The Eastern New Mexico News - Serving Clovis, Portales and the Surrounding Communities

Pre-existing conditions on longer bar patients from insurance

 


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As many others, Karen Graves was your average, every day hard worker without insurance.

But a heart attack two years ago changed all that.

After finding out she had congestive heart failure, not only was Graves forced to quit working and be placed on disability for six months, she was also unable to afford proper treatment for her condition.

“As soon as I would say I had congestive heart disease, insurance companies would reject me,” Graves said. “I couldn’t see my heart specialist because I didn’t have insurance and I couldn’t afford to pay to see him so I kept going to Quick Care.”

Graves worked as a medical transporter (which she does now), shuttling patients to and from medical appointments across New Mexico, Texas and Arizona. She was mid-route from Santa Rosa to Clovis with a patient when she began to have trouble breathing.

“I think I scared my boss because I called him and I said my chest feels like it’s closing and I can’t breathe and he said, ‘oh my gosh, you’re having a heart attack,’” she said. “Not the thing to say to calm me down at that moment.”

She laughed.

“I got my patient, made it back to town and went straight to emergency, and they immediately threw me in a room because my boss had already talked to them.”

Graves said she had to see a nurse practitioner at Quick Care to get her heart and blood pressure medications because she could not afford to see the heart specialist she needed.

Graves said she was receiving $163 per week from disability but she aver saged $150 per month in medical bills and paid $160 per month for rent.

She was barely making ends meet and was in constant pain due to rheumatoid arthritis in her back and fibromyalgia. Her heart condition also regularly gave her anxiety attacks.

Graves said she began to sink into a depression over her circumstances.

All that changed with the Affordable Care Act. Insurance companies are no longer allowed to reject medical patients due to pre-existing conditions.

Graves said she had worked with Mary Marez at Presbyterian Medical Services before, so she approached the certified application officer about affordable care.

“I came in here and Mary took half an hour for me to get what I needed to get,” Graves said. “I now have insurance and it’s insurance with a premium I can afford.”

Graves said Marez also helped her get a Presbyterian medical bill lowered.

She said she is paying a little more than $100 per month for her insurance premium under an affordable care plan called the Individual Silver Plan B.

“What’s going to happen now is she’s going to be able to get her prescriptions for free for the generic brands and she will pay a $5 co-pay for the name brands,” Marez said. “She will now be able to see the heart specialist she’s needed to be able to see all these years because of the coverage she is receiving.”

Graves said being able to now have health insurance has been life-changing.

“I have real insurance now. I feel like a real person,” Graves said. “It is such a blessing to have what we have today through the market place. There is nothing I could give them that would thank them enough for what they’ve done for me.”

Marez said Presbyterian will be holding public forums to give anyone information about affordable care plans and the opportunity to sign up.

She said s a forum Curry County is planning for sometime in March will be announced once a definite date and location have been determined.

 
 

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