Paralyzed Florida Woman's Fight for Essential Medical Gear Denied by Medicaid

The Struggle for Basic Needs

• ♿ Karen Evanoski, paralyzed from the chest down after a car accident, faces daily challenges due to denied medical equipment claims by Medicaid.
• 💡 She expresses frustration with the repeated denials, stating, "I'm a human, I'm not a drag on the system, and I deserve to be cared for."

Denied Medical Equipment

• 🛏️ Evanoski has been denied a shower chair twice, preventing her from showering for 16 years, relying instead on bed baths.
• ⚙️ Her ceiling lift, essential for getting in and out of bed, is also aging and malfunctioning, requiring manual intervention.
• 🛁 Despite renovating her bathroom for a roll-in shower, she cannot use it without the approved shower chair.

Medicaid and Insurance Denials

• 🏥 Evanoski's insurance, Sunshine Health (contracted by Florida Medicaid), denied claims for a new lift and shower chair, deeming them not medically necessary.
• ⏳ Appeals have been unsuccessful, leaving her without the essential gear for months.
• 💰 An attorney explains that private companies contracted by Medicaid have a financial incentive to deny care, as they are paid a fixed rate per patient.

The Fight for Quality of Life

• 💸 Evanoski, living on Social Security disability, has had to purchase a used manual lift when her primary one failed, putting her in a dangerous position.
• 📣 She hopes that by sharing her story, Medicaid and Sunshine Health will finally take action to improve her quality of life.
• ⚖️ Legal advocates highlight the complex appeals process, which can involve internal appeals with the plan and state administrative hearings.