ARRRGGGGG! I am so frustrated!!!! Maybe I just need to vent but if anyone has any advice for me, please feel free. I'd love to have some suggestions as to what to do. It's a long story but I'll try to make it as short as possible:
My family and I moved to TX in December. We applied for Medicaid for the children before we got jobs. They were accepted and the Medicaid was good through July 31. My husband and I are both working now so we no longer qualify but we do qualify for CHIP (the program for children who do not qualify for Medicaid but who do not have private insurance). So, to try to jump ahead here, in May I called my caseworker verifying exactly what would occur when Medicaid ran out. I wanted to make sure to do everything ahead of time so there would be no lapse in coverage. My caseworker assured me that everything would be fine. She would automatically send our info over to CHIP and they would pick up the children effective August 1. So, the first week of July I called CHIP to verify all was going according to plan. The first thing the lady asked me was to verify my address. I gave her my address but she said it was incorrect. I tried to explain to her that I have only lived in TX for a short time, I have never had another TX address. This is my address and I didn't know what else to say to her. I offered my social security #, date of birth, etc....and those of my children and husband. The lady said that wasn't good enough and until I could verify the address they have on file she would not speak to me. I had to call back three times and speak to three different people before I could finally convince someone that I know where I live and this is my address. Whatever they have in their computer is wrong and I have no way of just guessing what it might be. Finally that was taken care of and the address was changed.... Now, the problem.... They had sent my enrollment packet to the address they had on file so I never received it. The lady offered to send me a new one but it would take two weeks to receive. (Heaven knows that she can't just get one, put a stamp on it and mail it to me...they have a certain "process" to follow). The rule is that you have to have mailed the enrollment packet back to them with the premium by July 19th in order to have coverage for August 1. Well, due to the address problem, I didn't even get the enrollment packet until July 21. So now they will be effective with CHIP on September 1 but have no insurance for August.
Okay, for normal, healthy people, a month without insurance wouldn't be a huge deal... I have 5 children...2 of whom have CF. And this is the month that school starts, when they have to have all those physicals, shots, etc.... not to mention the CF meds and stuff, so this is a HUGE deal for us.
Now, the even bigger problem. Kacie, my 6 year old with CF, has been having major sinus problems since January. She has been to the ENT several times. We've tried nasal washes, antibiotics, several nasal sprays, etc but she just keeps getting infections. We were at the CF Center a couple of weeks ago and the CF doc says that the next time she has so much as a hint of a sinus infection she is having surgery, no questions asked. Her polyps were huge and the doc says we just can't wait any longer. It was only a few days after the appt that she got an infection. We were back to the ENT and he scheduled surgery for August 5. Well, guess what....we can't do it with no insurance. The docs are not very sympathic with my situation. They say she has to have the surgery and we can't wait any longer. Yet the surgery center won't even let me reschedule it without insurance or a huge downpayment. I certainly can't pay for it. Hell, I can't afford Creon for a month for both of them, let alone a surgery.
I have called Medicaid multiple times. I have spent every waking minute that I wasn't working for the past two weeks trying to get this fixed. I have gotten nowhere. The supervisor will not return my calls. I have spoken to damn near every worker they have at that office but to no avail. The assistant to the supervisor I spoke to on Friday had the nerve to tell me (very rudely) that if this were HER daughter, SHE would make sure that she got the care she needed no matter what she had to do. HER daughter would get her surgery regardless of whether she had insurance or not. She had me sobbing on the phone. I was so upset I could barely breathe. How dare she even pretend to know what kind of situation they have put me in. She has no clue what it's like. I feel like my daughter is suffering and I am completely powerless to help her. Because of a mistake that Medicaid made by sending the wrong addess to CHIP, my children can't get the medical care they need.
I am very upset that my situation is just being ignored by Medicaid. I spoke to my original caseworker late Friday before they closed. She told me privately that the only way to fix this problem right now is if I tell them that my husband has moved out of the house. Then our income will be within the limits and they will pick the kids back up for August. I don't see any other way out of this. It's either that or we wait until September, against drs orders, to have Kacie's surgery. And we will just have to hope and pray that nothing else goes wrong or that noone gets sick. It's just crazy to me that they can do this. People should be held accountable for the mistakes they make, but no one is in this case.
Sorry, I know this was very long.... I had to get it off my chest. No one in my life really understands what it is like to have to worry about your kids like we do. I feel like choking someone. I just don't know what to do other than to call them tomorrow and tell them that my husband moved out. I am sure they will not believe me as they are all familiar with my situation. They all know my name as soon as I call. But what can they do? They can't prove that he didn't move out...right? I'm stuck. I just need to hear what someone else would do in my situation....
Thanks much!
My family and I moved to TX in December. We applied for Medicaid for the children before we got jobs. They were accepted and the Medicaid was good through July 31. My husband and I are both working now so we no longer qualify but we do qualify for CHIP (the program for children who do not qualify for Medicaid but who do not have private insurance). So, to try to jump ahead here, in May I called my caseworker verifying exactly what would occur when Medicaid ran out. I wanted to make sure to do everything ahead of time so there would be no lapse in coverage. My caseworker assured me that everything would be fine. She would automatically send our info over to CHIP and they would pick up the children effective August 1. So, the first week of July I called CHIP to verify all was going according to plan. The first thing the lady asked me was to verify my address. I gave her my address but she said it was incorrect. I tried to explain to her that I have only lived in TX for a short time, I have never had another TX address. This is my address and I didn't know what else to say to her. I offered my social security #, date of birth, etc....and those of my children and husband. The lady said that wasn't good enough and until I could verify the address they have on file she would not speak to me. I had to call back three times and speak to three different people before I could finally convince someone that I know where I live and this is my address. Whatever they have in their computer is wrong and I have no way of just guessing what it might be. Finally that was taken care of and the address was changed.... Now, the problem.... They had sent my enrollment packet to the address they had on file so I never received it. The lady offered to send me a new one but it would take two weeks to receive. (Heaven knows that she can't just get one, put a stamp on it and mail it to me...they have a certain "process" to follow). The rule is that you have to have mailed the enrollment packet back to them with the premium by July 19th in order to have coverage for August 1. Well, due to the address problem, I didn't even get the enrollment packet until July 21. So now they will be effective with CHIP on September 1 but have no insurance for August.
Okay, for normal, healthy people, a month without insurance wouldn't be a huge deal... I have 5 children...2 of whom have CF. And this is the month that school starts, when they have to have all those physicals, shots, etc.... not to mention the CF meds and stuff, so this is a HUGE deal for us.
Now, the even bigger problem. Kacie, my 6 year old with CF, has been having major sinus problems since January. She has been to the ENT several times. We've tried nasal washes, antibiotics, several nasal sprays, etc but she just keeps getting infections. We were at the CF Center a couple of weeks ago and the CF doc says that the next time she has so much as a hint of a sinus infection she is having surgery, no questions asked. Her polyps were huge and the doc says we just can't wait any longer. It was only a few days after the appt that she got an infection. We were back to the ENT and he scheduled surgery for August 5. Well, guess what....we can't do it with no insurance. The docs are not very sympathic with my situation. They say she has to have the surgery and we can't wait any longer. Yet the surgery center won't even let me reschedule it without insurance or a huge downpayment. I certainly can't pay for it. Hell, I can't afford Creon for a month for both of them, let alone a surgery.
I have called Medicaid multiple times. I have spent every waking minute that I wasn't working for the past two weeks trying to get this fixed. I have gotten nowhere. The supervisor will not return my calls. I have spoken to damn near every worker they have at that office but to no avail. The assistant to the supervisor I spoke to on Friday had the nerve to tell me (very rudely) that if this were HER daughter, SHE would make sure that she got the care she needed no matter what she had to do. HER daughter would get her surgery regardless of whether she had insurance or not. She had me sobbing on the phone. I was so upset I could barely breathe. How dare she even pretend to know what kind of situation they have put me in. She has no clue what it's like. I feel like my daughter is suffering and I am completely powerless to help her. Because of a mistake that Medicaid made by sending the wrong addess to CHIP, my children can't get the medical care they need.
I am very upset that my situation is just being ignored by Medicaid. I spoke to my original caseworker late Friday before they closed. She told me privately that the only way to fix this problem right now is if I tell them that my husband has moved out of the house. Then our income will be within the limits and they will pick the kids back up for August. I don't see any other way out of this. It's either that or we wait until September, against drs orders, to have Kacie's surgery. And we will just have to hope and pray that nothing else goes wrong or that noone gets sick. It's just crazy to me that they can do this. People should be held accountable for the mistakes they make, but no one is in this case.
Sorry, I know this was very long.... I had to get it off my chest. No one in my life really understands what it is like to have to worry about your kids like we do. I feel like choking someone. I just don't know what to do other than to call them tomorrow and tell them that my husband moved out. I am sure they will not believe me as they are all familiar with my situation. They all know my name as soon as I call. But what can they do? They can't prove that he didn't move out...right? I'm stuck. I just need to hear what someone else would do in my situation....
Thanks much!
] The doctors [pedi] are quite simply amazing. I had Dr. Willey-Courand and that group. If you have them you're very lucky. They are very knowledgable, friendly, and know what needs to be done. Their all the kind of people that will sit you down say here's your problem, these are the options of what we can do to resolve it, and this is what I suggest.