The Zolotorow family

Craig and Mike Zolotorow

Ellicott City, Maryland

 

Phyllis Zolotorow is used to fighting for health care. For 24 years, she has battled insurance company bureaucracies to keep her son, Craig, alive.

Craig was 2 when he was diagnosed with an immunodeficiency disorder – commonly called “boy-in-the-bubble syndrome – that would require monthly infusions of medication for the rest of his life.

A year after Craig became ill, the insurance company changed his diagnosis to HIV/AIDS so it could deny coverage. Phyllis fought them and the State of Maryland forced the company to change the diagnosis back and cover the expenses or lose their ability to do business in the state.

Craig spent his childhood being treated by 12 specialists at Johns Hopkins Children’s Center. He battles diabetes, anemia, kidney disease and more. He had seven surgeries in three years and commonly spiked fevers up to 105 degrees.

By the time Craig was 10, the family’s 20 percent co-pay on his medical bills reached $250,000.

He reached his lifetime cap on insurance when he was12.

By then, he was eligible for Social Security disability payments with Medicaid as a co-insurer.

But as Craig’s medical bills declined and Mike Zolotorow, Craig’s dad, made more money, Medicaid paid less. The Zolotorows had to get a legal separation so Craig could qualify for Medicaid. In 1999, Phyllis had to leave her job to care for Craig full-time.

Four years later, Mike was seriously injured at work. He received workers compensation for a year, but at the end of 2004, his employer canceled his health insurance, and workers’ compensation paid only for treatment directly related to his injury.

In September 2005, Mike felt sick, but would not go to the emergency room because of the cost. Ten days later, he had a massive heart attack that left him dependent on an implanted defibrillator. Six months later, he needed quintuple bypass surgery.

If a public option had been available, Phyllis says, Mike would not have had to rely on employer-based insurance.

He could have been treated while his heart disease was still mild, his surgery would have been less extensive – and less expensive – and he would have been able to go back to work, adding to the tax base, instead of being permanently disabled.

The hospital applied for Medicaid and Social Security Disability Income, and Medicaid paid for his catastrophic illness. Once he received Medicaid approval, he was able to be placed on the list for a heart transplant.

“Without any insurance, a human being in the United States is denied the privilege of a life-saving transplant.”

Mike falls into what is known as the Medicare loophole – he has to wait two years to qualify for Medicare. Any expenses not covered by Medicaid until then are added to his debt. Physicians can refuse to treat him and he likely will have to rely on what care he can get in the emergency room, and he will have to pay for that.

Mike’s income on SSDI is too high to be able to qualify for full Medicaid. In Maryland, the maximum income for a family of two is $392 per month.

“By the time the deductible was met, he ended up with coverage only every other three months or so,” Phyllis said. “So we have uncovered expenses we may never be able to pay off. We get harassing calls daily from numerous medical collection agencies.”

Mike is one of tens of thousands of Americans who fall into this loophole because the Medicaid thresholds haven’t been raised along with disability payments.

Disability attorneys say there is no reason for the two-year wait for Medicare eligibility, but Congress has made no move to change it.

“I have no choice but to believe that the federal government wanted my Mike to die so Medicare didn’t have to pay his medical expenses, “Phyllis said.

Mike is on Medicare now, which Phyllis says is excellent.

“I can tell you through my experience I would opt for government-run insurance any day,” she said.

As for Craig, he is in college. He has the intelligence and capacity to earn a good living, but as it is now, if he ever makes over $30,000 a year, he loses his Medicaid eligibility, and no private insurer will take him.

“It’s cheaper to make sure all Americans have access to health care,” Phyllis said. “A citizen able to access health care is a healthier citizen. Healthy people work and add to the tax base and seek less or no social service assistance from the state or federal governments. A healthy working citizen adds to the economic growth of the United States.”

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Visit our new web site

It's official! We are WNC Health Advocates.
Please visit our new web site, Visit WNC Health Advocates
The new name reflects what we do -- advocate for health care for everyone and help people access and navigate our current health care system.
While we still hold onto the memory and the generous spirit of Mike Danforth, we need people to be able to see our name and understand who we are.

Help Life o’ Mike

We need your help now more than ever. Your tax-deductible donation will help us get Patient Pals and Family Friends to more people in need of peer support. Please consider a gift in honor or in memory of a loved one.
Donate here or mail your donation to Life o' Mike, PO Box 1213, Asheville, NC 28802.





Patient Pals & Family Friends

Life o' Mike has a peer support program for people with one or more serious or chronic medical issues or disabilities.

We aim to reduce isolation and fear among people who have conditions, including psychiatric illness, HIV/AIDS, diabetes, mild dementia or other cognitive disorder or disability, thereby reducing depression and complications as people learn to improve self-management of their medical conditions.

Patient Pals help alleviate feelings of isolation and frustration. They can help people develop a list of questions to ask the doctor and then accompany the person to the doctor to make sure all the questions are answered, taking notes to be sure the person understands the doctor’s answers.

Our trained volunteers also accompany their “Pals” to art exhibits, movies and walks outdoors, meet for coffee, call to check in and more.

Our Pals have experienced weight loss, improvement in diabetes, HIV, psoriasis, depression and more, just because they have someone who cares about them. Some relationships develop into longer-term friendships; other Pals move on to more independent lives.

Family Friends are there to help caregivers and other family members grow into their new role.

We need volunteers, who are asked to donate a minimum of one hour a week. Training is free and includes information on active listening, ways to help and when to know more help is needed.

And of course, we need funding.

To learn more, call Leslie Boyd at 828-243-6712 or e-mail lifeomike@gmail.com.

Life o’ Mike honors Joe Eblen


Life o' Mike presented its first Michael T. Danforth Community Service Award to Joe Eblen at a luncheon on June 8, in the Friendship Hall of First Congregational Church, 20 Oak St., Asheville.
Joe, seen here with Leslie Boyd, left, and his wife, Bobbie, has spent his life helping children and families, both as a coach and game official for more than 60 years, and as founder of Eblen Charities.

Start From Seed

Life o' Mike has a new program- Start from Seed (SFS).
SFS is a volunteer doula program aimed at providing non-medical, comprehensive support to low income, high-risk women and families of Buncombe County focusing on three areas:

1. We help new doulas with certification and training in return for their participation as a volunteer doula for SFS

2. We mentor volunteer doulas with their first few clients

3. Our volunteer doulas provide birth and postpartum doula services to low income, high risk moms, providing support and tools to empower them as a new parent.

A birth doula is a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; a postpartum doula provides emotional and practical support during the postpartum period.

Start from Seed clients are referred to us from the Buncombe County Department of Health’s Nurse-Family Partnership Program, Western North Carolina Community Health Services, and Mission Hospital. The Program is intended and designed for growing clients’ inner strength and helping them gain empowerment to help them cope with the emotional, physical and mental challenges of childbirth, labor, and motherhood.

Our new moms and their infants have many needs. If you would like to help them get off to a good start, please visit our Start from Seed web site: Start from Seed, or call Program Director Chelsea Kouns at 804-814-9946.

Events in the community

Free birth and labor classes

Peaceful Beginning Doula Services holds free birth forums, Peaceful Birth, 6:30-8 p.m. the last Thursday of every month (except November) at Spa Materna, 640 Merrimon Ave., above The Hop, in Asheville.
All are welcome, expectant women and their partners are encouraged to attend anytime during their pregnancy. We also encourage doulas and other maternal/child professionals to attend and share in the discussions. The forums are "birth circle" style, focusing on normal birth which follows the Lamaze Six Care Practices for Healthy Birth. The forums are led by certified and experienced educators.

NAMI Family-to-Family Class

NAMI of Western Carolina holds 12-week classes for families and caregivers of individuals with a severe mental illness 6-8:30 p.m. Mondays at Charles George VA Medical Center, 1100 Tunnel Road in Asheville. The course covers major mental illnesses and self-care. Registration required. Info at 828-299-9596 or rohaus@charter.net.

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