Tag: Health Care

“It’s hard for someone to understand what I go through every day”

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Janet* knows firsthand that life can change in a split second.  Several years ago she and her young daughter were in a severe car accident.  Janet’s daughter walked away from the scene without injury, but Janet faced severe injuries to her brain and body that left her in the hospital for months.

Months later, Janet underwent an extensive neuro evaluation to determine the full extent of her brain injury.  Hoping to return to college to finish her education, Janet was crushed when the doctor informed her that would not be possible. Work was not an option either as she faced difficulties with memory and sight.   Janet’s mom stepped in to help, keeping track of Janet’s doctors and documents, all while encouraging Janet to apply for disability benefits. When she tragically lost her mom, Janet applied for disability benefits only to be denied multiple times.

“It is hard for me mentally to even complete the documents and forms.  I get frustrated and confused.  It’s a really long process and I did the best I could, but it wasn’t enough.  My mom was my memory; she helped me keep track of my doctors and information, but she wasn’t there anymore.”

CareRing, a health-service nonprofit helping Janet with her medications and medical insurance, referred her to Charlotte Center for Legal Advocacy.  Janet connected with Health Insurance Navigator, Abigail Duemler, who served as a resource when Janet became increasingly frustrated that she was unable to receive the services she needed. After her application was denied again, Janet and Abigail appealed the denial and the decision was finally reversed, providing Janet critical health insurance under Medicaid for Disability.

“[Having access to the benefits I need and at a lower cost] has put me in a better place mentally.  I don’t have to worry as much.”

Janet said using her own voice to describe how the accident affected her life during the appeal helped them understand why she needed Medicaid for Disability in a way that words on a paper had not.

“It’s hard for someone to understand what I go through every day, but when I can talk to someone and explain [how my life has been impacted], they get it.”

Abigail’s help gave Janet the extra encouragement and knowledge needed to get through the long process. Janet explains, “I knew what I needed to do [to apply for Medicaid with Disability], but not entirely. [Abigail] helped me so much.”  For Janet, the process was long and exhausting, but her main takeaway was to not give up. “It was the extra push and motivation I needed to know someone was behind me, helping me through the process.”

Janet’s experience is just one example of how Medical Legal Partnerships, such as that between CareRing and the Advocacy Center, are central to helping community members. Medical Legal Partnerships form when health care organizations work alongside public interest law organizations to serve their community, playing a crucial role in addressing the needs of people who cannot otherwise afford health or legal services.

Janet is still awaiting a disability approval on her Social Security case, but with the positive ruling of her Medicaid case there is hope. She looks optimistically to the future, and proudly shares how well her daughter is doing in school.  “It’s taken awhile but my life has finally turned around to where I want it to be.  I’ve learned to deal with [the lasting effects of my car accident] and managing my pain.  I’m really happy now.”

Help support our efforts empower clients like Janet.

*Name changed for anonymity

Providing long-term stability for clients like Wendy

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Wendy affectionately calls her older sister, Melody, “the manager”.  Melody laughs at the nickname but graciously takes on the role, balancing her job at a local restaurant, managing the daily operations of their home, and caring for her younger sister.  The sisters have come to rely on each other but are quick to recognize that there are some things for which they need support.

Wendy and her sister Melody share a laugh

It was Melody who suggested Wendy contact the Advocacy Center.  Staff attorneys negotiated a payment plan for Melody with the county when she was facing foreclosure from back property taxes on her parents’ estate.  Then in the first year of COVID, the Advocacy Center helped Melody access unemployment insurance and food stamps.  She knew firsthand what a lifeline public benefits could provide. 

Heeding her sister’s suggestion, Wendy connected with Cara Meyer, a Health Insurance Navigator, who helped her enroll in Food and Nutrition Services (food stamps) and Medicaid for the Disabled, health care coverage that proved crucial when Wendy’s health condition deteriorated months later. 

Wendy spent three months in the hospital suffering from complications related to congestive heart failure and had her right leg amputated after developing blood clots. 

“When I came home from the hospital, I knew that I would need someone to help me learn how to maneuver with one leg, how to shower, [how to take care of myself],” Wendy says, “I was in a deep depression and needed help.”

Living with Melody and her husband, Wendy was grateful for everything her older sister did.  But Melody was the primary financial support for the family and Wendy knew it was taking a toll on her.  Wendy was unable to work because of her disability and her disability benefits were terminated years prior. 

“I physically could not get to the [Social Security Administration] office.  When I called, they said they could not take my message so I kept trying to call any number I could.  I couldn’t reach anyone.  Julieanne was able to get in touch with the right people.”

Julieanne Taylor, Senior Attorney and Public Benefits Legal Services Unit Manager, worked with Wendy to successfully appeal her Social Security Insurance (SSI) denial.  Wendy was granted back benefits and ongoing payments, providing a stable source of income for Wendy that allowed her to take care of her own personal needs and contribute to the household. 

Wendy and Melody’s story is reflected in many of our clients’ experiences.  Our clients often face multiple civil legal issues but lack the financial resources to address them.  As with Wendy and Melody, our clients’ needs are not limited to just health care, or public benefits, or property taxes, but more often a combination of several, which means we always need to look at the bigger picture. 

“[Each time your staff would address a problem] they would ask if there was anything else they could do to help.  Your staff [treated us with dignity] and that meant a lot,” says Melody. 

Julieanne, Cara, and Advocacy Center staff worked together to address Wendy and Melody’s problems in a holistic way, creating economic security, accessing critical health care, and ensuring longer-term stability.

When asked to describe the impact of their experience with the Advocacy Center, Melody struggled to find the words:

“I don’t think they’ve invented a word that’s big enough to say how wonderful this place is.”

Your support of the Access to Justice Campaign ensures we can fight for neighbors like Wendy and Melody, facing civil legal issues impacting their safety, security, and stability. Donate today to help us keep up the fight.

We need Medicaid expansion now

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1 in 10 North Carolinians has no health insurance, one of the highest rates of uninsured people in the country.  Low-income seniors, people living with disabilities, veterans, immigrants, and their families need access to affordable healthcare. Charlotte Center for Legal Advocacy fights for this right every day. 

The current Medicaid coverage gap in our state means that thousands of individuals have income levels that are too high to qualify for Medicaid but are too low for premium subsidies through the federal Health Insurance Marketplace, leaving them without access to vital health insurance.  Medicaid expansion would give 600,000 North Carolinians, nearly 100,000 of which live in Mecklenburg and surrounding counties, an affordable health insurance option.

Why do we support in Medicaid expansion?

Medicaid expansion has antipoverty implications.  Millions of Americans are pushed into poverty every year because of out-of-pocket spending on health care.  Research has found that Medicaid coverage cuts the likelihood of incurring a burdensome medical expense in half. 

Medicaid expansion makes health care services more accessible for everyone.  The current coverage gap puts vulnerable populations at an even greater risk, including people living with disabilities, people with complex medical needs, and those living below the poverty line.  Expansion would provide the critical coverage these individuals need, resulting in improved quality of care and better health outcomes in the process.  In North Carolina, nearly half of the individuals in the coverage gap are people of color.  Research has found that racial disparities in health coverage and access to care would be narrowed by Medicaid expansion. 

Medicaid expansion strengthens our community.  Currently 63% of North Carolinians in the coverage gap are from working families.  Expansion would benefit workers, allowing them to live healthier lives and be more productive.   With more individuals covered by health insurance, hospitals and doctors will decrease their costs for caring for uninsured individuals, allowing them to reduce health care costs for everyone. In addition, North Carolina stands to gain $1.7 billion in new federal funding with Medicaid expansion.  But without expansion, our state will lose billions of dollars each year, all while North Carolina taxpayers continue to fund Medicaid expansion in 38 other states.

How can I get involved?

We are in a critical period of garnering support in the Senate for Medicaid expansion. If you believe Medicaid expansion is critical, we urge you to call your legislators to let your voice be heard!

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Marking a tragic milestone: 1 million Americans lost to COVID-19

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As our nation mourns the loss of 1 million Americans to COVID-19, Charlotte Center for Legal Advocacy reflects on the tragic loss of our neighbors to the pandemic.   We mourn their deaths, we mourn for the families and friends that loved them, and we mourn for our community that continues to cope with this loss every day. 

While a monumental milestone, what is lost in the number is the disproportionate impact the pandemic has had across ages, races, income level, and healthcare access.   Older Americans account for 93% of deaths, including more than 200,000 deaths of residents and staff at long-term care facilities.  This figure, though tragic, is likely a gross undercount as it does not account for the nearly one million people living in assisted living facilities.  Some calculations indicate that roughly one third of COVID deaths were in facilities that house not only seniors with disabilities but also younger people (ages 31-64) living with disabilities.  The Nation Council on Disability noted, “For decades, federal and state healthcare data collection practices failed to capture baseline information about the functional disability status of patients and the public, leaving people with disabilities uncounted during and after public health emergencies.”  People with disabilities were often sidelined when resources in hospitals and personnel were scarce.  Furthermore, the existing shortage of care workers for people with disabilities prior to the pandemic was further exacerbated during the health emergency, leaving people with disabilities and their caregivers without sufficient support and at even greater risk of being institutionalized.

The disparity in rates of infection and death are further evident when race and income level are considered.  Hispanic, Black, and American Indian and Alaska Native people were about twice as likely to die from COVID as White people.  Hispanic and American Indian and Alaska Natives were at about one and a half times greater risk of contracting COVID than their White counterparts.  This variance is also tied to income inequality, as low-income workers were often employed in industries deemed “essential” and were left with no choice but to return to work despite the potential for increased exposure.  As a result, employees in several industries exempt from stay-at-home orders, including food services, agriculture, and manufacturing were twice as likely to die from COVID than others the same age. 

What lies at the heart of this disparity is years of systemic divestment that led to large gaps in healthcare resources and infrastructure for Black, Indigenous, and People of Color across all income levels.  This inequity existed long before the pandemic and was simply laid bare by the public health emergency.

Throughout the pandemic, we recognized that the families and individuals for whom we fought for fair access to health care and public services were also the families and individuals feeling the effects of the pandemic most intensely.  Life may have begun to return to normal for some in our community, but these vulnerable populations continue to be impacted by the effects of the pandemic.  When the public health emergency ends, tens of thousands North Carolinians without access to affordable healthcare will no longer be eligible for Medicaid in North Carolina, a state that has elected not to provide health insurance to all low-income adults.  (This Medicaid gap results in a population with income levels that make them ineligible for Medicaid yet too poor for premium subsidies through the federal Health Insurance Marketplace.  Without expansion, hundreds of thousands in our state will remain without access to affordable healthcare.)  Just as we mourn with our community for this tragic milestone, so too will we stand with our community to advocate for people living with the disabilities, People of Color, and low-income children and families that have been further marginalized by this public health crisis.

How to Manage Medical Debt

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Medical bills can be confusing, overwhelming, and often come when you are already in distress. It can be difficult to understand what you owe, to whom, and by when.  It can also seem that you are being pushed to pay amounts you cannot afford or do not owe to protect your credit.  If this sounds like you or a loved one, there is help available.   

Here’s what you need to know: 

  • Under the Affordable Care Act, nonprofit hospitals (like Atrium CMC and Novant Presbyterian) are required to offer financial help to certain people who cannot afford their medical care. Financial assistance is an important part of the nonprofit hospital’s commitment to its community.  
  • Ask for a copy of the Financial Assistance policy and Application up front.  Fill it out as soon as possible and provide all required information.
  • Getting help with medical bills does not jeopardize your immigration status. If you are not a citizen, you can ask for and receive help with medical bills for you and your family, without fear of negative consequences to your immigration status. If you speak a language other than English, you can ask for the information in your preferred language. 
  • Even if your bill is past due and you’re being contacted by a debt collector, you can ask the debt collector to pause collections while you seek financial help through the hospital’s program. 
  • In North Carolina, most past due medical debt cannot be garnished from wages, even after a lawsuit.  (This will vary by case.)  Contact the hospital or medical provider to ask for assistance up front.   
  • If you’re having an issue with debt collection, you can submit a complaint with the CFPB online or by calling (855) 411-CFPB (2372).  The Consumer Financial Protection Bureau (CFPB) takes complaints over the phone in Spanish and 180 other languages at 855-411-CFPB (2372).  

How to ask about financial assistance or charity care for medical bills: 

  1. Ask for a copy of the hospital’s Financial Assistance Policy up front. By law, the policy must explain how to apply for help. 
  1. Fill out an application form, if required, and be ready to provide information about your income, including last year’s tax forms or a current pay stub, and your expenses, including your rent or mortgage payment, utilities, credit cards, and other debts. 
  1. Ask your provider how long it takes to process your application for financial assistance, how to get answers to questions about the application, and what happens with your bill in the meantime. 
  1. Notify any debt collectors that you’re seeking financial assistance for the bill and tell them to pause collections while that process plays out—and if they already reported it on your credit, to show the bill as disputed. 
  1. Follow up with your provider about the status of your application as necessary. 

More Resources: 

Are you getting the help with your medical bills you are entitled to? 
Your rights when dealing with debt collectors 
Know your rights and protections when it comes to medical bills and collections 
Submit a complaint to the Consumer Financial Protection Bureau 

“I can tell you really care”: Treating clients with dignity and respect

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James and his late wife, shortly before her death

To James, it seemed life was testing him.  Coping with the loss of his wife and his mother within the same month, James felt hopeless.  Countless roadblocks were preventing him from moving forward and he wasn’t sure where to turn.  He decided to call Charlotte Center for Legal Advocacy. 

No longer able to keep up with the physical demands of his job with a moving company, James had been forced to retire early.  James relied heavily on his wife’s social security income.  Without his own source of income at the time of her passing, James’ economic security and stability were critically threatened.  At the Advocacy Center, he was quickly connected with a Health Insurance Navigator, Cara Meyer, and social work intern, Whitney Cooper, who addressed his concerns. 

“I had a lot on my plate and they pointed me in the right direction.  Everything they could do to help me, they did. By the grace of God, Cara & Whitney have been there for me.” 

Cara helped James apply for Food & Nutrition Services to address his immediate food insecurity, as well as to apply for Medicaid for the Disabled.  Cara took it a step further, helping James make an appointment with a primary care physician for the first time in years.  James needed a doctor that was easy to get to, due to limited transportation options.  With that in mind, Cara found a physician that would accept his insurance and was easily accessible by bus.  Whitney is now helping James apply for social security disability and the team connected him with resources to appeal denied unemployment benefits and request financial assistance from Crisis Assistance Ministry. 

James is grateful for the stability Cara and Whitney have been able to provide during this difficult time.  “If I had to [navigate the situation on my own] I think I would have gone crazy.  I had so many things going on.  They have been there for me, without them, I don’t know where I would be.”  But what James appreciated the most was the dignity with which he was treated.  “I can tell by the way they talk to me and what they do for me, that they really care.  It means a lot to know I have someone I can trust to help me make my situation better.” 

Health care coverage at a critical time

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Ana’s doctor referred her to Charlotte Center for Legal Advocacy to discuss health care options and other public benefits assistance as she approached retirement.  At the time, Ana didn’t know what an impact that call would have on her life. 

Ana immigrated to the United States from Mexico almost 15 years ago.  A legal permanent resident, she was not aware of the public benefits available to her. When she contacted the Advocacy Center, one of our health insurance Navigators, Abigail Duemler, helped her determine the benefits to which Ana was entitled.  Quickly approaching retirement age, enrolling in Food and Nutrition Services provided critical food security for Ana.    

Even more importantly, Abigail helped Ana to enroll in Medicaid and then in Medicare when she turned 65.  Having access to affordable health care was crucial when Ana became critically ill with COVID-19 last winter.  Fearing for her life and worried about the resulting medical bills, Ana’s family was relieved to know her medical costs would be covered.   As she continues to recover from the long-term effects of the illness, Ana remains thankful: “I am so grateful to [have health insurance].  When I receive the bills and see that Medicaid is paying, I am so grateful.  I don’t know what I would have done without your help.” 

When Ana speaks of the Advocacy Center, it is with immense appreciation: “You have been such a strong guide for me.  It’s an excellent organization.”  Yet Ana realizes there are so many more people just like her that might need help. 

“There are many people like me who come from another country, who may not speak English, and are not aware of the help they can get.” 

Navigating public benefit and health care systems is increasingly complex, even more so for non-English speaking North Carolinians.  The Advocacy Center’s team of federally trained health insurance Navigators includes bilingual staff members that are a critical resource for native Spanish speaking clients.  Ana hopes her friends and neighbors contact the Advocacy Center: “I want to help other people find [the Advocacy Center] so they can get support just like I did.” 

Advocating for breast cancer patients like Charlotte..

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Diagnosed with breast cancer at the age of 28, Charlotte knows how terrifying and stressful it can be to hear you are sick. But rather than address her health concerns and acknowledge what she may be feeling, Charlotte’s doctor immediately asked how she planned to pay for her treatment.  A single working mother of a 9-year-old son, Charlotte’s fears and stress levels were quickly amplified as the harsh reality of her expensive cancer treatment began to sink in.  

Concerned she would have to sell the house she had worked so hard to buy, Charlotte decided to advocate for herself. 

Charlotte learned about the Breast and Cervical Cancer Medicaid (BCCM) program from her sister who had been in contact with the Charlotte Center for Legal Advocacy.  BCCM helps eligible women to pay for their breast and/or cervical cancer treatment.  (To be eligible, women must be uninsured or have insurance that does not cover the necessary treatment, fall at 250% of the poverty line for their family size, and are a U.S. citizen or have qualified immigration status.)  Meeting these requirements, Charlotte proactively applied to the program on her own. 

“I applied for the Medicaid program on my own and they kept denying me.  I was really stressed during [my treatment].  The hospital was sending me bills and I didn’t know what I was going to do.” 

What Charlotte did not know at the time was that to be eligible to apply for BCCM, individuals must meet eligibility criteria for the Breast and Cervical Cancer Control Program (BCCCP). A BCCCP provider must then submit the BCCM application on behalf of that individual.  When she submitted the application on her own, Charlotte faced delays and hurdles in the complicated process.  

Charlotte contacted the Advocacy Center for help.  A Family Support and Health Care staff attorney at the Advocacy Center, Becca Friedman, identified the procedural roadblocks and communicated with the local agency to work towards a resolution.  Becca was able to advocate for Charlotte and Charlotte was successfully granted BCCM eligibility. 

The peace of mind Becca provided Charlotte as she underwent cancer treatment was critical: 

“If I didn’t have an advocate, the experience would have been so much more stressful.  Becca kept me updated and followed the process of my application because social services wasn’t updating me directly.  Without Becca, I don’t know what I would have done.” 

No longer plagued by the financial stress of her treatment, Charlotte was able to focus on what mattered the most: her health, her recovery, and her son. 

When asked what she wants people to know about her story, Charlotte quickly responds that she wants to help women going through the same thing.

“When you get the bad news.  That would be the first thing I would want to tell people: there is help available, you have options.” 

Charlotte is happy to say she is now cancer free, and life is slowly returning to normal.  Throughout her cancer treatment, she continued to work and re-enrolled in school.  Inspired by her journey, Charlotte is now pursuing a degree in the medical field. 

Your support of the Access to Justice Campaign ensures we can fight for neighbors like Charlotte, facing civil legal issues impacting their safety, security, and stability. Donate today to help us keep up the fight.

Open Enrollment 2021: FAQ Videos

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Open Enrollment for the Health Insurance Marketplace (AKA Healthcare.gov) will open Nov. 1, 2021, and last until Jan. 15, 2022. 

Our federally trained Navigators answer your top health care coverage questions and share important information on where to find help during this year’s Open Enrollment. Siga el enlace para videos en español.

Frequently Asked Questions

Let’s go over some Open Enrollment vocabulary: ACA, Obamacare, Healthcare.gov, Marketplace
What are the benefits of health care coverage from the Marketplace?
Who qualifies for health care coverage, how do you apply, & why do you need to re-enroll?
What programs are available to help people pay for health care?
What is the Medicaid gap or coverage gap? What are some resources for people in the Medicaid gap?
What are the rules on health care coverage for immigrants?

Where can I get help learning about health care coverage and how to enroll?

Preguntas frecuentes en español

Revisemos algunos conceptos importantes sobre el período de inscripción abierta: ACA, Obamacare, Mercado de seguros y www.cuidadodesalud.gov

¿Cuáles son los beneficios de obtener Seguro de salud en el Mercado de Salud?
¿Quiénes califican para Seguro médico, cómo aplicar y por qué necesita reinscribirse?
¿Qué programas de asistencia financiera están disponibles para asistencia de Seguro médico?
¿Qué es el gap de cobertura de Medicaid?¿Cuáles son las opciones para las personas en el gap de cobertura de Medicaid?
¿Cuáles son las reglas para que los inmigrantes puedan acceder a Seguro de salud?
¿Dónde puedo encontrar más ayuda disponible sobre temas de Seguro de salud?

Basic Health Insurance Terms

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Need to enroll in a health insurance policy or update the one you have?

Open Enrollment for the Health Insurance Marketplace (Healthcare.gov) is Nov. 1, 2022, to Jan. 15, 2023.

GET COVERED

There are a lot of special terms in the health insurance world, and they can be difficult to understand. We’re here to help you make sense of terms you see on Healthcare.gov.

Watch the video and scroll down for more terms defined.

Learn more about how to get covered, or call 980-256-3782 to reach a Health Insurance Navigator for free assistance. You can leave a message with a quick question or schedule a longer phone appointment.

Catastrophic Health Plan
The premium amount you pay each month for healthcare is generally lower than for other plans, but the out-of-pocket costs for deductibles, copayments and coinsurance (see terms defined below) are generally higher. To qualify for a Catastrophic plan, you must be under 30 years old OR get a “hardship exemption” or “affordability exemption” (the Marketplace determines that you are unable to afford health coverage because of the cost of the health insurance plan offered to you is too expensive or you have a financial hardship circumstance).

COBRA
A federal law that may allow you to temporarily keep health coverage after your employment ends. If you choose COBRA coverage, you pay 100% of the premiums, including the portion that your employer used to pay, plus a small administrative fee.

Coinsurance
Like a copayment (see next term), but in the form of a percentage of the cost of a healthcare service (e.g. you pay 20% of the cost of a visit or procedure).

Copayment
A set amount that you pay for a medical service or item, like a doctor’s visit. The insurance company covers the rest.

Deductible
The amount you have to pay for covered health care services (e.g. doctor and hospital visits, labs, etc.) before your health insurance or plan begins to pay. Often, the health insurance company will only pay a percentage of the costs after you reach your deductible. If you think you will need a lot of healthcare services in a year, you should look for plans with a low deductible.

Metal Categories of Health Plans
In addition to catastrophic plans, Healthcare.gov plans come in four metal categories: Bronze, Silver, Gold and Platinum. Bronze plans are usually best for individuals who have few health needs but want to be prepared in case of an emergency. Bronze plans have the lowest monthly premiums, but they have a high deductible. Gold and Platinum plans are often best for people who use a lot of health services. They have the highest monthly premiums, but each visit to the doctor and each prescription will have a low copay/coinsurance. Plans in all metal categories provide free preventive care (for example, a yearly wellness visit to your doctor).

Silver plans are ideal for individuals/families with income less than 250% FPL. If you select a Silver plan, you will receive cost sharing reductions, which means your out of pocket costs (deductible, coinsurance and copays) are also subsidized and may be very low.

Network
The doctors, hospitals and suppliers your health insurer has contracted with to deliver health care services to their members. Ask a healthcare provider if they accept your insurance before you visit. If you go out of network, your care will be more expensive.

Out-of-pocket Maximum
Usually a larger number than your deductible. This is the absolute maximum amount of money you will have to spend in the year on healthcare costs. After you reach this amount, the health insurance company will cover all services 100%.

Plans and Prices Tool: https://www.healthcare.gov/see-plans/#/ 
Saves you time! This tool allows you to see what plans are available in your area and how much financial assistance you qualify for before you fill out an application. 

Pre-existing Conditions
A health problem, like asthma, diabetes, or cancer, that you had before the date that new health coverage starts. Insurance companies can’t refuse to cover treatment for your pre-existing condition or charge you more.

Premium
The amount you pay for your plan each month.

Premium Tax Credit
The “subsidies” that lower the cost of your monthly premiums. You can take the premium tax credits in advance to lower your monthly cost, or you can take them as a refund at tax time.

To look up more key terms, visit the Healthcare.gov glossary.