More medical insurance anger. No, let's call it rage

[Joanne]

My children have been covered under the Texas program known as CHIP. My most recent renewal was denied, and the appeal denied. I make too much money.

 

I don't have access to health insurance. Even if I had stayed at my other job that had "benefits", I could not have afforded family coverage.

I can't afford it now. XH is not reliable on child support. He got up to $5k behind, and although he's made a payment (under the thread of imprisonment, he's still behind.) Even WITH that, I can't afford covering a family of 4.

 

My dd has a chronic illness. One of her meds is $1800 per MONTH.

My youngest had a skateboarding accident last night - broke his foot. His coverage ends Saturday. SATURDAY. The ER put a splint on him and told me to follow up with an orthopedist.

 

How am I supposed to do this? For both the acute and ongoing issue?? My only option is ask my xh to apply and see if that gets the kids coverage. He'll find a way to make this my fault and my problem.

 

I promise you, I will never, ever from a position of privilege make assumptions and statements about what other people should do. Medical issues and insurance issues have pretty much ruled and ruined my life over the last 5 years.

 

[Catwoman]

:grouphug:

 

I'm so sorry, Joanne. That is just so unfair. :angry:

[Hunter's Moon]

:grouphug:  :grouphug:  :grouphug:

[mommymilkies]

I'm sorry. :( you would likely be covered here in IL. One of the few good things this state offers. The system in this country is a nightmare.

[Spryte]

:grouphug:  :grouphug:  :grouphug:  :grouphug:

 

I'm so sorry.  That is horrible.  There is something very wrong with our system.  

 

One minor thought, which might help a tiny, tiny bit, when you're ready for it - if your DD's chronic condition requires meds made by Glaxo Smith Kline, they have a program called (I think) Bridges to Access.  Lots of their meds are on it, and it just requires a scrip from her doc for a year of free meds.  It's for uninsured people.  They also have a program for people who are "underinsured" - with high copays for meds.  I have several friends who have used it for a med that usually runs $1200 per month, and it covered it completely.

 

:grouphug:  :grouphug:  :grouphug:  :grouphug:

[Ravin]

That's horrible. Is your income variable? You can appeal and/or reapply. The actual costs you're burdened with should be factored, not just an absolute of income, especially if they're including the spotty child support. if you reapply or are reinstated on appeal, it will usually backdate to outstanding medical bills.

[mamaraby]

I'm sorry you're going through this. It won't help now, but perhaps when the exchanges are up and running things will be a little easier? I know in states where they've been working on it costs are coming out quite a bit cheaper than the hullabaloo elsewhere.

 

Open enrollment on the exchanges starts on October 1st. Since Texas elected not to run their own program (neither did Wisconsin), you'll go to the federal website - https://www.healthcare.gov/what-is-the-health-insurance-marketplace/#state=texas. It'll tell you what you're eligible for under the new law at that point. It's going to function much like enrollment periods for employer based coverage so you have to sign up during open enrollment or you'll have to wait until the following year unless you have a qualifying life event.

 

It sounds like so little, but maybe it will just be a matter of hanging in there.

 

Or moving out of state? Ok, so probably not that last one.

[lil' maids in a row]

I am so sorry.  Healthcare is such a terrible situation for so many people, I hope things change soon.  

[Mrs Mungo]

I'm so sorry. I can't imagine having to do without insurance. I have a child on pricey meds too. 

[T'smom]

I am so sorry. It just really sucks.

[Whereneverever]

 

 

:grouphug: :grouphug: :grouphug:

[Carol in Cal.]

Good gosh.  This is a nightmare.

[Annie Anne]

How far did you appeal?

Can you go to your representative, your governor?

With 2 kids in such conditions go as far as you can with it. Maybe they can find a grant of some kind. Maybe they can come down hard on xh.

I hope someone can do something.

[Murphy101]

Well if it matters, I have state coverage in Oklahoma for my kids. It's useless. I have not been able to use more than ONCE in the last year. Why? The very few drs who take it have ridiculous waits. I called over 10 drs Monday trying to find one that could see him for a plantars wart that had gone deep enough that wearing shoes was painful. We had already been waiting a couple months to make an appointment. Finally it was bad enough that we felt we couldn't wait for it to be covered. Self pay with a dr that does not take state coverage? Got in the next morning.

 

It's ridiculous, but I wouldn't bank on state coverage either. The entire system is crap. And I completely agree it's ruining lives.

 

(((Hugs)))

[LostSurprise]

Is TEFRA available in Texas? 

 

I don't know your daughter's condition or TX regulations but often TEFRA will step in for a disability when you don't qualify for a Medicaid program like CHIP. 

[ElizabethB]

Call the med manufacturer. I know people with expensive meds who get it free from the company, or reduced rates, this is usually through the company directly.

[LeslieAnneLevine]

Joanne have you looked into this?

http://www.dshs.state.tx.us/cshcn/

 

It is a program for children under 21 who need more medical care than the average child. It requires that you apply for CHIP or medicaid (which you have), but I don't think it requires that you qualify for it. I know in my state they have a similar program and it can work with medicaid or without. You might need to have the doctor fax them a medical report (I know that is the case in my state). They have an inquiry phone number listed on their website if you scroll down.

 

 

[StephanieZ]

(((hugs))) If you can make it until Jan 1, hopefully the new ACA exchange plans will be feasible for you. I am so sorry. The health insurance system is insane. I have many people I care about who are counting the days until the ACA plans roll out in order to get coverage. I have my fingers crossed, and my toes, for the ACA plans to be good in our state, and I hope they are good in your state, too. 

 

It is so wrong that families face this. So wrong. I am so sorry!

[StephanieZ]

For the foot, I would be on the phone to every ortho within 100 miles (then going further out) until someone agrees to see him tomorrow. Hopefully you can get it handled/set/casted before the insurance runs out. I am SO SORRY. Beg, plead, and maybe simply show up in someone's waiting room at 8 AM begging.

 

If you have any personal friends who are doctors nearby, call them and beg them to get you in with one of THEIR friend's who is an ortho tomorrow. Personal connections often help.

[StephanieZ]

For the foot, I would be on the phone to every ortho within 100 miles (then going further out) until someone agrees to see him tomorrow. Hopefully you can get it handled/set/casted before the insurance runs out. I am SO SORRY. Beg, plead, and maybe simply show up in someone's waiting room at 8 AM begging.

 

If you have any personal friends who are doctors nearby, call them and beg them to get you in with one of THEIR friend's who is an ortho tomorrow. Personal connections often help.

[Kim in Appalachia]

:grouphug:

 

I hope you are able to find some solution.  Yes, our entire medical insurance system stinks.  It really stinks.   :grouphug:

[fraidycat]

:grouphug: :grouphug: :grouphug:

[creekland]

:grouphug:  I'm not an expert, but I'm with the group that suggests seeing if you can appeal and contact the manufacturer of the med(s)... :grouphug:

[Melissa in Australia]

:grouphug:

[kiwik]

Hope things improve.