Story Bank: Sandra, York County

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Sandra*, 57, York County

"When I left for work that day, I was not expecting that I would be out of work." -Sandra

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Sandra was working as an in-home aide for children with behavioral needs when she sustained a traumatic brain injury.

"The first thing I said to my coworker was, 'I can't go to the hospital. I can't afford to miss work. I can't afford to go to the hospital,'" said Sandra.  

Sandra was afraid that her hospital bills would far exceed the costs her Marketplace health insurance would cover. "The neurosurgeon said I had a brain bleed, and I started crying,” said Sandra. “I could have died because I was worried about money."

Sandra spent much of her academic career studying psychology, but she never quite knew the extent to which people are impacted by brain injuries, until the accident.

Sandra's brain bleed has impaired her neurological functioning including processing speed, reaction time, coordination, and memory, in addition to her vision—to the point where she can no longer drive.  

"I am still seeing double and am light sensitive," said Sandra. "Things don't compute as fast and I don't see things and process them like you're supposed to. I can't drive. Once you can't drive, you have access to nothing."

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After Sandra's brain injury, she began receiving workers' compensation, which helped to supplement her income but put her over the income limit to qualify for services like MaineCare and SNAP, the Supplemental Nutrition Assistance Program. Her workers’ compensation income did not count in the Marketplace to qualify her for a subsidy. To qualify, she has had to liquidate her retirement savings.  

"I found myself in a place where I couldn't get Marketplace insurance unless I took a certain amount of money out of my retirement account to qualify me," said Sandra. "It became, 'Well, that's not enough to qualify you to get assistance, so you have to take more out.' I make too much in workers' comp to qualify for any services.”

Because she is not working and has no steady stream of income, her health insurance is becoming increasingly unaffordable.  

As a former state employee, she does not qualify for social security disability insurance, even though she is living with a potentially lifelong disability.

"The doctors so far say I likely won't go back to work, but I am still hopeful that I will," said Sandra. "If I don't, I don't know what is going to happen because the small amount of money I have left [in retirement savings] is not going to last very long."

At 57 years old, Sandra has quite a few years left before she can qualify for Medicare, so she must struggle to pay for a health insurance plan that costs too much for her restricted budget.

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Aside from the stresses of navigating the health insurance system with a brain injury, Sandra is dealing with the stress of maintaining relationships with loved ones.

She raised four children in York County whom she was close with. Since the accident, their relationships have shifted.

"Being a brain injury patient, it's not a bonding experience for families," said Sandra. "It is and continues to be very stressful. People are like, 'How do you stay home all day?' and I'm like, 'Honestly, I haven't felt good enough for that to be a problem.' My big outings are going to doctor appointments.”

Nearly two years have passed, and Sandra is still learning to cope with her brain injury and find ways to pay for the health insurance she needs.

"When I left for work that day, I was not expecting that I would be out of work," Sandra said, somberly. "Everybody says you know that things happen for a reason. I have not yet found the reason."

 

*Name has been changed to protect storyteller.