Medicaid and financial help

Discussion in 'General Parenting' started by klmno, Jul 3, 2008.

  1. klmno

    klmno Active Member

    I have been researching online and calling every place and it appears that applying for this stuff is going to open a big can of worms. First, there is some clause that keeps popping up on application requirements that says something like I have to "assign my rights to dept. of medical assistance or applicant won't be eligible". What the heck does that mean? What rights do they expect me to sign over?

    Then, I would have to agree to let them establish paternity with "absent parent" (lots of luck on that one) and try to obtain child support from him. Does this mean we have to wait all the years it will take for them to find him and establish paternity? Does this mean that if they do get him into court and require that he pay child support, that he will be given parental rights- (as in visitation and others)? difficult child was not born in this state- in the state where he was born, they told me that even if the parent was not paying court-ordered child support, they would have parental rights. I never pursued it because social services there told me they knew the father and his history and the baby would be better off without him in his life- so I moved here. The lady here told me that I should have already filed for custody and guardianship of difficult child. (I have no idea if she is right or not.) But, geez, I am his bio-mom; his father's name is not even on the birth certificate because in the state I gave birth in, if the father doesn't show up and "claim" paternity, the mother cannot list the father. No one else has ever raised or supported difficult child, so why do I need to file for custody? This lady here, though, says that if I establish custody and guardianship, that even if the state goes after him, they will not give him (the father)parental rights. I'm not so sure I believe that.

    Not only do I want to avoid that can of worms like the plague, but you know this means I would have to discuss all of this with the GAL and get her approval or else she is going to stir up more with social services, custody, judge and everybody. I don't see how I can go through all this and them not find out that difficult child has a gal and then they will contact her.

    Does anyone have any experience with even a portion of this? Can anyone offer any insight or suggestions? I can't afford another attorney to ask.
     
  2. mom_in_training

    mom_in_training New Member

    Hmmm, I do not recall anything popping up about " assign my rights to dept" when I did applications for my son but I have only applied for Ins not financial and I am in Ca. I think the rules are pretty much the same regardless of what state you live in with the exception of a few things as well as the amount granted being varied. As far as your difficult children father and having rights. Well they do regardless if they pay child support or not unfortunately but you might want to look into the abandonment laws since he has had to contact and that alone very well could eliminate his parental rights period. My difficult children father falls under that catagory (Abandonment) I never went to court for guardianship for either of my kiddos (They are both adults now) The county purued him for child support but never caught up with him or when they did they would leave a calling card (Idiots) and he would just run again knowing that they were onto him. He never paid a penny in child support ever. What a loser of a man (Better yet a boy!!) A man would never abandon his children like he did.
     
  3. klmno

    klmno Active Member

    Thanks, MIT. It sounds like the same type of "father" in this situation. I found out while I was pregnant that he was in trouble legally for not paying support for his daughter. who was about 13yo at that time.

    I can't quite figure out what the "sign over rights" clause is referring to- if it just means that I would sign over rights to any additional payment for service I might receive, that is one thing. If it means that I would be signing over rights to decisions regarding difficult child's health care, that's another.

    The more I look though, it seems like I would make too much to get this help (insurance). Which is a catch-22. If I don't get it, I am paying almost $1000 a mo. in cost for our private insurance through my employer. So, I'm not netting enough to pay 2 bills, much less the house payment, co-pays, groceries, etc. They have an exammple on their website. It is based on a family of 3 paying $350/mo for insurance cost. Who are they kidding? We're talking about a difficult child who has been in a psychiatric hospital. But- insurance for me alone would probably cost more than $350/mo.

    Yet, if they remove him from my home and place him in another home- that other home would get all kinds of assistance.
     
  4. mom_in_training

    mom_in_training New Member

    I know you cannot win when it comes to the eligibility requirements. I recently discovered exactly why many disabled and elderly adults go without their medications etc... The maintenance fee that Social Security allows for an individual is only a whopping $600.00. Its like hellooooooo it surely takes more then that for an individual to survive. But this would be the amount + $20.00 this ($620.00) they will deduct from a persons income and if they still are over the the qualifying $ amount allowed then the difference would be their share of cost otherwise known as a spendown.. My son did not qualify for SS or Medi-caid and has a share of cost of $1100.00 per month. Big Yikes!!!!!!

    Are you applying for Medi-Cal or SSI for your difficult child? If so just FYI they use the SS $ criteria for eligibility. You might be able to qualify with a share of cost.
     
  5. klmno

    klmno Active Member

    Well, I was looking into Medicaid (primarily for difficult child) or the state insurance assistance. One of the state insurance assistance programs has the cut off that is below (although not a lot below) what I earn (on average) since I haven't been working full time due to his appointment requirements. This program is supposed to be easier to get than Medicaid, so if he wouldn't qualify for it, he wouldn't qualify for medicaid, in theory. There is another state ins. assistance that gives $100/mo per child to a family to help them pay for medical insurance. But that would not be anywhere close to solving the problem either. (Our insurance alone cost $950/mo) not including a separate insurance for basic dental. The insurance I'm paying for now is an HMO- nothing extravagant, and I still pay co-pays for dr's and medications. I would be better off to work a little less to make sure I fall below that line (I get paid by the hour now)- if they won't check with my employer to see how many hours he would let me work. Will they do that?

    difficult child might qualify as disabled- someone from a state agency insinuated that because he has been in a psychiatric hospital (short, acute stay though) and will have spent 6 weeks in juvy this year. She said that qualified him for disabled status because he has been "institutionalized". I'm not sure I buy that, but I don't know. And if I got that status for him, what does it take to get the label off if the difficult child does improve and things get better after a few years?

    I thought about the abandonment idea- I'm not sure that can work if legally, paternity was never established. (The man knows- he just won't acknowledge any of it and refused my offer to prove it to him and when I called him to tell him that his son had asked to speak to him, when difficult child was about 6yo, he told me it wasn't his problem, that I was the one that wanted the baby)
     
  6. klmno

    klmno Active Member

    Here are the exact words:

    [QUOTEI understand that to receive benefits from the Medicaid/FAMIS PLUS/FAMIS programs, I must agree to assign my rights and the rights of anyone for whom I am applying to medical support and other third-party payments to the Department of Medical Assistance Services. If I do not agree to assign my rights, I will be ineligible for Medicaid.][/QUOTE]

    Could someone put that in layman's terms for me?
     
  7. Wiped Out

    Wiped Out Well-Known Member Staff Member

    Klmno,
    When we applied for medicaid for difficult child we did it through the Katie Beckett program. Someone on this site recommended it to me. husband and I both have jobs and good insurance. difficult child still qualified because all they do is look at the income (if any) of the child. Have you tried it through Katie Beckett yet?
     
  8. klmno

    klmno Active Member

    No, I haven't tried that, Sharon. You mentioned that before, I think, and I must have assumed it was a state assistance. I will look it up on line now. Thanks!!
     
  9. klmno

    klmno Active Member

    Ok- what did you have to do and how much info had to be released to get difficult child qualified as disabled?

    And what agency did you apply through?
     
  10. Wiped Out

    Wiped Out Well-Known Member Staff Member

    The information was all about difficult child. What his income was, what his disabilities are. What doctors he sees, their addresses and phone numbers. School info-ie does he have an IEP?

    We just googled Katie Beckett and then, if I remember correctly, there was a map and we checked where we were and it came up. It's a national law but maybe each state handles it a bit differently?

    The first time through we had to go through an interview with a representative from Katie Beckett. Each year you have to reapply so keep copies of everything you fill out. We didn't the first time. Also every other year you have another interview. The people were very friendly.
     
  11. klmno

    klmno Active Member

    Yes, he has an IEP. It is for ED, although I have ofetn wondered if it shouldn't be OHI. Anyway, he isn't diagnosis'd with anything the school district considers a real learning disability. Even though his diagnosis is BiPolar (BP) (or at least, it is common consensus that we have to treat it as BiPolar (BP) right now- it might have been prozac induced mood cycling)- I have found that a whole lot of people seem to think this is just a name for a kid with depression and conduct disorder. So, I fight a lot of battles over that.
     
  12. witzend

    witzend Well-Known Member

    THey won't deny you services until sperm-donor pays, but they will hound him to the grave.

    I think that as far as "assigning rights", they mean that if you are suing someone for payment of damages which caused the medical problems, you and difficult child are assigning the right to recover to the state.
     
  13. klmno

    klmno Active Member

    Thanks, Witz! They can hound donor all he wants. They can get his blood and prove everything (there was NO CHANCE it could have been anyone else- unless mothers have started carrying babies over a year). But, I'll be damned if a guy who can't acknowledge his baby, support his baby, or otherwise even show the slightest concern over how the child is doing, much less step up to see if it is his or support him, is going to pop up at my house thinking he has equal rights. And, at this point, difficult child would like to do a little talking to him too. But, then difficult child has been crushed over all this and truly believes that it is because "he is a bad kid". That was really a part of what triggered all this to begin with, along with a couple of other hard things to swallow that were going on at the same time.

    I don't have any problem making sure that I am not getting paid for medication issues by someone else if they are covering the cost.
     
  14. DammitJanet

    DammitJanet Well-Known Member Staff Member

    I will explain this whole thing in detail in just a few. Im ebaying. LOL. Wait till I see if I can snipe a bid out from under someone!
     
  15. DammitJanet

    DammitJanet Well-Known Member Staff Member

    Ok...let me see if I can explain medicaid. I dont know if VA has Katie Beckett or Waivers for the disabled. I have never been able to find them in NC.

    There are normally several types of Medicaid for kids which is basically federally funded but the income limits differ in each state because of the poverty levels in each state. You have a federal poverty level and the state poverty level. At your sons age he would qualify basically for Medicaid for Children. I could peruse your states website and pull up the income guidelines but basically what they do is take your income, deduct certain income deductions for working and come up with a "net income". That net income has little to do with what your actual net income really is. You also have to meet what is known as reserve limits such as bank accounts and property limits.

    Now the states also have another childrens insurance program which is known by each state as a different name. Down here it is Health Choice. It is for kids whose parents make too much for Medicaid but cant afford insurance through work or whose jobs dont offer insurance. These kids cannot have been carried on insurance either for 6 months I believe. The income limits are much higher than for medicaid and depending on the parents income and number of people in the home, the monthly payment...or co-annual payment is very low. My older two kids were on this when I worked at Social Services because it would have cost me 250 a month to add them on to a family plan and I only brought home about 1500 a month as it was. I think I paid 60 every 6 months for them to be on Health Choice. Now granted I had 4 people in my family whose income they counted.

    Ok...for Medicaid they will go after the absent parent and try to get paternity established if it isnt already established. They will also attempt to force child support and court order insurance to be established on the child and tell the father that he is responsible for half of all unreinbursed medical expenses. His tax returns can be garnished. They can also suspend any licenses he has. drivers, hunting, fishing, etc.

    Now for disability...it is a bit different. The income limits are a bit higher but the still take your income into account. It is true that his recent problems will all be taken into account and he will probably meet the criteria. I would definitely apply. If he gets approved for even 1 dollar in disability he automatically gets medicaid. When I worked at DSS, Cory was on SSI and he got next to nothing in money from SSI but that medicaid was invaluable in providing the funding for all his placements and workers and therapy. Most places dont take private insurance anymore. It simply wont pay for any long term help but medicaid does. I think I got like 50 bucks a month in disability but that medicaid saved his skin. And at one point for quite some time, I only had one other kid living with me. Billy went to stay with my mom so only Jamie was living with me. They considered our rent, electric, car payment, etc in figuring the payment plus expenses for the other child.
     
  16. klmno

    klmno Active Member

    Thanks, Janet! That is VERY helpful. Now, disability questions- do I apply with social security first? How long is the process? Are there potential problems with this down the road (obtaining a job, applying to a college, etc) if the disability is a mental health issue? If he ever gets this under control to maintain it and be more functional in society, can he get off the diability? If he gets the disability and then automatically gets medicaid, are they still going to pursue the father? Will I still have the decision making in difficult child's health care - what he gets and who he gets it from?
     
  17. Sara PA

    Sara PA New Member

    We chose not to pursue the disability route with our son because of the possible long term consequences combined with the very firm belief that my son's biggest problems were caused by the medications and that he would mature out of the lesser problems. When we were considering it, he happened to discover that he would not be permitted to emmigrate to Canada if he had been labeled "disabled". That made us think about the job applications that ask if you ever collected disability. I don't know what doors it might close in reality but we chose not to do it. But then, we had resources and didn't absolutely need the help.
     
  18. klmno

    klmno Active Member

    Sara- are you saying he would never be able to live outside of this country? And even if the disability status changed, it could effect his ability to get a good job at some point?

    GEEZ-
     
  19. Sara PA

    Sara PA New Member

    It was a while back so I may be foggy on the details but as I recall Canada doesn't normally accept people for residency who have been disabled. I think that's pretty standard for most countries though exceptions can be made. He was hellbent on leaving the US at the time and was researching it. This is about immigration, not visiting.

    And I don't know about how prospective employers might use the information. There is the Americans With Disability Act to consider. It is designed to prevent discrimination but reality isn't always what it should be, as we all know.

    When push comes to shove, you have to make a decision based on what is best for your situation. I think you are wise to question all aspects
     
  20. DammitJanet

    DammitJanet Well-Known Member Staff Member

    Well...my take on this is that I would base my decisions on what is best now not on what may happen some day down the road. Who knows...we may not even be here anymore!

    Yes you can get off disability if you get better. I am on it and I know plenty of people who have attempted to get off it. Cory has been on it since he was 5 and has tried to work several times but has failed at his work attempts so they havent pulled it. He keeps trying though. Maybe one day he will make it past the trial period.

    I have no idea if disability stops you from immigrating to another country but that has never been a plan of mine.
     
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