Jill H is a married, stay-at-home mother of two young children. She lives in Lockport, a small town near Buffalo. Jill has experienced jaw and dental problems for most of her life, occasionally seeking treatment when the situation would become unbearable. Jill sustained an injury during one of these surgeries, and was left with migraines, pain, and jaw pain that she thought she would have to live with for the rest of her life.
“I didn’t have health insurance, which wasn’t a problem until, suddenly, it was.”
At age 66, Jerome S was new to Medicare and did not realize that he would not have prescription drug coverage through Medicare Parts A and B alone. Jerome has 13 prescriptions, and his only options were to either pay out-of-pocket or to stand in line at Bellevue Hospital to drop off his prescriptions and wait 72 hours to pick up his medicine. After hearing there might be better options available, Jerome decided to call Community Health Advocates.
After Ethan was denied medical coverage for gender transition surgery, CHA helped Ethan meet the requirements he needed for his surgery to finally be approved.
“CHA helped clarify my benefits and put my mind at ease when I was denied services.” -- Ethan
Jo Young is an actress living in Manhattan. A few years ago she enrolled in Medicaid, and has continued to recertify each year through the NYSOH Marketplace. Shortly after undergoing surgery, she tried to make an appointment at her primary care doctor for monitoring, but the office informed her that her Medicaid had been discontinued. Jo was shocked and extremely worried, as she needed regular care and follow-ups, but couldn’t afford those services without insurance. After going many months without medical care, Jo decided to seek assistance from Community Health Advocates.
Donald Burdick found himself in deep medical debt resulting from a computer error that accidentally enrolled him in two plans at the same time. Neither plan was listed as his primary insurance, so neither paid for his care, resulting in thousands of dollars of medical debt. Despite needing care for ongoing medical issues, Donald stopped going to his primary care doctor for fear of incurring even more debt.
While recovering from a catastrophic illness that nearly took her life, Joclyn found herself in a medical billing nightmare. Although treated in an "in-network" hospital, to her surprise the surgeons who operated on her were "out-of-network," and billed her upwards of $70,000. Community Health Advocates intervened and saved her financial life. Working closely with the NYS Department of Financial Services and other stakeholders, CHA brought to life stories of surprise medical bills from out-of-network providers.
Roseann has chronic obstructive pulmonary disease (COPD) and needed oxygen at home for the first time. Recently insured under a new plan, she was told that she would have to pay a co-pay of $500 a month for the oxygen. On a limited income, Roseann could not afford this amount and reached out to the CHA advocate at Chenango Health Network. After talking to Roseann’s plan, the CHA advocate was able to help Roseann get the prior authorization she needed for this durable medical equipment so it would be paid for by her insurance.
Tracey contacted a CHA advocate at S2AY Rural Health Network to learn about her health insurance options as a small business owner. The CHA advocate explained the employer mandate, how she could qualify for small business tax credits and how to benefit from the new health care laws. Because of the help that she received, she decided she could finally provide her employees with coverage.
“I am relieved to know that there is a free program in my community that can help me and my employees use and understand our health insurance.”
Mateo is an uninsured full time college student living in Queens. He first contacted the CHA advocate at Make the Road New York when he received collection notices for unpaid medical bills. In April 2014, Mateo needed medical care and wound up with an unaffordable bill. The CHA advocate helped Mateo find and complete the hospital financial assistance application. With CHA’s help, his bill was reduced to an amount that he could pay.