Health Benefits Program Helps Ailing Senior

Senior with Devastating Illness Receives Help from Coastline's Health Benefits Program in Getting Back Her Mass Health Coverage

by Abrah J. Salk

Rose L.* had been receiving Mass Health coverage for 26 months, when during their annual review of their clients they contacted Rose and requested her husband's financial information.  Rose did not understand this request, as she was the only one using Mass Health - her husband was not.  Nevertheless, she sent in the requested information and was then informed by Mass Health, that she was no longer eligible for coverage.  This would've been traumatic enough, given that most private insurance companies have a $600+ monthly premium.  However, this news was even more devastating to Rose, because she had just undergone colon surgery and was enduring chemotherapy for colon cancer.  Rose was beside herself - she didn't know what to do.  She contacted a few private insurance companies and once she informed them that she had cancer, she was quoted $1000+/month.  What senior citizen can afford $1000/month for health insurance? The stress of Rose's disease was overwhelming, and now one thing more had been added to her plate - the stress of wondering how she could afford it all. 

During this time, Southcoast Visiting Nurses were coming to Rose's house to help her with her ostomy (the surgically created opening in the body for the discharge of body wastes) and it was one of these nurses that suggested Rose contact Coastline.

Rose called up Coastline and shortly thereafter, Ann Fagundes, a Home Care R. N. at Coastline, visited Rose and reviewed her case.  She determined that Rose was medically eligible for a spousal waiver from Mass Health.  Having this waiver would mean that  Rose would be eligible again for Mass Health coverage.  All she had to do was fill out a bunch of forms and send them to the Mass Health main office.  Rose turned to Carolyn Avery, the Health Benefits Coordinator at Coastline, for assistance.  Carolyn met with Rose and helped her fill out the very confusing Mass Health forms.  Finally, after all of the paper work was approved by Mass Health, Rose had medical insurance coverage once again.

Rose is shocked at just how difficult it is for seniors with devastating illnesses to get coverage.  Without Coastline's assistance, she doesn't know what she would've done.

Rose's experience with Coastline has been nothing but "positive - very helpful in every aspect".  No matter who she contacted at Coastline or what department she contacted, her "calls were always returned promptly".

Rose summed up her feelings towards Coastline, "The Agency - thank G-d it's there."

For information about any of Coastline's programs, please call (508)999-6400 or send email to: information@coastlineelderly.org

*Name has been changed to protect privacy.