The waiting room at the Wake County Department of Social Services smelled like burnt coffee and old carpet. When I arrived on a Tuesday morning in late February 2026, Curtis Bianchi was already seated in the third row, holding a manila folder stuffed with papers so thick the metal clasp had bent outward. He had the look of someone who had rehearsed what he was about to say many times on the drive over.
A social worker named Patricia Okafor had suggested I speak with him. She described him as “one of the ones who falls through every crack that isn’t supposed to exist.” I introduced myself, and Curtis nodded, shifting the folder to his lap. He put on a small, composed smile. “I’m fine,” he said, which is exactly what Patricia had warned me he would say first.
A Budget Built on Assumptions That Kept Changing
Curtis Bianchi is 42, single, and works as a certified pharmacy technician at a chain pharmacy in Raleigh, North Carolina. He earns approximately $31,200 per year before taxes — a number that sounds workable until you understand the full picture. He is raising his eight-year-old daughter, Maya, largely on his own. He is also the primary caregiver for his father, Leonard, 71, who was diagnosed with Type 2 diabetes in 2022 and has had progressively worsening mobility since a fall in the spring of 2024.
After-school care for Maya runs $650 a month. Leonard’s out-of-pocket prescriptions, before any coverage intervened, were running between $290 and $430 monthly depending on the quarter. Curtis’s rent on a two-bedroom apartment in east Raleigh is $1,340. When I added those figures together in my notebook, the monthly obligations before food, utilities, or transportation came to roughly $2,280 — on a take-home income of approximately $2,050.
Curtis told me he had roughly $8,200 in a savings account when his father’s health began declining seriously in mid-2024. “That was supposed to be my retirement,” he said, looking at the folder in his lap rather than at me. “I know that sounds like nothing, but I built that over six years. I was proud of it.”
The First Denial — and What It Actually Meant
Leonard Bianchi had been covered under a private Medicare supplement plan, but as his care needs grew, the gaps in that coverage widened. Curtis began researching Medicaid for his father in August 2024, specifically North Carolina’s Medicaid program for low-income adults 65 and older. According to NC DHHS Health Benefits, older adults in North Carolina may qualify for full Medicaid based on income and asset thresholds that are evaluated separately from the applicant’s adult children.
Curtis submitted the first application in September 2024. It was denied in November. The stated reason was incomplete documentation of Leonard’s asset holdings — specifically, an old savings bond from 1987 that Curtis hadn’t known existed until a caseworker flagged it. The bond’s current value was $214.
Curtis resubmitted in December 2024 after locating and documenting the bond. That application was denied in January 2025 — this time because the caseworker’s notes incorrectly recorded Leonard’s Social Security income as $1,180 per month when the actual figure was $980. The $200 discrepancy pushed Leonard above the income threshold on paper. Curtis didn’t discover the error until he requested a written explanation.
Eight Months of Watching the Savings Account Drain
Between September 2024 and April 2025 — eight months — Curtis paid out of pocket for his father’s medications, two specialist co-pays, and one urgent care visit that cost $380 after a partial Medicare payment. He estimates he spent approximately $3,600 of his savings during that window. “I stopped looking at my bank account after a while,” he told me. “It was making me sick to look.”
Maya, his daughter, had no idea. Curtis described dropping her off at school each morning and telling her to have a great day. “She’s eight. She doesn’t need to carry this. So I carry it.” He said it flatly, not for effect. Patricia, the social worker, had used the phrase “puts on a brave face.” Sitting across from Curtis, I understood exactly what she meant.
The appeal process, Curtis told me, felt like learning a second language while exhausted. He submitted a written appeal in February 2025, attached a corrected income verification letter directly from the Social Security Administration, and requested a fair hearing. “Patricia helped me understand I had that right,” he said. “I didn’t know you could fight it. I thought a denial just meant no.”
The Approval — and the Complicated Relief That Followed
Leonard Bianchi’s Medicaid coverage was approved in April 2025, seven months after the original application. Because the approval followed a successful appeal, coverage was backdated to the original application date in September 2024 — meaning some of the out-of-pocket costs Curtis had paid during that period were potentially reimbursable. He was still working through that process when I met him in February 2026.
The relief Curtis described was real, but it was not clean. He had spent down roughly $3,600 in savings during the eight months of limbo. His savings account, which once held $8,200, stood at approximately $4,700 by the time the approval came through. “They can maybe give some of that back,” he told me. “But I can’t get back the stress. I can’t get back what that did to me. I was making decisions at work while I was thinking about this. I was picking up Maya while I was thinking about this.”
Since Leonard’s Medicaid approval, his prescription costs have dropped to a $3 monthly co-pay under the program’s drug benefit. The urgent care and specialist visits that previously required substantial out-of-pocket payments are now covered. Curtis estimates the active coverage saves the household between $310 and $450 per month in direct medical costs.
The Retirement Question He Can’t Stop Asking Himself
What stays with me from my conversation with Curtis is not the bureaucratic error, or even the denials. It is the retirement question he kept returning to, unprompted. He is 42. He has approximately $4,700 in savings after the Medicaid ordeal. He is not enrolled in any employer-sponsored retirement plan at his pharmacy job — his employer offers one, but the matching threshold requires consistent contributions he hasn’t been able to maintain.
“I’m going to be sixty-two in twenty years,” he said, folding the top of his manila folder back and forth. “My dad needs care right now. Maya needs things right now. I think about the future and I just — I put it away. I have to put it away or I can’t function.” He paused. “But it doesn’t go away. You just can’t look at it while you’re standing in line here.”
The childcare costs remain the most immediate pressure. At $650 per month, after-school care for Maya represents more than 30 percent of Curtis’s take-home pay on its own. He has inquired about the Child Care Subsidy program through NC DHHS, and a caseworker is reviewing his eligibility based on his income level and single-parent status. That process, as of the date I spoke with him, had not yet produced an outcome.
Patricia Okafor, who connected me with Curtis, told me his case is common in ways that should make policymakers uncomfortable. “The people who most need these programs are often the least equipped to fight the process,” she said. “Not because they’re not smart. Because they’re exhausted. They’re working. They’re caregiving. And then they have to become their own case managers on top of all of that.”
When I left the waiting room that morning, Curtis was still seated, waiting to speak with a benefits specialist about the child care subsidy application. He had rearranged the papers in his folder and was reading something carefully. He looked focused. He looked tired. He looked like someone who had learned, at some cost, that you have to read everything — because no one else will read it for you.
Related: A 64-Year-Old FedEx Driver With a 2-Year-Old Has Almost Nothing Saved — Now Social Security’s 2026 Changes Are Closing Her Window
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