MICHAEL BRYANT / Staff Photographer
Phil Venezio sits in his wheelchair at the door to his N.J. home. Last year, at 55, he got sick, and lost his job. He was rejected for a Medicaid program called Global Options Nursing Facility Transition because his disability check is $77 over the qualifying limit. He has appealed.
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A fall through insurance-coverage gap
Phil Venezio worked for 30 years before he got sick and lost his health insurance. The he missed qualifying for Medicaid by $77.
MAYS LANDING, N.J. - Phil Venezio worked for 30 years selling laboratory equipment to schools and industry. He supported a family, paid taxes, saved what he could.
Last year, illness and disability overwhelmed him so fast, at age 55, "it felt like a dream," he said. "Could this be me?"
He couldn't work, lost his job, and with it, his health insurance. Venezio now receives $1,988 a month in disability from Social Security, which he paid into all his adult life. This is not enough to afford private health insurance for him and his wife, Kathy, he said.
The State of New Jersey denied him health insurance under Medicaid, a safety net for the poor.
The maximum income allowed is $1,911 a month.
He's $77 over the limit.
So he has no insurance.
"They're penalizing me because I've worked hard and paid into Social Security all my life," he said. "That part kills me the most."
"It's pretty surprising in a year's time," he added, "how you can go from successful to nothing."
Venezio worked for a variety of companies over the years, selling countertops, cabinets, sinks, fixtures - everything a company or school might need for a lab.
He made a middle-class living, $60,000 to $90,000 a year, he said.
His wife works part-time at a clothing store near the Hamilton Mall and makes enough pocket money to buy their weekly groceries, he said. She also spends a lot of time attending to his medical needs.
On Nov. 18, 2007, getting out of bed, Venezio couldn't stand up. He'd been complaining of pain for months. Doctors found a mass on his spine, which turned out to be an infection, he said, "that ate away at the bone, which caused the bones to rub, resulting in extreme pain."
After treating the infection, surgeons "inserted titanium rods and screws to rebuild my damaged spine," he said.
The infection and surgery left him in a wheelchair with nerve damage and a 30 percent chance of walking again. He needs a catheter because he no longer can control his bladder.
When he could no longer work, his employer offered him the option - required by law - to continue his company health insurance for 18 months. But that cost $1,097 a month. He couldn't afford it.
He has spent about $12,000 out of pocket, he said, and his savings are nearly gone. He also owes more than $7,500 in medical bills, and creditors are calling.
He dialed 211 in Atlantic County, a human-services hotline.
He was referred to Mason Meltzer, a social worker with the Department of Intergenerational Services.
Meltzer could not speak about Venezio, citing privacy. But when asked whether he has many clients who make too much to qualify for Medicaid, but can't afford insurance themselves, he cited the nation's economic troubles and replied:
