Client Spotlight: Helping Pennsylvanians Overwhelmed by the Healthcare System
Losing a job is stressful, especially when a benefit includes health coverage. Tom had lost his full-time job and the insurance that came with it. Since then, he had only been able to find part-time work—and he struggled to meet that commitment because his health was declining and he was receiving no medical treatment. Tom, an insulin-dependent diabetic, suffered from depression and also needed hernia surgery. Tom’s wife, Tina, tried to get coverage through the Federal Marketplace but decided it would cost them more than they could afford. She had also applied for Medicaid, but they were denied because their household income exceeded the Medicaid limits.
By the time Tina contacted PHLP, she was desperate. Without medical care her husband’s health had declined so much she feared he soon would not be able to work at all. After talking with Tina, it was clear that her husband’s chronic health conditions were limiting his ability to work and that he would be a good candidate for Medical Assistance for Workers with Disabilities (MAWD). This program allows individuals to qualify for Medicaid even when their income is above the normal Medicaid limits. We explained MAWD to Tina and mailed her the application, as well as the medical forms a doctor needed to complete to verify the effects of Tom’s health problems.
Tina contacted us a month later to report that Tom’s MAWD application had been approved and how relieved she was to know that he would have affordable health insurance that would allow him to get the care he needed.
PHLP steps in when low-income and vulnerable Pennsylvanians like Tom—who need timely, appropriate, affordable and quality care—get overwhelmed by the health care system. We respond when patients and their caregivers delay or fail to get needed care or seek care in inappropriate but more easily accessible settings, such as emergency departments.