state provided health insurance

[CalicoKat]

We have COBRA for our old health insurance available for another year. But because of the high monthly payments we're looking at state provided health insurance for the family. It was suggested to me yesterday at an appointment.

 

Do they provide for pre-existing conditions? And medications?

 

DH filled out the application to see if we'd even qualify and we do. We'd also get some grocery money which would be nice.

 

Hmmm, this is a long step from where we were last year.

[Ottakee]

I am sure it varies by state and exactly what program you qualify for but my kids have state insurance. They all have Medicaid but Michigan also offers Mi Child which has a very small fee (like $5/month) and might have some tiny co-pays. So far for us, the state insurance pays better than what our private insurance did--with less hoops to jump through.

 

My son (23 and disabled--mentally impaired) gets a small amount (was $80/month) on a food card but that does help as well as his disability check is quite small.

[NotSoObvious]

Are you talking about Medicaid?

 

If so, my girls are on it (straight Medicaid, not connected to an HMO) because they are adopted through foster care. They were on it in Utah, and now in Virginia, so I feel like I have a pretty good idea of coverage.

 

They have covered almost everything except my daughter's speech at one point. Apparently she wasn't "bad enough" even though you can't understand her! I could have fought it, but we managed another way.

 

They covered vision therapy, too.

 

They cover everything from the pediatrician, medications (eve things our primary insurance won't pay for), etc. You just have to make sure you go to providers who accept Medicaid. That's where it can get tricky. My girls are on our insurance, with Medicaid as a secondary. I've found that we have way more options this way. You may have to take what you can get. It's usually ok for medical things, but for dental, you'll *probably* not have the best choices. It may be worth trying to pay out of pocket for dental so you can have better dentists---this is MY experience, and I am very picky about dentists.

Medicaid also covers vision. It covers appointments and glasses every two years. However, it only covers really cheap frames and it won't cover the polycarbonate lenses, which are important to me. So, we pay out of pocket for glasses.

Let's see, it also paid for their regular therapy (out patient mental health), it covered my daughter's sleep study, and we didn't pay a thing to have her tonsils removed. Mind you, we also have a primary insurance and we've been told that if you have primary insurance and use Medicaid as a secondary, they usually pick up whatever the primary doesn't cover. This has been our experience.

 

It's been easy for us, but it's something my girls will always have until they are 18, so I never really think about it.

 

We are super grateful for Medicaid because sometimes, it's been the only way we could pay for certain things that might have otherwise not happened, like vision therapy. On the same token, we've also had to weigh the quality of services we can access through Medicaid against the benefit of just paying out of pocket.

 

I hope that helps! I've found the key to Medicaid is that is a doctor insists that it is medically necessary, they are pretty sure to pay for it.

[shinyhappypeople]

Yes, they cover pre-existing conditions. It's been a God-send for us. We pay $8/mo total for our 2 kids. If not for Healthy Families (the program here in CA), our girls would be uninsured (coverage from DH's job is VERY expensive). Anyway, I'm very grateful for it and think you should go for it. The dental coverage is so-so, vision is good, health coverage is excellent so far.

[shinyhappypeople]

It's usually ok for medical things, but for dental, you'll *probably* not have the best choices.

 

 

:iagree: This has been our experience as well. Very few dentists accept the plan. We were lucky enough to find a new primary dentist on the plan that's good, but finding a specialist? Ugh. We had to drive over an hour away to find an oral surgeon, even though there are half a dozen within 5 miles of my house. That kind of stunk (a lot), mostly because gas is so expensive and we had to do multiple appts (I think I paid $50 in gas or close to it). But, other than that, I have no real complaints about the program.

[dancer67]

Depends on the state. We have state insurance because my DH is self employed and we meet the income guideline. It is free for us. But, it sure is a pain in the arse dealing with them.

 

They do cover pre-existing conditions. We have no co-pays, and it is 1.00 for scripts, or even OTC drugs.

 

It has been a blessing to us. I used to feel guilty about it, but my husband works. We pay into the system.

 

You should call and inquire about it. Doesn't hurt.

[CalicoKat]

Are you talking about Medicaid?

 

If so, my girls are on it (straight Medicaid, not connected to an HMO) because they are adopted through foster care. They were on it in Utah, and now in Virginia, so I feel like I have a pretty good idea of coverage.

 

They have covered almost everything except my daughter's speech at one point. Apparently she wasn't "bad enough" even though you can't understand her! I could have fought it, but we managed another way.

 

They covered vision therapy, too.

 

They cover everything from the pediatrician, medications (eve things our primary insurance won't pay for), etc. You just have to make sure you go to providers who accept Medicaid. That's where it can get tricky. My girls are on our insurance, with Medicaid as a secondary. I've found that we have way more options this way. You may have to take what you can get. It's usually ok for medical things, but for dental, you'll *probably* not have the best choices. It may be worth trying to pay out of pocket for dental so you can have better dentists---this is MY experience, and I am very picky about dentists.

Medicaid also covers vision. It covers appointments and glasses every two years. However, it only covers really cheap frames and it won't cover the polycarbonate lenses, which are important to me. So, we pay out of pocket for glasses.

Let's see, it also paid for their regular therapy (out patient mental health), it covered my daughter's sleep study, and we didn't pay a thing to have her tonsils removed. Mind you, we also have a primary insurance and we've been told that if you have primary insurance and use Medicaid as a secondary, they usually pick up whatever the primary doesn't cover. This has been our experience.

 

It's been easy for us, but it's something my girls will always have until they are 18, so I never really think about it.

 

We are super grateful for Medicaid because sometimes, it's been the only way we could pay for certain things that might have otherwise not happened, like vision therapy. On the same token, we've also had to weigh the quality of services we can access through Medicaid against the benefit of just paying out of pocket.

 

I hope that helps! I've found the key to Medicaid is that is a doctor insists that it is medically necessary, they are pretty sure to pay for it.

Two of my children have Medicaid cards through DCFS too. It's always been secondary to our primary for them. Now it's the rest of us that need something.

[CalicoKat]

:iagree: This has been our experience as well. Very few dentists accept the plan. We were lucky enough to find a new primary dentist on the plan that's good, but finding a specialist? Ugh. We had to drive over an hour away to find an oral surgeon, even though there are half a dozen within 5 miles of my house. That kind of stunk (a lot), mostly because gas is so expensive and we had to do multiple appts (I think I paid $50 in gas or close to it). But, other than that, I have no real complaints about the program.

hmmm, I wonder if we can keep COBRA for the dentist portion.

 

Totally understand how difficult it is to find a doctor to take the insurance once you have it. When my babies were still foster children that was frustrating.

[ThisIsTheDay]

We have COBRA for our old health insurance available for another year. But because of the high monthly payments we're looking at state provided health insurance for the family. It was suggested to me yesterday at an appointment.

 

Do they provide for pre-existing conditions? And medications?

 

DH filled out the application to see if we'd even qualify and we do. We'd also get some grocery money which would be nice.

 

Hmmm, this is a long step from where we were last year.

 

I think some of the answers may vary, depending on your state. We considered this option a few years ago.

 

The cons, for us: My kids had to go without insurance for three months before they would be eligible for state insurance. Our monthly income was so very close to the cut off that I knew any variation might drop us instantly from the program, and then we'd be stuck.

 

In the end, my dh kept COBRA for himself only. He has an extenuating medical condition that made sense to continue his coverage, for both dr. appts and prescriptions (well over $1500/mo.). My kids and I dropped from the existing insurance under COBRA and chose a higher deductible, lower premium plan from Blue Cross/Blue Shield. We've been on that for five years, and have been blessed with no major medical expenses.

[CalicoKat]

I think some of the answers may vary, depending on your state. We considered this option a few years ago.

 

The cons, for us: My kids had to go without insurance for three months before they would be eligible for state insurance. Our monthly income was so very close to the cut off that I knew any variation might drop us instantly from the program, and then we'd be stuck.

 

In the end, my dh kept COBRA for himself only. He has an extenuating medical condition that made sense to continue his coverage, for both dr. appts and prescriptions (well over $1500/mo.). My kids and I dropped from the existing insurance under COBRA and chose a higher deductible, lower premium plan from Blue Cross/Blue Shield. We've been on that for five years, and have been blessed with no major medical expenses.

We're too close to the cuttoff too and the rep. recommended we stay on the COBRA. :( .

 

BUT the rep. is local and after listening to DH he mentioned that his dad is the local HR at the company DH's been trying to get a job. DH sent him his resume (again). If nothing else dh's got another contact to demonstrate that he's looking for jobs when he goes to qualify for unemployment.

[mytwomonkeys]

my husband & i don't qualify, but my kids qualify for "healthy kids" insurance. we live in FL and it cost $20 a month for both children & it is a blessing for sure. the co-pay is very little as well. my husband and i have catastrophic insurance, which basically will cover us if something big occurs. we got it through ehealthsurance.com. the deductible is too high to use it for day-to-day issues, such as colds, etc. but it will be invaluable should one of us have bigger health issues.

Edited December 23, 2011 by mytwomonkeys

[CalicoKat]

my husband & i don't qualify, but my kids qualify for "healthy kids" insurance. we live in FL and it cost $20 a month for both children & it is a blessing for sure. the co-pay is very little as well. my husband and i have catastrophic insurance, which basically will cover us if something big occurs. we got it through ehealthsurance.com. the deductible is too high to use it for day-to-day issues, such as colds, etc. but it will be invaluable should one of us have bigger health issues.

 

Thanks! I'll ask DH to see if we can get the kids on it. That would bring down our COBRA monthly payment.

[butterflymommy]

My state has a subsidized program for children. There is a sliding scale fee, we pay at the top of the scale which is still really affordable ($90/ month). When we had less income I think it was only $15/ month. It is excellent coverage and through an HMO so we have a good selection of drs. There is dental and eyeglass coverage as well.

 

My husband and I are covered through another subsidized program but it is only slightly cheaper than private insurance-- about $8000 a year. The coverage is ok but not great. No prescriptions and high copays.

 

Pre existing condition laws vary state by state-- eventually no insurance company will be able to deny pre existing conditions under the Obama legislation (unless it's revoked).

[jennsmile]

We use AltruaHealth Share for our family (kids & I.) DH uses school insurance but is close to $1000 a month and we aren't that sick so we found Altrua Healthshare. It is $205 for me and the boys. They cover the big stuff and if I paid more I could get so many dr appts a year. I love that they cover my maternity with my midwife. If you want more info feel free to pm me.