, individualized patient care that involves the latest in clinical and technologic developments, we want to educate our patients

Yale Medical Group - Medicaid Page

I do agree with all the posters that you ought to pursue solutions with the administration of Yale. Contacting the YMG group may help you documenting your case as far as the Medicaid requirements.

By Marite (Marite) on Wednesday, September 22, 2004 - 05:42 pm: Edit

Yay, Xiggi, we may be getting somewhere with this info! Here's to your sleuthing abilities!

By Candi1657 (Candi1657) on Wednesday, September 22, 2004 - 05:52 pm: Edit

Xiggi, thanks for the link, but I think that those are for CT Medicaid recipients under sub-contracted HMO programs, because of statements such as "Medicaid Managed Care" and programs like "Blue Care Family Health Plan". Correct me if I'm wrong.

By Mini (Mini) on Wednesday, September 22, 2004 - 05:54 pm: Edit

"As much as I appreciate the gesture, I cannot accept!"

Oh, well, guess I'll have to send the check to my alma mater to underwrite the education of the millionaires' kids. (sure you won't reconsider? if you do, please don't be shy; it's only money, and there's plenty of it out there - most of us would be DELIGHTED!)

By Marite (Marite) on Wednesday, September 22, 2004 - 06:07 pm: Edit

Candi:

I would be delighted to help out financially, but I also hope not only for your sake but for Yale's and for other students in your situation who, I hope, will also have a chance to attend a selective college, that Yale comes through.

By Marianne (Marianne) on Wednesday, September 22, 2004 - 07:22 pm: Edit

I hate to be the voice of scepticism here, but
(1) why aren't your parents dealing with this?;
(2) Yale New Haven Hospital and St. Raphael's, the other large hospital in the area, are full of patients on Medicaid;
(3) the Yale Health Plan is not a major medical. My understanding is that use of it, with referrals to specialists, when needed, is paid for through tuition. In that case, the financial aid office should be involved;
(4) before writing to the Yale Daily News, how about working with your residential college dean. They bend over backwards to help students;
(5) have you directly contacted specialists you need to see if they take Medicaid? I think you are eligible, as a student with an ID, for basic care at the Health Plan. Have you been to one of the genral practitioners there with your dilemma? He or she would be the one to refer out;
(6) given your medical needs, why didn't you work all this out before leaving home?

By Candi1657 (Candi1657) on Wednesday, September 22, 2004 - 07:34 pm: Edit

Again, thanks for the offers guys, but I would like to go to the administration first. It's only right.

Marianne,
1)My mother tends to feel overwhelmed, like she can't handle things. It is for this reason that I've been the one to fill out financial aid papers, insurance waivers, etc. Her lack of education makes her feel insecure.
2)Yes, there are many people here on Medicaid. But if you carefully read the post, you would notice that CT (and NY) Medicaid is sub-contracting their care to HMO's. Practitioners are now mainly accepting the sub-contracted Medicaid (as per the website Xiggi offered) and not full Medicaid (which very few people in states that are now sub-contracted have). I was sub-contracted in NY and had to be released and be full Medicaid again because I'm out of state.
3) No, Yale Health Plan is not paid through tuition. It is a separate plan that is not mandatory, but preferred.
4) I've already contacted my residential college dean once, and I'm planning to again.
5) I've called ortho and rheum (numbers patient advocate gave), but I keep getting the run around and being referred to more people. As many people as I've seen and talked to at UHS, I think someone would have told me if contacting a general practitioner there would help.
6) I'm eighteen years old. Granted, this is not an excuse, but I didn't forsee everything. I just figured I would take my Medicaid card up to the local health facility and everything would fall into place. I mean, this sounds naive now, but I had to do everything by myself (see number one).

By Marianne (Marianne) on Wednesday, September 22, 2004 - 07:55 pm: Edit

Why don't you go to financial aid and arrange for more money (loan or grant) in order to access the basic services at Yale Health Plan. Then establish a relationship with a general practitioner at the Yale Health Plan. He or she can offer a wealth of information about specialists in the area. You are wise to continue to see you college dean for help. But in the end, if you cannot find specialists in CT who take Medicaid because of the sub-contracting issue, that's not Yale's fault.

By Candi1657 (Candi1657) on Wednesday, September 22, 2004 - 08:11 pm: Edit

"Why don't you go to financial aid and arrange for more money (loan or grant) in order to access the basic services at Yale Health Plan."

The only thing that they would likely offer me (at least what I can surmise from the conversations we've had) is an increase in self-help (loan). However, two financial aid counselors have previously told me (looking at my financial aid package) that I'm in danger of borrowing too much already. I do have Yale Health Basic (offered to all undergrads) but it offers pretty limited services.

"Then establish a relationship with a general practitioner at the Yale Health Plan. He or she can offer a wealth of information about specialists in the area."

I'm not too sure about that. Even the people at UHS that are supposed to specialize in special cases like mine keep on acting as if they are not sure how to approach my situation. But I'll give anything a shot.

"But in the end, if you cannot find specialists in CT who take Medicaid because of the sub-contracting issue, that's not Yale's fault."

I never said that it was. However, I think it would behoove people at Yale UHS to become more knowledgeable about such matters so that I don't have to go back and forth for days trying to figure out simple information. That's the most frustrating part. That there are so many people that I've spoken to, and very few people that actually know anything about Medicaid. It is giving me so much anxiety having this hang over my head for so long.

By Marite (Marite) on Wednesday, September 22, 2004 - 08:21 pm: Edit

Candi:

Your dean must have an assistant who could do all the investigation and coordination on your behalf, together with the helpful advocate you talked to earlier. The assistant may not know about medicaid, etc... but s/he has the advantage over you of familiarity with the Yale bureaucracy. Knowing which office to contact is very important. Let the assistant do the work for you. But you do need to write that letter.

By Xiggi (Xiggi) on Wednesday, September 22, 2004 - 08:22 pm: Edit

Candi, I am sorry if the YMG turned out to be another closed door. I am afraid that it shows how little I know about Medicaid. You explained the differences arising from the NY versus CT residency status, and I did not pay enough attention to it.

I would still encourage you to contact the administrators of the groups, as they may be able to advise you. Would a change in residency be possible because you are technically self-supporting? Again, I apologize for bringing up possibilities that have already been rejected. In the meantime, remain positive and things will work out! We'll keep looking.

Marianne, I do not believe that it is helpful to try to ascertain whom deserves blame or responsibility. This is a matter well beyond the potential understanding of a teenager. Because most adults do not expect a person like Candi to HAVE To deal with this type of issues, she probably receives less respect than she deserves. In the past weeks, I have had to set up specialists appointments in a new environment, and I can guarantee you that it is not as easy as one imagine ... and this despite having full coverage and the unabated support of my family and school.

By Candi1657 (Candi1657) on Wednesday, September 22, 2004 - 08:50 pm: Edit

Marite, I'm planning to contact the dean tomorrow. But which do you think is a better idea, to go in person or write the letter? I value your opinion.

Xiggi, it's the thought that counts and you've been so supportive and I truly appreciate it. Well, legally and tax-wise, I am not self-supported. In reality I am essentially, because I find a way to purchase most of my necessities without getting my Mom involved. She has helped me with buying some stuff I needed to move here. On a regular basis outside of this circumstance, however, I buy my own clothes and other necessities and have for years. The patient advocate brought up re-applying for Medicaid in CT, which sounds like a good idea, but I would be under a sub-contracted HMO in CT and couldn't use it when I'm in NY.

By Achat (Achat) on Wednesday, September 22, 2004 - 09:03 pm: Edit

Candi, maybe if you are staying in CT for 9 months of the year, re-applying in CT would be better? Could you switch over when moving to NY?

By Candi1657 (Candi1657) on Wednesday, September 22, 2004 - 09:19 pm: Edit

I don't know. I don't think it is as simple as my statement perhaps implied. In the waiver of the HMO I filled out, it seems that Medicaid views me as a NY resident temporarily staying outside of the state. And even if I were to switch over, I don't think switching back and forth would be so easy. I think you have to count as a resident before applying any state's Medicaid, so I'm not sure how one could switch residency back and forth.

By Marite (Marite) on Wednesday, September 22, 2004 - 09:37 pm: Edit

Write a detailed letter and give it to the Dean. Your case is complicated, and if you merely tell the dean, he may not remember all the details when trying to get your case solved. He will probably delegate much of the work to an assistant who will need to be made aware of all the issues involved.
As you probably have realzied by now, you know far more than the various people you have talked to at Yale about both your medical condition and your needs, and about the ins and outs of Medicaid. In your conversation with the dean, you can outline the main issues, and then give him your letter.
As well, have as much paper trail as possible. In complicated cases where many individuals and/or offices are involved, it is useful to have everything documented.

Good luck to you tomorrow.

By Candi1657 (Candi1657) on Wednesday, September 22, 2004 - 09:48 pm: Edit

Thanks, Marite. I will start on the letter tonight.

By Achat (Achat) on Wednesday, September 22, 2004 - 09:56 pm: Edit

Candi, I understand. My mother-in-law used to be on Medicaid because we couldn't get insurance for her - too many pre-existing conditions while being over 75. I was just hoping there would be a simple solution but there isn't.

But to tell you the truth, she did get reasonably good coverage in NJ when she was very sick. So if you stick around somewhere for long, it's fine. But if you don't you are on your own..

By Mlee (Mlee) on Wednesday, September 22, 2004 - 10:05 pm: Edit

Candi,

Have you tried contacting the medical social work office of Yale New Haven hospital and clinics, if there is such an office? Medical social workers should know the ins and outs of Medicaid and how it works at their institution. Good luck.

By Candi1657 (Candi1657) on Wednesday, September 22, 2004 - 10:07 pm: Edit

Achat,

Are you sure it was Medicaid? Isn't that Medicare?

By Over30 (Over30) on Wednesday, September 22, 2004 - 10:10 pm: Edit

Candi, I have no idea if this would be useful, but you might want to contact the SHOUT organization at Yale. I know you're 18 now and they advocate for children, but it seems as if this group might be able to point you to someone who can help. http://www.childrensdefense.org/studentoutreach/shout_movement.asp

By Robyrm (Robyrm) on Wednesday, September 22, 2004 - 10:18 pm: Edit

Can I make an offhanded suggestion as well...I would CC your letter to the undergraduate dean to the dean of the medical school and to the president (or whatever they would call it) of the hospital. Sometimes there is flexibility in systems which seem impervious when you know the right person...When I was in medical school I had an insurance plan through my parents that did not cover care at the hospital where I was doing my training (an HMO thing). I had a significant medical problem which needed follow up, and the hospital had a fine program which met my needs perfectly. I wrote to the dean, the hospital director and the chairmen of the departments involved (of the medical school). Next thing I knew, I received services as a "courtesy". I filed bills with my insurer, and anything that wasn't covered the hospital would write off.

You are "one of their own" and you have significant medical needs that are not going to get better if you have to stress about this...It doesn't take much time to CC these people...and it could do the trick!

By Achat (Achat) on Wednesday, September 22, 2004 - 10:21 pm: Edit

Candi, it was Medicaid. My mother-in-law came here to the US with a green-card when she was 73. She did not qualify for Medicare.

Anyway, it isn't perfect. We also had a hard time finding doctors.

By Achat (Achat) on Thursday, September 23, 2004 - 09:08 am: Edit

Candi, I don't mean to make light of your situation by mentioning my mil getting medicaid. It does take a lot of persistence to find the doctors.

Do keep us informed of your situation. You should get regular insurance and I really wish you get it somehow (including using our help).

By Marianne (Marianne) on Thursday, September 23, 2004 - 09:57 am: Edit

Xiggi,
It seemed to me that the general gist of the thread,from many ofthe posters, was that "bad" Yale was not doing anything to help Candi. I was simply pointing out that it may be a lot to expect of Yale that they immediately solve this young womans problems or that they have all the answers she needs.
Candi:
"Then establish a relationship with a general practitioner at the Yale Health Plan. He or she can offer a wealth of information about specialists in the area."

"I'm not too sure about that. Even the people at UHS that are supposed to specialize in special cases like mine keep on acting as if they are not sure how to approach my situation. But I'll give anything a shot."

I think you should start by establishing a relationship with a gp at the Health Plan. Give them more of a chance to help you.

By Justanothermom (Justanothermom) on Thursday, September 23, 2004 - 10:34 am: Edit

Candi,
I am more than happy to help as well.

It is important, though, that you get Yale involved in finding a longer term solution for your medical care. I can't help feel that Yale has a vested interest in helping you succeed at their institution. Your acceptance as an URM becomes meaningless if not tied with the necessary support that gives you the opportunity to succeed.

I wouldn't let Yale off the hook in providing you with a viable medical option. In advocating for yourself, you'll be advocating for others, with similar problems.

Despite these issues, I hope you are staying positive and focused on your classes. Good luck!

By Candi1657 (Candi1657) on Thursday, September 23, 2004 - 10:49 am: Edit

Achat,

I didn't think you were doing that at all. I was just curious. I appreciate your support greatly.

Marianne,

When you say things like "give them more of a chance to help you" (meaning UHS), I can't help but have the distinct feeling that you don't understand what I've been through with UHS over the past couple of days. If someone sitting in front of a database of doctors listed by specialty and insurance that they accept cannot help me, I don't see how the average general practitioner at UHS could (especially since they never refer someone with Medicaid, they refer people with UHS-accepted health plans). I appreciate your advice, but just thinking about the frustration associated with dealing with UHS is making tears well up in my eyes as I'm sitting here right now.

By Candi1657 (Candi1657) on Thursday, September 23, 2004 - 11:01 am: Edit

I typed the letter to the Dean last night and sent it to myself in an e-mail (so I can print at a computer cluster nearby, since I don't have a printer). I've sent it to myself three times (twice last night and once today) and for some reason it's still not showing up on my e-mail...Maybe I can try by my Yale e-mail.

By Marite (Marite) on Thursday, September 23, 2004 - 11:29 am: Edit

Candi:

Cc your letter to the various people you have contacted so they know the dean is in the loop. My S is having some difficulty contacting friends who have just gone off to college. He's thinking of finding out their new addresses. Perhaps your Yale email address is easier to access.

By Emptynester (Emptynester) on Thursday, September 23, 2004 - 12:37 pm: Edit

"But in the end, if you cannot find specialists in CT who take Medicaid because of the sub-contracting issue, that's not Yale's fault."

Respectfully disagree. As a parent who has done the FA papers for several years, it seems to me that this is an FA issue the school should have dealt with competently in the beginning. They had all the necessary documents. They understand health care/insurance is a necessity. They expect/want all students to have private coverage. It should have been included as part of the original package. JMHO as I understand FA. This poster's situation may be outside of Yale's experience but that doesn't excuse what is happening. Ditto Robyrm's suggest of cc's and good luck! Hope you can get this resolved very soon. Also think Blossom was very wise in telling you to make it someone else's problem if at all possible.

By Dadofsam (Dadofsam) on Thursday, September 23, 2004 - 12:44 pm: Edit

Candi:
Justanothermom and Emptynester said it better than I did. You need to work on getting this resolved for the long term as well as the short term. Yale ought to be strongly interested in helping you succeed. Unfortunately, it sounds like most of the people you have been in contact with don't look beyond their immediate situation or responsibilities and realize that.

In addition to sending letters or e-mails, you should try to get an appointment to meet with this dean or someone in that office to discuss the whole situation. Otherwise the letter may get put into a stack of things in someone's inbox.

By Candi1657 (Candi1657) on Thursday, September 23, 2004 - 01:12 pm: Edit

OK, I finally got it printed out. My French class ends at 2:20 p.m. After then I'll go out, print more copies of the letter and go to the dean's office directly.

By Songman (Songman) on Thursday, September 23, 2004 - 01:23 pm: Edit

Jeez Candi I just deleted a report that Yale medical center is being sued in a class action suit over this issue.I will try to find it and post link

By Songman (Songman) on Thursday, September 23, 2004 - 01:58 pm: Edit

Yale New Haven Hospital, Inc, Yale-New Haven Health Services Corp. and the American Hospital Association
A class action lawsuit has been filed against Yale New Haven Hospital, Inc, Yale-New Haven Health Services Corp. and the American Hospital Association on behalf of uninsured patients. The suit alleges that the defendants have failed to provide healthcare services to all Connecticut residents regardless of ability to pay, which is a violation of Yale-New Haven's criteria for federal and state tax exempt status as a non-profit. This suit is the 47th case in the nationwide nonprofit class action litigations which commenced on June 17, 2004.

If you feel you qualify for damages or remedies that might be awarded in this class action please fill out the form below.

Sorry did not get to read entire thread..is this the hospital that refused treatment?

By Mstee (Mstee) on Thursday, September 23, 2004 - 02:11 pm: Edit

Candi--I have no advice, but just want to add my good wishes to solving this problem. Sounds so frustrating. Health care in this country is so screwy. I was fuming last week because it took three calls over a three week period to our HMO (Kaiser in CA) and at least an hour of my time to get approval for a meningitis shot for my son. The third person I contacted finally was able to figure out how to expedite this simple request! I can only imagine the run-around you are getting. But don't give up. There has to be someone there who can figure this out!

I would also love to contribute to a fund to just buy the darn insurance if it comes to that. You shouldn't have to be going through this!

Am trying to figure out what to do in my own S's case. Theoretically he is covered by Kaiser, but in a true emergency would he get what he needs in Chicago if we don't buy the University coverage? Still puzzling over that one. . .

By Marianne (Marianne) on Thursday, September 23, 2004 - 02:25 pm: Edit

Emptynester,
Colleges offer students a choice of major medical insurance: the college sponsored major medical or the major medical of the student's choice. If a student doesn't sign up for the college sponsored major medical, or work with FA to make it part of the package, the college assumes the student is choosing to come with his or her own major medical. If Candi didn't choose the Yale full coverage for financial reasons, and elected to come to New Haven with her Medicaid coverage, how is it now Yale's responsibility to find coverage for her?
Everyone:
The class action suit has to do with Yale New Haven hospital not using funds set aside for indigent care but rather forcing people to pay their bills. I don't think it is the same issue as what Candi is dealing with.

Not to become an apologist for Yale, but from reading the thread it does seem like there are people trying to help Candi. As I said previously, if they are not coming up with instant solutions, that doesn't mean they are avoiding responsibility.

By Marite (Marite) on Thursday, September 23, 2004 - 02:43 pm: Edit

Another non-helpful post from Marianne.

By Candi1657 (Candi1657) on Thursday, September 23, 2004 - 02:48 pm: Edit

"Yale New Haven Hospital, Inc, Yale-New Haven Health Services Corp. and the American Hospital Association
A class action lawsuit has been filed against Yale New Haven Hospital, Inc, Yale-New Haven Health Services Corp. and the American Hospital Association on behalf of uninsured patients. The suit alleges that the defendants have failed to provide healthcare services to all Connecticut residents regardless of ability to pay, which is a violation of Yale-New Haven's criteria for federal and state tax exempt status as a non-profit. This suit is the 47th case in the nationwide nonprofit class action litigations which commenced on June 17, 2004."

That is not quite related to my current issue, but it has some of the same themes concerning less than comprehensive health insurance. It's quite ironic, because when I was just speaking on the phone to my grandmother last night she said, "You don't have to worry about it if you have an urgent problem. They have to take you, even if your insurance isn't comprehensive." It's a shame what people that have no insurance (or less than comprehensive) insurance have to go through to get healthcare. I hope the hospital makes sufficient changes to its policy in the future.

By Marianne (Marianne) on Thursday, September 23, 2004 - 02:53 pm: Edit

Marite,
I'm not sure the posts encouraging Candi to write letters to the newspaper, etc., are helpful. Shouldn't she be working with the people at the Yale Health Plan who are trying to help her? She hasn't even seen a doctor there yet, who coordinates care with specialists in the area. I'm not sure what you are referring to when you say "another non-helpful" post?

By Candi1657 (Candi1657) on Thursday, September 23, 2004 - 02:53 pm: Edit

Update:

I spoke to the dean (and gave him my letter). He is probably the nicest, most considerate man I have ever met in my life. He immediately contacted the Head of Student Medicine and left a message on his voicemail. He said that my job now is to stop worrying, take a nap, and relax. He said that he will take care of everything.

I feel like a massive weight has been lifted from my shoulders. Thanks to those who came up with the idea of going up to the Dean and giving him the letter. I'm so happy right now.:)

By Candi1657 (Candi1657) on Thursday, September 23, 2004 - 02:57 pm: Edit

Marianne,

I already told you why that wouldn't be helpful. You haven't responded to me telling me why my line of reasoning concerning that matter is wrong...If you did I would listen honestly and openly. I honestly believe that I would encounter a better source of information on specialists who accept full Medicaid by walking all the way to Yale-NH and asking a random physician. I believe you are a good person, but I can't help but get a negative vibe from you when your first post announces your skepticism and when you nitpick at points that I feel I've already sufficiently responded to. Correct me if my perception is wrong. I don't wish to antagonize you.

By Mstee (Mstee) on Thursday, September 23, 2004 - 03:02 pm: Edit

Candi--YES!!! That is exactly what I hoped would happen. . .

By Demingy (Demingy) on Thursday, September 23, 2004 - 03:02 pm: Edit

Yaay, Candi! Sorry to have taken so long to post, but I have been keeping up with your ordeal. I'm so glad that someone else is finally taking care of this. It is like so many people here said, you really shouldn't have to worry about this and now it sounds like you really don't have to. :)

By Sybbie719 (Sybbie719) on Thursday, September 23, 2004 - 03:12 pm: Edit

Hi Candi,

Thank goodness you finally have a person who is willing to get this solved for you.

Now, on to ENJOYING being a freshman and take that well deserved nap!

By Achat (Achat) on Thursday, September 23, 2004 - 03:13 pm: Edit

Second that.

By Emptynester (Emptynester) on Thursday, September 23, 2004 - 03:46 pm: Edit

"Colleges offer students a choice of major medical insurance: the college sponsored major medical or the major medical of the student's choice."

My experience is with two sons at two different colleges where only after we accepted FA offers and received our academic year bills and in one case had actually paid for first term, we were informed about the insurance issues-- " choice of major medical insurance: the college sponsored major medical or the major medical of the student's choice." The FA forms (someone correct me here if I am wrong; but I don't remember anything) don't specifically address this issue because I assume it isn't usually an issue. Maybe your experience with FA was different? There is a space for special circumstances which Candi will know how to fill out this next year as she now understands Yale's position on this issue. I don't know how she could have been expected to anticipate this being a problem. Based on the forms I fill out, I wouldn't have the first go round. Yale obviously didn't but should have IMHO. Again if my understanding of FA is correct, the school comes up with a $ amount they believe the student/family can afford. Looking at her file, Yale might have been able to see there was no private insurance coverage or ability to pay for that coverage. Thus IMHO it should have been part of the original package. I can just imagine the Kafkaesque nightmare this student found herself in but am very glad to learn it may now be resolved. The nap idea sounds like really good advice!

By Marianne (Marianne) on Thursday, September 23, 2004 - 03:47 pm: Edit

Candi,
I have quite a bit of experience at the Yale Health Plan. The doctors there coordinate referrals to outside specialists. They are very familiar with the local medical community. There are many fine, caring people working at the Health Plan. You are entitled to visits with the doctors there through you basic coverage. I'm sorry if you perceive may questions and suggestions as nitpicking, but it is not an insignificant detail to suggest that you make an appointment with a doctor at the Health Plan before tackling the entire Yale medical community on your own. Also, I did recommend that you continue to make use of your dean, and that seems to have worked for you.

By Marite (Marite) on Thursday, September 23, 2004 - 03:52 pm: Edit

Candi:

I am SO, SO glad for you. Exactly what I think a dean should say to a student, and a brand new one at that. Even though the dean knows far less about Medicaid than you do, he has far more resources than you to sort the situation out--including staff who know their way around Yale and have time to investigate.
The weather is glorious. I hope you are enjoying your classes.

By Candi1657 (Candi1657) on Thursday, September 23, 2004 - 04:02 pm: Edit

Thanks to all. I'm truly enjoying my classes and the weather is fine...

I'm just so relieved that I don't have to back to UHS. They are good, decent people, but their lack of knowledge concerning this area is very disheartening, to say the least. It's makes more sense, anyway, to be set up with a primary-care physician that can truly refer me to a specialist (because he accepts my insurance).

I think I'll take that nap now.;)

By Marianne (Marianne) on Thursday, September 23, 2004 - 04:08 pm: Edit

Marite,
Would you kindly specify what were you referring to when your characterized my post as "another non-helpful post"?
Thanks!

By Marite (Marite) on Thursday, September 23, 2004 - 04:15 pm: Edit

Answer:
>>Not to become an apologist for Yale, but from reading the thread it does seem like there are people trying to help Candi. As I said previously, if they are not coming up with instant solutions, that doesn't mean they are avoiding responsibility. >>

By Marianne (Marianne) on Thursday, September 23, 2004 - 04:27 pm: Edit

I thought it would be helpful for her to understand that sometimes getting help from people takes a little bit of time, especially when the problem is a complicated one. Instantly writing off people who are trying to help but don't have an immediate solution doesn't always work to one's advantage.

By Candi1657 (Candi1657) on Thursday, September 23, 2004 - 04:41 pm: Edit

Marianne,

Your words are really starting to upset me now. "Instantly writing off people who are trying to help but don't have an immediate solution doesn't always work to one's advantage."

How did I write anyone off? I couldn't sit around and wait for them to figure out what to do when they don't even understand the nature of the program that they're dealing with. As I said early on in the thread, I need to see someone very soon. I am off of anti-inflammatory medication and in a good deal of pain. So no matter how well-intentioned they may be, if they can't offer that immediate help despite knowing the urgency, I am forced to look elsewhere. It's not being hasty, but prudent.

By Thumper1 (Thumper1) on Thursday, September 23, 2004 - 05:18 pm: Edit

Candi, Perhaps someone already suggested this...could you get a referral and/or information from your NYC physicians? Most doctors have connections with others around the country. It seems like this would be particularly possible since NYC and New Haven are not all that far apart. Your doctors in NYC should be able to help you seek the continued medical care within the Medicaid system. Certainly they must have had instances of folks relocating, for example. Try calling them.

By Mom2003 (Mom2003) on Thursday, September 23, 2004 - 05:20 pm: Edit

Candi
Ignoring posts that one does not like is the way to sanity (and a good nap). Of course my son will laugh when he reads this because he has seen me fuming at many small things but do as I say and not as I do.

Seriously, I am REALLY happy that you can now concentrate on studying instead of worrying. It must feel good to handle such a major issue on your own and find a good resoultion to the problem.

By Candi1657 (Candi1657) on Thursday, September 23, 2004 - 06:27 pm: Edit

Thumper1,

I was under sub-contracted Medicaid in NY, not full Medicaid and the doctors I had in NY were a part of that plan. I could not see them under full Medicaid. Still, contacting them might be a very good idea. I'll call my Mom about it since she has the numbers.

I'm happy to see that you all are sharing in my relief, as you shared my worry over the past couple of days. You all have been a great resource.

By Momofthree (Momofthree) on Thursday, September 23, 2004 - 06:35 pm: Edit

Dear Candi,

So happy to know that advice to go to the Dean was helpful, and that HE was both kind and helpful. It is so good to hear the lift in your "voice." All the best!

By Mini (Mini) on Thursday, September 23, 2004 - 06:49 pm: Edit

So...now what are you going to do for fun??? (I hope you didn't take up my suggestion about pledging Skull & Bones...)

Congratulations!

By Candi1657 (Candi1657) on Thursday, September 23, 2004 - 07:04 pm: Edit

Hehehe...Thanks, Mini...Skull and Bones is drawing me in (I mean, how cool is it to be in a beatiful, square, tomb-looking building performing secret rituals passed down for generations)...

I'm hanging out with the people in the suite above me tonight...nothing crazy, I have a lot of Psychology reading to do.

By Xdad (Xdad) on Thursday, September 23, 2004 - 07:29 pm: Edit

Skull and Bones ... not a bad line on Candi's resume when she will run for President. :)

As everyone else, I am very happy to read that a solution is in the works. I would also encourage you to try to identify other weaknesses in your FA package. I am a bit concerned that you have to rely on your finaid to support yourself, because that is very hard to do. On the other hand, I have no doubt that you will keep on overcoming all problems that face you.

By Achat (Achat) on Sunday, September 26, 2004 - 05:13 pm: Edit

Candi, let's know how this goes next week.


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