Thursday, May 26, 2016

OK Either Way

I've been spending much of this week trying to get my Medicaid coverage reinstated. As of now, it's still supposed to terminate at the end of this month. Here's what seems to have happened.

In Colorado, USA, we have an online state health care exchange. Many insurance companies sell policies on the exchange, and if you don't qualify for Medicaid, you choose from one of those plans. Hopefully, based on your income, you get some kind of subsidy. For 2014 and 2015, we had private health insurance with a high deductible. We got a subsidy to help with our premiums. But this year, since I make so little, and with my business expenses, my business actually runs at a loss, we qualified for Medicaid. Until recently.

It's not that I've made any more than I estimated at the end of last year. My income has been exactly what I expected. The problem seems to be that the government can't seem to wrap their heads around the fact that I'm self employed, even though I've been filing my taxes that way since 1988. I don't get a steady paycheck. I have clients who pay on time sometimes, but not all of the time.

My two remaining clients that pay me my monthly income are radio stations. I write and produce song parodies for radio. Topical stuff, mostly. I do a parody each week for them, and get paid by the month. The problem with radio stations is that invoices frequently get lost, or skipped, or paid late. So some months I get less, others more. It all depends on when they decide to pay. And every December, no one is in the office for the last two weeks of the year. So nothing gets paid in January. They catch up in February. I've dealt with that for my entire career. You just have to plan for it.

That's what happened this year. Nothing in January, but I got paid double in February. Actually, it was more than that, because one station also paid an old invoice from last November that had gotten lost. So my deposit in February was more than twice what it should have been. That apparently raised a red flag, and they decided I was making too much money.

When I went to the local Medicaid office to ask about it, I was told that Medicaid averages your income out for the year, but the Department Of Labor goes month to month. They sent the notification to Medicaid that I was too rich. I guess it's too much to expect that all of the agencies that are affected by this would use the same rules.

So I ended up back on the phone with Connect For Health Colorado this afternoon. That's the name of our state health care exchange. A very nice guy stayed on the phone with me and took down all of our financial information. He thinks we should be able to stay on Medicaid, but he couldn't get it to go through because of some computer hangup. I almost told him to get a Mac, but I was nice. He had to create a ticket, which they will hopefully follow through on before my coverage runs out.

Even though I'm working as hard as I can to keep our coverage, I'm at peace with whatever happens, as I keep saying. I'd like to see my oncologist on July 7th like I'm scheduled to, but if not, that's OK. It's just a consultation. I'm supposed to get my PSA tested beforehand, and then meet with the doctor to discuss where we are. No treatment is planned for this visit. My next Lupron shot isn't scheduled until September. So I have some time.

As I said in a previous post, the one thing I'll really miss if I lose coverage is seeing my therapist. She takes Medicaid, which many good practitioners don't because Medicaid doesn't reimburse well, or in a timely manner, and it's a constant headache to deal with. I can relate to that! But she is one of the ones who does take it, and she's been really great. Therapy has done me a lot of good, and I've only had five sessions. But I can live without that if I have to.

If I lose Medicaid, and am forced onto a private health insurance plan for the rest of the year, I will probably abandon conventional treatment, at least for now. I can't pay out of pocket for treatment until I hit my deductible. That's just not possible. And I don't feel like I can ask for more help than has already been offered.

If you've been reading my recent posts, you know where I'm at with conventional treatment anyway. I'm fine with staying on Lupron for as long as it keeps working, as long as it's covered, and as long as I can keep taking 5-HTP to counteract the emotional volatility. But I am not paying out of pocket for a drug that has so many negative effects on my body. I'd rather just trust God for my healing than do that. I'd rather try naturopathic treatment than do that too, and I plan to do just that. I have help to pay for that, for which I am very grateful.

Here's the thing about trusting God in this context, at least to me. I know that many don't like the fact that I frame it that way. I don't mean to imply that if you seek standard treatment, you don't trust God. But I feel like I can trust God for this. I have so many people praying and believing for my healing, I'd like to at least see if I'm healed. If I lose coverage, my plan is to simply get my PSA checked every month. If, by the end of the year, it still hasn't risen, I'll use whatever coverage I have next year to get a second biopsy. My last PSA was 1.42, down from 15.8 before I got my first shot.

In case you haven't been following along or don't know, PSA is a protein produced by the prostate gland. They measure how much PSA is in your bloodstream with the PSA test. Any number above 4.00 is considered abnormal. As long as my PSA number stays the same or goes down, I'm in good shape. Once it starts going up again, I'm in trouble.

Lupron has been holding my PSA down. After my first shot, my number went down to 4.00. Just before my second shot, it was 1.42. Since Lupron is keeping my number low, I have no idea whether God has healed me or not. And make no mistake, I believe that he can heal me if he chooses to. But it's his choice, and I'm fine with whatever he has decided. But I'd like to find out. I don't really want any more Lupron shots if I'm healed, whether they're covered or not.

If Medicaid stays in place, I intend to ask my oncologist if he thinks it would be too big a risk to delay my next shot and just keep testing until my PSA starts rising again. If it does, I'll get the next shot. If not, I'll get that biopsy and see if I still have cancer. If I lose Medicaid, I'll get my PSA tested on my own. If my PSA shoots up and I have no insurance, or a high deductible, I'll seek naturopathic treatment.

I've already gone through losing disability. If you haven't read about that, check out my most depressing post ever, and my most viewed post, (go figure) Full Disclosure. Losing disability was a much more crushing blow than this would be. If you've been reading this blog, you know that my first choice would be to abandon traditional medicine and trust God for everything, including my life. Losing Medicaid, for me, would be a green light to do just that. I'll take it as a sign.

So as I keep saying, I'm OK either way. I'm OK with insurance or without it. I'm OK whether God heals me or takes me home. I don't want to fight. Except with the government. I still feel that nobody should have to bankrupt themselves to stay alive, especially when so many are using up their retirement savings to pay for treatment, which should be there for them to live on, or at least support their families in the event of their death. It's not right. Someone needs to tell me what's Christlike about the system that we have in this country. So even though it's not that big a deal to me if I lose Medicaid, because I'm not interested in most of the treatments that insurance covers, I will still fight for what I believe I'm entitled to.

One really cool thing happened today, though, that I want to tell you about. Long time readers know that I struggled with weight loss from my cancer, or Lupron, or both. My weight, which should be right at 130, dropped down to 120 for a while. I saw a nutritionist to learn how to gain weight, which has always been very difficult for me. The nutritionist that I saw, a young woman I call Katie for the purposes of this blog, gave me some recommendations.

During our conversation, the subject of my homemade dark chocolate ice cream came up. That tends to happen, in case you hadn't noticed. She thought it sounded really good, which it is. So I decided then and there that if her program worked for me, I would take her some ice cream. As you know if you've been paying attention, I've gained 11 pounds since then. I've been holding at 131 for about three weeks.

So I tried to make an ice cream run a couple of weeks ago, but she was on vacation. Today was her first day back, so I went over to her office with a cooler of chocolate heaven this afternoon. I was glad that she remembered me. She was glad that I had gained so much weight in so little time. And she was very glad to get the ice cream. She even asked about my dog's knee surgery! What a nice person. I was really happy to finally be able to do that. It was the highlight of my day.

My nutritionist's services were paid for by Medicaid, of course. If I had had to pay for that out of pocket, I probably wouldn't have done it, and I'd still be struggling to stay above 120. Now, since it seems like I have a handle on things, it's OK if I don't need katie again.

Likewise, since I know what I'd like to do next with regard to treatment, it's OK if I don't have coverage for that. If it means I get one or two less Lupron shots and have to accelerate my plan to go naturopathic, that's fine with me. For all I know, I might be cancer free right now, and don't even know it.

I've never understood, let alone practiced this passage of scripture before, but it really rings true to me now.

I am not saying this because I am in need, for I have learned to be content whatever the circumstances. I know what it is to be in need, and I know what it is to have plenty. I have learned the secret of being content in any and every situation, whether well fed or hungry, whether living in plenty or in want. I can do all this through him who gives me strength. (Philippians 4:11-13)

So whether I keep coverage or lose it, and whether I live or die, I'm at peace. I'm OK either way. #waroncancer


  1. I see a Healing Touch therapist once a week. This week, we talked about a gradual shift that's occurring in my thinking about "fighting" cancer. I shared with her that I'm losing my desire to consider this a battle. After 32 radiation fractions, I'm exhausted. I don't have the passion nor the energy for a battle. That I was ok with whatever happened. Her response was simply "It is in your surrender where you will find your greatest healing."

    I understand some of us need to fight cancer. But I'm learning it's not the only path. I feel less alone knowing that you get it. That you understand this alternate path. The fact that you are at peace is a critical part of healing both the spririt and the body. For what it's worth, I think you're on the right path.

    1. Thanks for that, Robert. I'm looking forward to meeting you in person. We have a lot in common!