East Texas family fights for Medicaid coverage

East Texas family fights for Medicaid coverage
Each of the twins weighed less than two pounds at birth. (Source: Stormie Wilburn)
Each of the twins weighed less than two pounds at birth. (Source: Stormie Wilburn)
Oliver is Jensen's big brother. (Source: Stormie Wilburn)
Oliver is Jensen's big brother. (Source: Stormie Wilburn)
Oliver and Jensen Ivey were born prematurely in January. Their mother, Stormie, went into labor 19 weeks early. At that time, doctors told her that her children would only have a ten percent chance of survival. But there was another problem that was found at this point: Jensen’s umbilical cord had stopped functioning.
Doctors stopped her labor, then Stormie and her fiancé Cameron waited as long as they could, three weeks, for the children to grow enough for a stable birth. Then on January 31, the twins arrived at Good Shepherd in Longview. Oliver weighed 1 pound 11 ounces and Jensen weighed just 1 pound 9 ounces. At this time, doctors gave the twins an 85 percent chance of survival.
The twins spent several months in hospital care. Oliver came home to Kilgore first, then Jensen came home in August. Since then, Stormie and Cameron have kept the twins healthy through coverage with Medicaid.
“Cameron’s work insurance wouldn’t cover half of what [the twins] need,” Stormie said.
But with the month of December, came a problem. Cameron would take home an extra paycheck. It was not a pay increase, but the extra calendar squares meant his bi-weekly pay period resulted in three checks instead of the usual two. This pushed the family above the financial threshold for Medicaid, even though their annual income hadn’t changed. Then their insurance was cut.
“That’s not what you need when you have to take care of twins,” Cameron said, “and one that has to be watched 24/7.”
In addition to his breathing machine, Jensen uses a feeding tube. Medicaid covers both the tube and the breathing machine, and since they lost their coverage they were at risk of losing both life-sustaining pieces of equipment. Both are provided by Apple Home Healthcare, and the parents were happy to say that the company allowed them to keep the machines. They said the company didn’t even consider taking them away. But that still left the couple struggling to afford other services. Jensen sees five specialty doctors.
“He has lung disease, a narrow airway and a food aversion,” Stormie said. She added that he also has a hole in his heart.
The family spent weeks trying to get an appointment with a cardiologist, and that appointment was on the books for December. But because they lost their coverage, they had to push it back to January.
That’s when their Medicaid would be re-instated. In January, Cameron’s pay period will return to the normal two checks per month, which lowers the family back to a level that qualifies them for coverage.
At the beginning of December, they went to the local Health and Human Service office in Longview.
Stormie says they were told, “the only way that we could get the insurance back on was if Cameron moved out.”
That would lower the household income. The parents broadcast their story on social media. Feeding supplies and supplemental oxygen came from local families, and even from people all the way in California. Earlier this week, the family contacted the Office of the Ombudsman, an independent appeals agency within Texas Health and Human Services. Stormie says they were told the same thing, that the family would have to wait until January for coverage to be re-instated.
KLTV reached out to Health and Human Services for more information on Thursday morning. Then Stormie called the newsroom at 3 p.m. Thursday. She told us she had just received a phone call from HHS that their coverage would be re-instated overnight, by Friday. When we reached out to HHS again after hearing from Stormie, HHS said “There is a process whenever a client is denied coverage and today the issues were resolved. The twins will receive the critical care they need.”
We pressed them again through email and asked why the family was denied coverage twice already and that coverage was finally re-instated with just eight days left in the month. They were not able to respond to our follow up by the time this article was published.
Stormie and Cameron say they want to help others who go through the same scenario. Stormie is a full-time mom right now, taking care of her kids. She describes herself as an advocate for premature and NICU moms.
The family is covered through May 2017, but then Cameron runs into the same situation in June. He will receive three checks that month. It’s not clear yet whether they will run into the same problem.

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