Where do I start? I'm afraid I've been avoiding my blog this weekend because there's just so much I have to say. All of the ideas I have floating around in my head and I always think, I need to blog about that. But then I face what most of you are likely very familiar with, not enough time.
I'll start with Friday. I woke up early so that I could begin working on my 'list' of phone calls. I started calling at 8:01. My first ambitious goal, get ahold of someone who can help me figure out why Chelsea is no longer receiving her Medicaid (she gets social security benefits for her disability and a Medicaid card is an automatic). Somehow while I was gone for a month, they changed her insurance plan...why??? I'm not quite sure. I'm just thinking changing insurance plans while in the middle of receiving chemotherapy for cancer, is not a good idea! So yeah, can you see me freaking out? Well phone number one gave me phone number two, phone number two gives me phone number three to call, and phone number three gives me phone number two to call!!!! What? Here it was 8:30 and I still hadn't even talked to anyone that could talk to me. Phone number three insisted she couldn't do anything and that I need to call back the previous number, frustrated, I told her I needed to talk to her supervisor, or somebody who could help me. Well, I did get somebody else, but she was utterly confused and could not help me right away. She told me she needed to talk to HER supervisor and look into this and call me back.
Sooooo.... I stayed home by the phone with both children ALL day waiting for her to call back. And for the other 5 phone calls I had to make (insurance companies, jazzercise corporate, hemonc nurse, etc.) I was only able to leave messages. Do you think anybody called me back, ha! Until ... I was walking out the door at 4:30 (we were out of diapers) both kids were already strapped in their carseats, and the lady from Medicaid calls. She tells me because Chelsea does qualify for SSI she SHOULD be getting a Medicaid card (isn't that what I called to tell her?) BUT, here's the best part ... she told me that because Chelsea is on SSI, our family is only a 3 person family, not a 4 person family (I looked around and counted, yep, still 4 people here, hmmmm). Guess what that means? The lower cost insurance plan they just approved for Logan 2 weeks ago we would no longer qualify for, b/c we're a three person family. No matter what I did to convince this woman we were a four person family mattered. By the end, she was confused too, and told me she would have to work on this Monday and call me back. Not sure if any of that makes sense to the outside world, but let me just tell you it's extremely annoying. I told Ryan, shoot, if we would just go out and have a few more kids at least we would qualify for better health insurance.
I did eventually make it to Sam's to buy diapers, and can you imagine my surprise when my 29.99 box of Huggies has risen to 38.99!!!! That's almost $40!!! for a box of diapers!!! Not to mention the baby wipes have risen over 30% and paper towels a whopping 25%!!! So let's get back to those guidelines for getting Logan health insurance. Why is it that the cost of EVERYTHING has gone up, people are getting paid a little bit more to help offset some of these costs, but still the guidelines for who qualifies for assistance remains the same. There's a cap amount a family can earn in order to receive help and we're above that amount for a 3 person family (not for a 4 person family though). Tell me what part of all of this makes sense? I'm just flabbergasted and I feel like I need to write a letter or contact someone, but I'm not sure who. Who is in charge of making the cutoff regulations for healthcare assistance? I think the guidelines need to change at a similar rate as the cost of living. The more the prices of living go up the more we need assistance. The whole system is insane. I think we need to move to Canada.
*Disclaimer, just so you know, we're not on the verge of being homeless or anything, it's just while times are tight getting Logan on better insurance would have saved us $100/month and right now, every little bit helps.
As I tried to step out of the house for the 2nd time on Friday, our nurse called from Children's. We have a plan. Because the culture from the inside of Chelsea's ear grew mold on Thursday they are first checking for sensitivities so we know what medication she can use. We will then check her chemistry numbers on Tuesday when we do labs to be sure her liver enzymes are down to normal before starting anything new. We are also scheduled for a CT scan of the right side of her head on Tuesday morning. Get this ... unsedated! ha! This will be interesting. Apparently her Down syndrome puts her at high risk and they would have to coordinate the CT scan with the anestesiologist and that could take up to two weeks! So we're going to try it this way first. She's not showing any symptoms of the mold growing in her blood or bone, but the scan will help us confirm that. We also have a follow up with the ENT on Tuesday afternoon. Basically we'll be there ALL day on Tuesday.
Hello world!
3 years ago
6 comments:
We're having problems with medicaid too, they changed plans in the middle of feb and went a week without anything but basic medicaid that NO ONE WILL TAKE except for children's mercy.
We couldn't get my son's abx script on saturday because his name didn't match his card, they wanted to know if I changed there name.
I think they are all smoking something over there.
reminds me I need to call them LOL
ugg
hope they get it sorted out soon. Can they put logan on chip?
Yes, I agree the cut-off for assistance needs to be changed. And it's almost as if they are trying to punish anyone that needs help by giving you the run around! Good luck with it all. That has to be exceedingly frustrating and I truly feel for you.
What is the cut off for a family of 4?
If I recall in Missouri the cut off for a family of 4 was somewhere around 3700.00 ish a month but there are basically 4 levels of medicaid (beyond disability medicaid). The your so poor you don't have to pay anything (mostly non employed, minimum wage). And then the next 3 levels you have to pay something each month according to your income and family size. The first level being $24.00. The second being $75 ish, and the third level was somewhere around $150ish if I recall right.
If you get SSI you shouldn't have to pay but if you have other children on medicaid, it doesn't matter, it's not $24.00 per kid, it's for the whole family.
I just talked to them yesterday and they told us that our daughter would not get kicked off of medicaid (our son just qualified for SSI), fingers crossed they were right. But then were lucky enough that in another month or so, we'll have a baby so then we'd be able to get her back on anyways.
Do you know...is SSI based on income? I can't seem to get a straight answer from the powers that be. I mean, if you have a child with a life altering, permanent disablility, is the automatically given SSI benefits based on disablility or is it based on household income? How is SSI determined?
WIth Medicaid, do you have copays, deductibles and out of pocket expenses? Wow, those monthly premiums are incredibly less expensive than private insurance that I pay, not to mention the copays, out of pockets, ect ect ect.
Are you happy with the way you are treated at doctor/hospital/offices when you say you have Medicaid? Is it easy/hard to find doctors/hospitals who accept Medicaid? Are you happy with the benefits offered and paid for?
You seem much more knowledgable than the agency reps. THanks for your input!
SSI is totally based on income. If your income is high enough your child won't get it. the exception to this could be if your child was instintuionalized. Once your child is 18 that will may change. They also care if you own more than 2 vehicles's, rent houses for income, own property (besides where your home is) huge savings account's ect. Those can all get you not qualifed.
No copays, deductables, or out of pocket expenses for children on medicaid. Mind you though, that if you have a job, and they offer insurance odds are your child won't qualify. Unless your company charges an extreme amount of $$ each month. However if your company doesn't offer insurance (which is the situation we are in), or you don't qualify yet for it ect then that is different.
FYI: This is for Missouri and not disability medicaid. Each state does it different and i'm not sure how disability medicaid runs in missouri, yet.
Children's Mercy has to take missouri medicaid. No problems there. There are 4 different insurance plans offered for medicaid. Each one has different dr.'s although all cover children's mercy. There are a lot less regular dr.s (outside the hospital) that will take medicaid, and usually will only take one of the plans. We were actually seeing a wonderful ped in Kansas (out of KU MED) but had to stop as his office doesn't take missouri medicaid (takes KS, just not MO). So far we've had little issues with what they have paid for. No issues with paying hospital bills, one dr. bill I'm working on and one apria bill im working on (although that may be apria's fault). And to be frank, we were going bankrupt paying his bills before so this is an improvement.
Now I'm preggo and get medicaid too, because my dh had lost his job when we found out I was preggo. When you are preggo and on medicaid, they cannot kick you off, no matter your income changes, until 2 months after the baby is born. I did have a more limited amount of hospitals that would take medicaid. What i did, was found the midwives that I wanted, and asked them which plan did they accept and that is how I choose. I have to pay either $1 or $2 copays for prescriptions, which is nothing. Other than that there is no fee, nor do I have to pay each month for me. But in a few months i will be kicked off and need to purchase private insurance until my dh can get a job that has insurance.
Now if you have a child with a disability there are also medicaid waivers. Each state is different. The waiver essetially entitles your child to medicaid as a secondary insurance with your reg insurance as primary. We would of tried this next if the SSI didn't go through.
you can email me at cori_n_wes_mom@yahoo.com for more ?'s.
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