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Sunday, April 17, 2016

Grateful for Insurance

On Friday, we had Ian's model waiver meeting. What is model waiver you ask, well it is one of the Medicaid programs, which is available to only 200 people is the state of Maryland. It is designed to avoid costly long term hospitalization of children with complex medical needs and disabilities by providing medically necessary supportive services in the home funded by Maryland Medicaid. The serve children with complex medical needs who are at risk of long term hospitalization/institutionalization without necessary services in the home and who are under the age of 22 at the time of the referral and are not eligible for any other Medicaid funded programs. 

Every 6 months we have to have a meeting to go over changes and coordinate his care for the next 6 months. These meetings can be tedious, even when they are about your child. Everyone who cares for Ian is at the meeting....his care coordinator (Medicaid case manager), pediatrician, home nursing agency, hospice agency, and a parent(s). We go over everything; all his doctors, when he saw them last, what was said and done and when he will see them again; all his medicines (and he is on quite a few), how often he gets them and his doses; all his equipment; all his medical supplies (a lot of those as well); his nursing needs and the hours he gets (what our private insurance does not cover Medicaid does); and his hospice needs. At the end of the meeting, the cost of services is gone over...if Ian was in a facility it would cost the state over $400,000 a year to care for him. By us keeping him home (would there be any other way), it cost the state just under $200,000 a year to care for him. I can't imagine what it would cost us without insurance....and today I am grateful for model waiver so we can spend our days with Ian home. 

1 comment:

Marci Scher said...

Mary Maslow Both of your children are such a blessing. Thank goodness that the is available to you to reduce your stress in at least one area! Hugs