Tracy Oakes of Saint Lawerence County didn’t understand why he was abruptly shifted out of Medicaid coverage to Medicare. After sleuthing, Tracy learned his shift in insurance coverage changed because he had missed ONE monthly payment. When he inquired further, he learned his income was too high to qualify for Medicaid, and so he was required to make additional payments. The additional payments and Tracy’s ongoing health needs due to his chronic condition resulted in a lot of stress for the Oakes family.
The same day he found out about his new coverage, he was in a serious head-on motorcycle accident – so serious that the nearest hospital capable of handling his injuries was in Burlington, Vermont and required an airlift to get there.
When the bills came in the mail, Tracy found out he owed $159,194 for the airlift and medical care. His wife, Cheryl, who had power of attorney, was responsible for payment. “With all the changes in Tracy’s insurance, we did not know what we were going to do about medical bills in general,” Cheryl said.
The accident, while physically devastating to Tracy, took an additional toll on both of them: “we were really nervous about the amount of bills adding up.” The Oakes were worried about being crushed by a financial burden they felt shouldn’t apply to them.
Fortunately for them, an advocate at ACR Health was able to re-enroll Tracy in Medicaid and got him coverage for his accident. They were even able to get Tracy enrolled in a Supplemental Needs Trust so that he wouldn’t have to worry about additional payments to Medicaid each month.
When Cheryl learned that there would be almost no out-of-pocket expenses because of Tracy’s accident, she cried. Instead of dealing with the overwhelming financial burden that would’ve resulted from the surprise bill they received, the Oakes were able to move on with their life and focus on getting Tracy back to full health.