Joanne Posted August 29, 2013 Share Posted August 29, 2013 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. Quote Link to comment Share on other sites More sharing options...
Catwoman Posted August 29, 2013 Share Posted August 29, 2013 :grouphug: I'm so sorry, Joanne. That is just so unfair. :angry: Quote Link to comment Share on other sites More sharing options...
Hunter's Moon Posted August 29, 2013 Share Posted August 29, 2013 :grouphug: :grouphug: :grouphug: Quote Link to comment Share on other sites More sharing options...
mommymilkies Posted August 29, 2013 Share Posted August 29, 2013 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. Quote Link to comment Share on other sites More sharing options...
Spryte Posted August 29, 2013 Share Posted August 29, 2013 :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: Quote Link to comment Share on other sites More sharing options...
Ravin Posted August 29, 2013 Share Posted August 29, 2013 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. Quote Link to comment Share on other sites More sharing options...
mamaraby Posted August 29, 2013 Share Posted August 29, 2013 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. Quote Link to comment Share on other sites More sharing options...
lil' maids in a row Posted August 29, 2013 Share Posted August 29, 2013 I am so sorry. Healthcare is such a terrible situation for so many people, I hope things change soon. Quote Link to comment Share on other sites More sharing options...
Mrs Mungo Posted August 29, 2013 Share Posted August 29, 2013 I'm so sorry. I can't imagine having to do without insurance. I have a child on pricey meds too. Quote Link to comment Share on other sites More sharing options...
T'smom Posted August 29, 2013 Share Posted August 29, 2013 I am so sorry. It just really sucks. Quote Link to comment Share on other sites More sharing options...
Whereneverever Posted August 29, 2013 Share Posted August 29, 2013 :grouphug: :grouphug: :grouphug: Quote Link to comment Share on other sites More sharing options...
Carol in Cal. Posted August 29, 2013 Share Posted August 29, 2013 Good gosh. This is a nightmare. Quote Link to comment Share on other sites More sharing options...
Annie Anne Posted August 29, 2013 Share Posted August 29, 2013 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. Quote Link to comment Share on other sites More sharing options...
Murphy101 Posted August 29, 2013 Share Posted August 29, 2013 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))) Quote Link to comment Share on other sites More sharing options...
LostSurprise Posted August 29, 2013 Share Posted August 29, 2013 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. Quote Link to comment Share on other sites More sharing options...
ElizabethB Posted August 29, 2013 Share Posted August 29, 2013 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. Quote Link to comment Share on other sites More sharing options...
LeslieAnneLevine Posted August 29, 2013 Share Posted August 29, 2013 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. Quote Link to comment Share on other sites More sharing options...
StephanieZ Posted August 29, 2013 Share Posted August 29, 2013 (((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! Quote Link to comment Share on other sites More sharing options...
StephanieZ Posted August 29, 2013 Share Posted August 29, 2013 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. Quote Link to comment Share on other sites More sharing options...
StephanieZ Posted August 29, 2013 Share Posted August 29, 2013 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. Quote Link to comment Share on other sites More sharing options...
Kim in Appalachia Posted August 29, 2013 Share Posted August 29, 2013 :grouphug: I hope you are able to find some solution. Yes, our entire medical insurance system stinks. It really stinks. :grouphug: Quote Link to comment Share on other sites More sharing options...
fraidycat Posted August 29, 2013 Share Posted August 29, 2013 :grouphug: :grouphug: :grouphug: Quote Link to comment Share on other sites More sharing options...
creekland Posted August 30, 2013 Share Posted August 30, 2013 :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: Quote Link to comment Share on other sites More sharing options...
Melissa in Australia Posted August 30, 2013 Share Posted August 30, 2013 :grouphug: Quote Link to comment Share on other sites More sharing options...
kiwik Posted August 30, 2013 Share Posted August 30, 2013 Hope things improve. Quote Link to comment Share on other sites More sharing options...
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