Heather's Story

“When my first son was born, we had private insurance through an employer; however, it did not cover specialty care in the hospital, including the neonatologist even though our baby was born premature.  Our bill was $110,000 and we thought that we would have to declare bankruptcy.  But the doctor’s office suggested that we contact the Virginia Insurance Commission.  They took our case and mediated a settlement on the bill.  We still ended up paying tens of thousands out of our own pockets.

“Both our boys are developmentally disabled and we learned that they were eligible for a medical waiver through the Virginia Department of Medical Services.  The boys were entered into the Medicaid Program by being eligible for the Elderly and Disabled Consumer Directed Waiver. However the enrollment process was extremely difficult and lengthy.  From being told that there were no programs because of income (which wasn't true) to having the state lose the children's birth certificates to never receiving promised follow-up phone calls, it was a time consuming, arduous process.  But we persisted and finally received the boys' acceptance letter and Medicaid cards.  We then waited for a call from the home health agencies and it never came.  The paper work never got from the Health Department to the Home Health agencies.  The coverage we now receive saves us about $2,000 a month in therapy costs and medically necessary liquid nutrition."

- Heather K., Virginia