Iowa's Medicaid system frustrates Moulton patient
MOULTON, Iowa —
Thousands of Iowa’s Medicaid patients will lose coverage from AmeriHealth Caritas at the end of the month.
KTVO sat down with one of those patients from Moulton, 39-year-old Cory Stansberry, who says he's sick of having to jump from provider to provider in Iowa’s newly privatized system.
"I’ve struggled all my life with being overweight," Stansberry said.
Stansberry committed to gastric bypass surgery last year. UnitedHealthcare, one of the three Managed Care Organizations in Iowa’s system, agreed to pay for the procedure.
"When I had the surgery, I weighed close to 400 pounds," Stansberry said.
He's down to 190 now, but the struggle goes beyond his weight.
For Stansberry, the Medicaid system is another uphill battle.
The first surgery is behind him. Only now, Stansberry said he needs excess skin removal, a procedure he thought was covered. According to his doctor, he was wrong.
“He was having a difficult time with Medicaid and the MCOs to get them to pay for the skin removal surgery," Stansberry said.
Doctors told him one option is to pay for the second surgery out of pocket.
"If I had $30 or $40,000 then, I didn't need Medicaid,” Stansberry said.
His other option was to join a gym. Stansberry told KTVO one of the main reasons he switched over to AmeriHealth was because they agreed to cover his gym membership at the Ottumwa YMCA.
Now, Stansberry is losing AmeriHealth.
The Iowa Department of Human Services addressed the situation earlier this month. Iowa DHS Director Jerry Foxhoven says patients like Stansberry don't have anything to worry about.
Foxhoven told medical council earlier this month: "We're making this as seamless as it can be made. In other words, there isn't going to be a time period where someone has to say 'will I have coverage, and what do I need to do to get coverage?’ they have coverage."
By Dec. 1, all AmeriHealth patients will be switched over to UnitedHealthcare.
Mt. Pleasant Republican Representative Dave Heaton agrees that it will all work out for patients like Stansberry..in the end.
"I understand this is a great, big undertaking,” Heaton said. “People are going to have to have some patience and I’m kind of hoping that perhaps we can get an extension on the time allotted for people to switch over."
Foxhoven said patients will have 90 days after they're switched to UnitedHealthcare, to make alternative plans.