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Frank Gray

Frank Gray writes about area people and issues and what sometimes happens when the two become entangled. His column is published Tuesdays, Thursdays and Sundays in The Journal Gazette and on journalgazette.net. With the newspaper since 1982, Gray has also been a reporter, assistant metro editor and business editor.

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Published: September 20, 2009 3:00 a.m.

Address snafu costs woman her Medicaid

Frank Gray
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Clint Keller | The Journal Gazette

Dee Willke lost her Medicaid coverage because of an error with her address, leaving her without her doctor.

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Clint Keller | The Journal Gazette

Dee Willke lost her Medicaid coverage because of an error with her address, leaving her without her doctor.

The past few years have been a rough patch for Dee Willke.

Once, she had a good position at a bank, and she even invented a program for keeping track of dormant accounts. She was proud of that.

Then one day, as she was saying goodnight to the bank’s vice president, she collapsed on the floor. She had suffered a seizure that was eventually attributed to a case of rheumatic fever she had as a toddler.

The bank was good to her, Willke said. It took care of her. But in the bank consolidations that were happening at the time, her employer was taken over by another bank, and her department was eliminated.

Displaced employees were given placement assistance, but Willke never found a job through that program. Before long, she found herself having to rely on temporary positions with the hope they would become permanent.

The seizures always spoiled that. She’d be on the job for a short time, suffer a seizure and never be called back to work.

Gradually, Willke’s life went downhill. Work became more and more scarce until it essentially disappeared. Willke lost her home and ended up living in her car, cleaning up in a gas station restroom.

An acquaintance took her in for a while, but before too long she was back living in her car. For a time, she lived in her ex-husband’s basement before she finally moved into a shelter.

About four years ago, unable to work because of seizures that couldn’t be controlled, Willke qualified for disability. She got Medicaid and Medicare, which paid for doctors and medications. Finally, there was some stability in her life.

People on Medicaid, though, have to be recertified periodically, and Willke’s recertification was to take place around last December.

It should have been routine. She’d be sent papers and would have to provide documentation, including medical records.

For some inexplicable reason, though, the papers weren’t sent to Willke at the address she’d had since she started receiving Medicaid. Instead, they were sent to her at a post office box. The problem is, Willke didn’t have a post office box and never had, ever.

So the documents were returned, and Willke was immediately removed from Medicaid.

Willke didn’t know any of this was happening until she made an appointment to see one of her doctors early in the year and was told he wouldn’t see her because she no longer had Medicaid.

“I’ve been fighting it ever since,” she said.

She had to reapply for Medicaid but was told that medical records submitted were incomplete, although Willke says her doctors did submit complete records.

In August she was turned down, then had to start an appeals process.

Meanwhile, everything was falling apart. Medicaid had stopped paying her premiums for Medicare, which covered her prescriptions, so she had to pay for those medications herself. She was unable to see her doctors, and as prescriptions that were supposed to help control her seizures expired, she was unable to get them renewed. Her doctor bills went unpaid, and they were sent to collection agencies, putting a black mark on her credit, a bad thing because she was about to buy a small house that would let her live in her own home for far less than rent anywhere else.

On Thursday, just a couple of days after Willke originally called with her problem, she got a call from someone at Medicaid. The mix-up, which started with paperwork being sent to the wrong address, had been corrected. She’d be reinstated. Presumably the overdue doctor bills sent to collection agencies would be paid.

But it took at least eight months of stress, Willke complains. She wonders whether she’ll be able to get back the doctors who dropped her when her Medicaid disappeared.

And in a few weeks, it will all start once more. Willke will have to go through the recertification process all over again.

Let’s hope they get her address right this time.

Frank Gray has held positions as a reporter and editor at The Journal Gazette since 1982 and has been writing a column on local topics since 1998. His column is published Sunday, Tuesday and Thursday. He can be reached at 461-8376, by fax at 461-8893, or e-mail at fgray@jg.net.