Some in VIM Care Find ACA Mandate Very Perplexing

COURT HOUSE – Volunteers in Medicine has provided free health care for the uninsured and underinsured in Cape May County since 2002. With the Affordable Care Act in place, many of its patients must sign up for Medicaid or another insurance plan. The problem is with some programs, there is a $2,500 deductible. Many cannot afford that much and they are confused about how they are going to receive health benefits and whether they can still use VIM services.
Jaquelina Meiluta, executive director of VIM, said they are trying to keep it as simple as possible.
“If a patient is now eligible for Medicaid, they should apply as they will have access to more and better services than VIM can provide,” Meiluta said. “As they apply and transition to this new system, VIM will continue to provide care. It is our goal that there are no gaps in service.
“If they choose to purchase a plan on the bronze exchange that has a $2,500 (or greater) deductible they can continue to come to VIM. We recognize that the monthly premium after tax credits, etc., may be ‘affordable’ but the $2,500 deductible is not. So these people are still welcome at VIM, so long as they meet our other two criteria – live in Cape May County and earn no more than 300 percent of the Federal Poverty Guidelines ($34,470 for a single and $46,530 for a couple).”
Medicaid has no deductible and Meiluta said it provides good coverage with no or little out-of-pocket expense.
Meiluta said if patients choose not to purchase a plan it will not affect their care at VIM, which strives to provide the highest level of primary care to residents with limited access to medical insurance.
“Everyone is affected in some way,” Meiluta said. “Some VIM patients now qualify for Medicaid, whereas before they earned too much. Some patients may elect to participate in an exchange and buy insurance. Many will be caught in the middle, too much for Medicaid, not enough for premiums, co-pays and deductibles.”
Andrea Grecco of Stone Harbor has been with VIM for about six months after recently moving to Cape May County. She is a patient who was caught in the middle, earning too much from her job as a part-time data analyst to qualify for Medicaid, but not enough to afford high co-pays and deductibles. She is completely baffled about what to do.
“I am so happy at VIM with the care I have gotten there and I don’t want to leave,” Grecco said. “I have Lyme disease, fibromyalgia and now stomach problems and I wonder what will happen to my doctors at VIM? Will I have to see all new doctors? I have to go back there for test results so what happens there? I am so confused and about ready to give up. I’m right on the cusp of making too much for Medicaid but I honestly don’t think I will be able to afford any other health insurance program. It’s a real mess for everyone stuck in this situation.”
Glenn Fellenbuam of Cape May has also been with VIM for six months. With only occasional part-time work, Fellenbaum qualifies for Medicaid, though he is happy at VIM.
“I’ve been really happy with VIM and what they have done for me,” Fellenbaum said. “I don’t really want to leave there but if I get Medicaid, I have to go where they send me so I have to leave. I don’t have any major illnesses, just high blood pressure, but it was nice knowing there were good doctors I could turn to. I don’t know for sure what will happen with Medicaid but I guess I will soon find out.”
VIM will provide help for those struggling to make the right decision.
“VIM has arranged for two sessions with patient navigators from CompleteCare so that our patients can at least understand their options better,” Meiluta said. “Our volunteers are available to answer questions, and provide assistance but only the individual person or family can decide what is best for them.”
Meiluta said Medicaid is a tough subject for some patients. Some don’t want to sign up for Medicaid because it is “welfare.”
“Others simply don’t understand it and/or are afraid of leaving the comfort zone that is VIM,” Meiluta said. “However VIM’s role is to serve the people of Cape May County who slip through the cracks. We don’t duplicate services. If someone is eligible for Medicaid or even veterans assistance, they need to seek care through those agencies. We need to focus on those patients who do not have access to these programs. I cannot stress enough that we will continue to provide care while they transition to the Medicaid system.”
Teresa Smith of Wildwood also earns too much to qualify for Medicaid so she is stuck in the ACA Marketplace.
“I’ve been happy at VIM but I fall through the cracks in many areas,” Smith said. “VIM is great but still limited on what they can do. I need surgery and even though I can get charity care, there are many other bills I will have to pay for. I don’t know what will happen now with having to get health insurance but I can honestly say it really is hard down here in Cape May County. Everything you try to do with healthcare seems hard here in this county. It’s really bad.”
VIM is located at 423 N. Route 9 in Court House. For information call 463-2846 or visit: www.vimcmc.org.
To contact Deb Rech, email drech@cmcherald.com.