joannqn Posted September 29, 2011 Share Posted September 29, 2011 Up until today, they've always accepted my husband's profit and loss statements to insure my children. Today, they told me that they couldn't process our review because I didn't provide enough information. Now they want: His business ledger with all client info and invoicing for the last three months Receipts proving all business expenses for the last three months All bank account statements for the last three months (business and personal) He's working on printing it all off now because all of his invoicing is via email and everything else is in Quickbooks or online. It will end up being 2-3 inches worth of paper, and while he's printing all that, he's not able to work. Ugh. If we had a choice, we wouldn't provide it. It feels very violating to be giving them the information for every client, every penny earned (and where it came from), and every penny we spent (and where we spent it). I actually feel ill from it. I called to quotes for individual insurance. We simply can't do it. Even catastrophic is outside our ability to pay. It's either give the state everything they want or be completely uninsured. Dh and I haven't had insurance for years, but I can't stomach making my children go without medical care when they are sick or hurting like we do. I hate this world. Today is one of those days where I regret bringing children into it. I want to beg my kids not to have children when they grow up, because this world sucks too much. Quote Link to comment Share on other sites More sharing options...
bagel270 Posted September 29, 2011 Share Posted September 29, 2011 That's why my kids no longer have insurance. They wanted everything, and we didn't want to give it to them. Quote Link to comment Share on other sites More sharing options...
newlifemom Posted September 29, 2011 Share Posted September 29, 2011 I'm sorry Joann. I don't know what to say. I hope that you guys will be able to take care of things with as little info given out as necessary. :grouphug: Quote Link to comment Share on other sites More sharing options...
Starr Posted September 30, 2011 Share Posted September 30, 2011 :grouphug: I hope your insurance is up and running soon. How often do you have to do this? Quote Link to comment Share on other sites More sharing options...
joannqn Posted September 30, 2011 Author Share Posted September 30, 2011 They review food stamps every six months and children's medical every year...at least that's how it was. I don't know if they've changed that. If it was just the food stamps, we'd just drop it and find a way to do without the $390 they give us. It only lasts half a month anyway. The good news is that I am confident that we will become self-sufficient again. DH's business is growing despite the economy. I'm trying to figure out how to get my day more organized and efficient (easier said than done with the age my kids are) so I can take over bookkeeping and billing to free up more of his time for billable work. Quote Link to comment Share on other sites More sharing options...
milovany Posted September 30, 2011 Share Posted September 30, 2011 (edited) Joann, why can't you just send them last year's tax return? Edited September 30, 2011 by milovaný Quote Link to comment Share on other sites More sharing options...
joannqn Posted September 30, 2011 Author Share Posted September 30, 2011 They require the most recent information. If you have a "real job", they want the last two pay stubs. If you're self-employed, you apparently have to give them your entire life for the past three months. Their rules also state that if our income goes up $100 or more above the amount they used for qualification for two months straight, you have to call and report it so they can reduce your benefits. Fortunately, you can call the third month when it goes back down to have them increase your benefits again. It's really crazy. DH wants to hand deliver (it's not like 2 inches of paper is going to fit in their tiny little postage paid envelope anyway) and ask some questions, because the Washington Administrative Code doesn't require all this paperwork. Quote Link to comment Share on other sites More sharing options...
milovany Posted September 30, 2011 Share Posted September 30, 2011 This must be for the food stamps, right? We don't get those, but do have the medical cards. We're self employed, too, and and we don't have to do all that. I just sent off my 2010 tax return a month ago. I'm sorry! :grouphug: Quote Link to comment Share on other sites More sharing options...
joannqn Posted September 30, 2011 Author Share Posted September 30, 2011 It's for both. I asked if it would be required for just children's medical (thinking I'd just tell them to skip the food stamps), and they said it was required for that too. Quote Link to comment Share on other sites More sharing options...
Starr Posted September 30, 2011 Share Posted September 30, 2011 It's a pain but worth it unless they don't really need all the extras. It sure sounds like overkill. Quote Link to comment Share on other sites More sharing options...
joannqn Posted September 30, 2011 Author Share Posted September 30, 2011 (edited) I talked to them today. She said she needed verification of income and expenses and started spitting out a bunch of business terms. I said, "Whoa! I'm not a business person. What exactly do you want? She gave the example of some people keep a calendar of all of their appointments...like if he's a musician, he'd have a calendar showing all of his appointments and give us a copy of the bill he sent out for each appointment. Then she listed all of this other stuff she needed. The notes I wrote down from the conversation said she needed his entire ledger for the past three months, copies all of bills sent out, copies of banking statements for all business and personal bank accounts for the past three months, and all expense receipts for the past three months. I specifically told her that the guy I talked to about a month ago when I called for the "interview" told me he'd send me the application (about 20 pages of printout from their system) that I needed to sign and return with profit and loss statements. She told it there were new rules. He's at about an inch of paper and three hours of work so far. Edited September 30, 2011 by joannqn Quote Link to comment Share on other sites More sharing options...
milovany Posted September 30, 2011 Share Posted September 30, 2011 It's for both. I asked if it would be required for just children's medical (thinking I'd just tell them to skip the food stamps), and they said it was required for that too. I'd perhaps suggest talking to someone else then. I just had this conversation with someone less than two months ago. They asked about me sending the types of records you're talking about, then I asked if I could just send my tax return from last year and they said "sure." Just a thought .... but also keep in mind, we're just going into our second year with the cards, so have only done this re-confirmation once. ETA -- I posted while you were posting the above reply. So maybe they have changed just in the last two months. Wild. I don't know if we'll stick with it if they require so very much. Quote Link to comment Share on other sites More sharing options...
Starr Posted September 30, 2011 Share Posted September 30, 2011 Are there rules in writing? Quote Link to comment Share on other sites More sharing options...
joannqn Posted September 30, 2011 Author Share Posted September 30, 2011 These rules are not listed in the Washington Administrative Code that they reference on their website. That requires much less verification. Quote Link to comment Share on other sites More sharing options...
happyhomemaker Posted September 30, 2011 Share Posted September 30, 2011 I would ask to speak to a supervisor about your situation or at the very least ask to be shown in writing why you should give the information they are requesting. It sounds like you have a casework who is overstepping his/her bounds of authority to me. We have had issues with caseworkers making up rules, and I wouldn't be surprised if that is what is happening in your case. Quote Link to comment Share on other sites More sharing options...
joannqn Posted September 30, 2011 Author Share Posted September 30, 2011 My husband is going trying to finish printing up the request information by tomorrow and hand deliver. He'll ask those questions while he's there before he hands it over. He's pretty unhappy about being required to divulge client information. Quote Link to comment Share on other sites More sharing options...
cindergretta Posted September 30, 2011 Share Posted September 30, 2011 They just shifted medical over from DSHS to someone else, effective Oct.1, I believe. I sent my review in to the wrong place because I sent the food stamp and medical review in to DSHS. But DSHS doesn't handle it anymore. And the benefits have changed for medical, too. (It seems like the changes only affect adult medical and we don't get that, so I am not sure.) It used to be that once approved for medical, it was guaranteed for a year, regardless of income changes. I wonder if they have changed that, too. Food stamps, however, can still change from one month to the next, although I was told to report only permanent changes, like a raise, not a one - off OT check or whatever. Dh did get a raise in the exact amount of our food stamps. Yup, we lost our food stamp benefits. So, we aren't any worse off, but we also weren't able to move ahead, either. No wonder people get stuck in the system for so long. They make it impossible to move up and get ahead. Every step forward in personal income equals less benefits, so no opportunity to actually get on your feet. ::sigh:: Sorry about the Hollywood production of a review. It's a good thing you and your dh don't have anything else to do, like work or take care of children. :glare: Quote Link to comment Share on other sites More sharing options...
cindergretta Posted September 30, 2011 Share Posted September 30, 2011 My husband is going trying to finish printing up the request information by tomorrow and hand deliver. He'll ask those questions while he's there before he hands it over. He's pretty unhappy about being required to divulge client information. I'll bet his clients would be thrilled, too. He should (IMO) be allowed to blacken out names and such. But that probably defeats their purpose. :glare: (NO hostility here.... ) Quote Link to comment Share on other sites More sharing options...
joannqn Posted September 30, 2011 Author Share Posted September 30, 2011 You want to know what even more funny? They told me that I could hand deliver the information and then wait 24 hours for them to scan in the documentation (they're going to scan over an inch of paper!) before calling to request they process the application. I'd be calling so we don't experience too much of a lapse of coverage. Quote Link to comment Share on other sites More sharing options...
joannqn Posted September 30, 2011 Author Share Posted September 30, 2011 Well, DH took care of it. Turns out that "Amy" lied, and they didn't need all of that. We still have medical care for the kids. If I recall, we can make up around $7,000 a month and still qualify for state medical (at some point it switched from free to $20 per kid per month). We're at less than half of that. Quote Link to comment Share on other sites More sharing options...
Kertie Posted September 30, 2011 Share Posted September 30, 2011 I realize you may know this and have already decided it won't work, but I'm tossing it out there because I've met a number of people who did NOT know this. We were all without insurance when I was pregnant with #2, and I discovered that both my OB and ds's pediatrician offered a 40% discount if I paid the full amount at the visit. Our copay with insurance had been $30--with no insurance and the discount, it was $40. Most, if not all, places will do this. Obviously, it would get a lot more complicated with, say, an ambulance ride or surgery, but, again, just tossing it out there in case it is at all helpful for you or anyone else. I'm sorry you're having to deal with this--it's just so stressful:(. Quote Link to comment Share on other sites More sharing options...
milovany Posted October 1, 2011 Share Posted October 1, 2011 Well, DH took care of it. Turns out that "Amy" lied, and they didn't need all of that. We still have medical care for the kids. Ugh, how frustrating for you to have done all that only to not have needed it. I'm sorry! (But glad you're good to go again.) Quote Link to comment Share on other sites More sharing options...
joannqn Posted October 1, 2011 Author Share Posted October 1, 2011 All they wanted today was the detailed expense report from Quickbooks and bank statements. They took the latter but didn't even look at them. The ledger, the billings, the receipts weren't necessary. And that was after waiting an hour and a half to talk to someone. Quote Link to comment Share on other sites More sharing options...
Snickerdoodle Posted October 1, 2011 Share Posted October 1, 2011 We were all without insurance when I was pregnant with #2, and I discovered that both my OB and ds's pediatrician offered a 40% discount if I paid the full amount at the visit. I thought it wasn't legal to have different prices for cash patients vs. insurance billed patients. Doesn't that constitute insurance fraud? Or do they use different billing codes for the same procedures? Quote Link to comment Share on other sites More sharing options...
unsinkable Posted October 1, 2011 Share Posted October 1, 2011 Well, DH took care of it. Turns out that "Amy" lied, and they didn't need all of that. We still have medical care for the kids. If I recall, we can make up around $7,000 a month and still qualify for state medical (at some point it switched from free to $20 per kid per month). We're at less than half of that. That's $84,000/ year. :confused: Quote Link to comment Share on other sites More sharing options...
MamaJo Posted October 1, 2011 Share Posted October 1, 2011 Well, DH took care of it. Turns out that "Amy" lied, and they didn't need all of that. We still have medical care for the kids. If I recall, we can make up around $7,000 a month and still qualify for state medical (at some point it switched from free to $20 per kid per month). We're at less than half of that. $7000 a month is a lot! Quote Link to comment Share on other sites More sharing options...
MamaJo Posted October 1, 2011 Share Posted October 1, 2011 That's $84,000/ year. :confused: More than that if it is net. Quote Link to comment Share on other sites More sharing options...
MamaJo Posted October 1, 2011 Share Posted October 1, 2011 I thought it wasn't legal to have different prices for cash patients vs. insurance billed patients. Doesn't that constitute insurance fraud? Or do they use different billing codes for the same procedures? I don't think it is fraud because the same opportunity is available for those with insurance, they just don't take advantage of it. Our insurance requires us to go to the ER if our doctor is closed and we are always offered a discount if we pay the bill within 12 days. Quote Link to comment Share on other sites More sharing options...
m0mmaBuck Posted October 1, 2011 Share Posted October 1, 2011 I thought it wasn't legal to have different prices for cash patients vs. insurance billed patients. Doesn't that constitute insurance fraud? Or do they use different billing codes for the same procedures? I know we are allowed by law to offer a discount to cash patients. By not using insurance, there is less paperwork involved and therefore the procedures cost less (via less work for the billing clerk, less paper, postage, etc). Quote Link to comment Share on other sites More sharing options...
m0mmaBuck Posted October 1, 2011 Share Posted October 1, 2011 JoAnn, $7000/month??? Is that what the business can bill out or what you as a family can bring in? That seems crazy high either way. Quote Link to comment Share on other sites More sharing options...
Liza Lee Posted October 1, 2011 Share Posted October 1, 2011 My husband is going trying to finish printing up the request information by tomorrow and hand deliver. He'll ask those questions while he's there before he hands it over. He's pretty unhappy about being required to divulge client information. I would STRONGLY suggest that he redact the information about his clients. Just take a big fat black marker and strike out things like clients last name and part of the address so that the caseworker cannot know exactly who it is. For example, instead of: John Smith 123 Oak Street Anytown, OK Give the caseworker: John ****** *** Oak Street Anytown, OK Quote Link to comment Share on other sites More sharing options...
unsinkable Posted October 1, 2011 Share Posted October 1, 2011 More than that if it is net. Aww, you're so mathy! :lol: (This is a family joke. We say it to each other all the time when an every day math problem comes up and someone solves it.) Quote Link to comment Share on other sites More sharing options...
Tammyla Posted October 1, 2011 Share Posted October 1, 2011 Wow, $7000 a month. I wonder how many people realize that, and what the amount is here in our neck of the woods. Well, DH took care of it. Turns out that "Amy" lied, and they didn't need all of that. We still have medical care for the kids. If I recall, we can make up around $7,000 a month and still qualify for state medical (at some point it switched from free to $20 per kid per month). We're at less than half of that. Quote Link to comment Share on other sites More sharing options...
kalanamak Posted October 1, 2011 Share Posted October 1, 2011 And that was after waiting an hour and a half to talk to someone. Everyone is in a huge tither because of agencies combining, shifting duties, and RIFs (reduction in force). It is a truism in state government that the more redundant the worker, the more scatterbrains they have in that department: if something isn't getting done, it can't be because the job/pay/expectation is so bad only the lost-at-sea stay there, I mean all employees are on the ball -- right, so it must mean we don't have ENOUGH of them. The solution is hire more. And now that riffing is taking place, the long-tenured dead wood is what is going to be left. The last big RIF we got a secretary of 21 years tenure who COULD NOT TYPE and had never sent an email. I kid you not. That said, all insurance supplement is on the chopping block in the state, and I don't see much hope of a voter-supported tax increase, but I have been surprised before. I know things are serious because I went to a meeting with the rep from my town and the next district over. I've never seen a Dem and a Repub so united in message, ever. It was "tell us what you think we should keep and what we should cut". (The united part is that both of them want us to know they would like to be re-elected, and they aren't going to look like knights in shining armor this year, IMO). Quote Link to comment Share on other sites More sharing options...
mycalling Posted October 1, 2011 Share Posted October 1, 2011 It could be worse, you could have needed 6 months worth like we do.:glare: But it's wonderful the kids can have insurance with us being self-employed. There are no realistic insurance options for the self-employed out here. Quote Link to comment Share on other sites More sharing options...
FairProspects Posted October 1, 2011 Share Posted October 1, 2011 The amounts are gross, not net, and yes they are well into the middle class, but at that income rate you do have to pay a premium per month (but not a high one). The amount you can make increases with family size, so being that there are 6 people in Joann's family, they get a pretty high bar. Quote Link to comment Share on other sites More sharing options...
joannqn Posted October 1, 2011 Author Share Posted October 1, 2011 (edited) The income limits are listed at this link. There are three tiers: Children's Medical is completely free. SCHIP medical $20 has a $20 monthly premium per child but everything is free after that. SCHIP medical $30 has a $30 monthly premium per child but everything is free after that. I have four kids so we can make up to $4922 and get children's medical, $6153 and get the $20 premium medical, and $7383 and get the $30 premium medical. I'm very much aware that those limits are very high. I was shocked when I first found out. I personally think the free medical limit is well over reasonable limits. If we made that much, we'd be able to afford an individual policy and wouldn't need free or low cost medical. In fact, we did pay for our own individual policies when we made around $45,000. It boggles my mind that a $59,000 salary would put our family in the needy category. Getting medical for adults is another story. Those limits are much lower and there is a very long wait list; we've been on it for a couple of years. Edited October 1, 2011 by joannqn Quote Link to comment Share on other sites More sharing options...
mycalling Posted October 2, 2011 Share Posted October 2, 2011 Getting medical for adults is another story. Those limits are much lower and there is a very long wait list; we've been on it for a couple of years.Our limit for a family of 10 was under $900 per month.:001_huh: No, that's not a typo. Our state's children's copay medical income limit for us expecting our 9th is $96,500! :thumbup: At least we will never have to worry about them. Of course, if we made near that much, we wouldn't need the state. Sadly, the state's benefits are much better than any other insurance here. Quote Link to comment Share on other sites More sharing options...
joannqn Posted October 2, 2011 Author Share Posted October 2, 2011 Our limit for a family of 10 was under $900 per month.:001_huh: No, that's not a typo. Our state's children's copay medical income limit for us expecting our 9th is $96,500! :thumbup: At least we will never have to worry about them. Of course, if we made near that much, we wouldn't need the state. Sadly, the state's benefits are much better than any other insurance here. In the state of Washington, you limit would be $144,696. Quote Link to comment Share on other sites More sharing options...
mycalling Posted October 2, 2011 Share Posted October 2, 2011 In the state of Washington, you limit would be $144,696.:svengo:That's insane! Quote Link to comment Share on other sites More sharing options...
snipsnsnailsx5 Posted October 2, 2011 Share Posted October 2, 2011 JoAnn -I see you are in Washington state...have you looked into Basic Health? Dh doesn't get medical through his job, he's a personal health care giver for an elderly man with MS. I am a stay at home mom now so I don't have insurance through a job anymore either. We applied for Basic Health and its $45/month for each of us with a $15 co-pay for office visits. It seems to cover all the basics. I haven't looked into what it covers as far as serious issues or treatments though. Quote Link to comment Share on other sites More sharing options...
cindergretta Posted October 2, 2011 Share Posted October 2, 2011 Are they still enrolling for Basic Health? I know it is on the chopping block and the waiting list is about a mile long. eta- Congrats on the girl!!! Enjoy the pink! Quote Link to comment Share on other sites More sharing options...
joannqn Posted October 3, 2011 Author Share Posted October 3, 2011 JoAnn -I see you are in Washington state...have you looked into Basic Health?. There is a very long waiting list that you can put yourself on by visiting their website. We did that couple of years ago. Quote Link to comment Share on other sites More sharing options...
Mommy22alyns Posted October 3, 2011 Share Posted October 3, 2011 :grouphug: I definitely understand. Quote Link to comment Share on other sites More sharing options...
snipsnsnailsx5 Posted October 3, 2011 Share Posted October 3, 2011 Yikes I didn't know that about the waiting list. We enrolled about 4 yrs ago I think now? Maybe 3 yrs ago....and there was no wait list at all. :( Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You can post now and register later. If you have an account, sign in now to post with your account.