You may have seen the story recently on the news or on social media. A couple in Texas is considering divorce because the skyrocketing medial costs for their disabled daughter are becoming cost-prohibitive. If they divorced and the wife filed as a single, unemployed parent with the state, she and her children would qualify for Medicaid, which would basically provide them free healthcare.
To some, it may seem ludicrous to consider divorce due to expensive medical care not covered by health insurance. But when your child’s health is at stake and you have no money to cover the bills, you’ll do just about anything.
Rewind back to 2012. Chloe was in sixth grade but hardly attending school and we were hanging on by a thread. We knew we needed help but there were little resources in our small town. Our school district wasn’t equipped to handle her mental illness and learning disabilities nor were they willing to provide much support.
When we had exhausted all other treatment options available for Chloe, we began investigating residential treatment centers. We quickly learned that unless she had Medicaid, it would be near impossible to get her admitted and equally difficult to keep her there longer than a month. At $700-$1,400 per day, private insurance companies have little desire to pay for long-term treatment that has minimal research on outcomes, like mental health.
Nonetheless, we knew residential treatment was the next step for Chloe and we insisted on her admittance until a bed was made available to her. But like we had been advised, our private insurance carrier wanted her discharged after two weeks. We knew she would need months in treatment but at $900 per day we weren’t sure how we would be able to afford it.
Jeff and I had been married for 14 years at that point. Though we had never even spoken of divorce before, we did that year. We would never qualify for Medicaid unless I was a single mother. Fortunately, we stumbled upon a quirky law which allowed us to switch Chloe onto the children’s Medicaid program in our state when we moved her to another treatment facility.
We weren’t so fortunate for her second round of treatment in Utah. The health insurance companies want to “preauthorize” certain medial conditions – residential treatment is one of them. Due to Chloe’s deteriorating behaviors and mental state, it was emergent that we sent her when we did and not wait for our insurance carrier’s “preauthorization.”
Now, almost 24 months later, we have just submitted our first appeal to our insurance company for denying her treatment. It is a long, confusing and complicated process, and we decided to hire a third party company that specializes in insurance denials management.
Jeff and I have remained married during her treatment program and didn’t have to resort to divorce, primarily due to both of our parents’ generous financial support of Chloe’s program. It makes my blood boil, though. How many middle class families have the family resources to send their child to residential treatment at $11,000 per month? Right – not many! Similarly, families around the United States face daunting choices daily because private health insurance may not cover costly medical expenses. It’s not right.
If you’d like to add your voice to the healthcare crisis, please visit the Save My Care website for more information.
Below is the original video coverage of the Texas couple considering divorce. Click to view the Today Show’s story.
Great article, thanks Andrea