What to do, what to do????

Discussion in 'General Parenting' started by tpcmom, Apr 12, 2005.

  1. tpcmom

    tpcmom New Member

    Of course I have to much going on in my life to keep all these things straight in my head.

    My son was hit by a car, he is 19 and just released from my health insurance 2 weeks prior the accident.

    They are fighting saying he caused the accident, jumped in front of the car between 2 parked cars so I do have a lawyer, but don't see much coming out of this, it's his word against the driver and so on and so on.

    Now, I can get the surgery covered by the state somehow. (not sure how it works) but the surgeon's office gave me a name and number of a social worker (i think) at the hospital and she told me I had to set the date up and they could start the paperwork for this and have the state pay.

    now my other problem, he is going to need physical therapy for his knee. My car insurance pretty much has been exhausted (It was nearly $10,000 just for the emergency room) so he needs to file for medical assistance. I don't know how that will work since he still lives with me and I'm sure they'll go by my income, but anyway, there is a waiting list for the "adult basic" medical insurance. I wrote them and asked how long is this waiting list, I don't want him to have surgery without the physcial therapy.

    My cobra was way to much money, it is about $380 per month and he would need at least 4 months (starting from March) to about June to cover everying. So that's what about $1,500. that I DON'T have!!!!

    So now I don't know what to do? Should I hold off the surgery until I find out he is approved for the medical assistanc? What if he isn't approved? Should I try and do the Cobra, I really don't have this kind of money, really that's alot of money for me.

    I'm stuck here and don't know which way to go.

    Anyboyd got some good sound advice for me?????
  2. bigblueagain

    bigblueagain New Member

    well there are several things going on here.
    First of all, for state assistance your income should not be factored in......since he is 19 they normally do not factor in your income as he is considered an adult. I definitely would go ahead and apply. Is he employed by anyone that would have him with some qualifying income?
    Second, is he a full time student? I am assuming he is not since you said he was released from your coverage. Employers are only obligated to provide coverage under a family plan when the student is over 18 if they are full time students, and you have to provide the insurer with a letter from the registrar of the school to prove that.
    Thirdly, the COBRA would most likely have the same conditions as #2. Also you usually only have 60 days from the end of regular coverage to declare intent to continue on the COBRA, then you have just a certain time after that to pay. As to the amount, it does seem fairly reasonable though. Most COBRA coverage is for the full amount of the family plan without employer contribution. I know of some folks whose COBRA ran $600-800/mo. So even though it seems high, if there is anyway you qualify it might be worth it.
    As to the physical therapy, yes your son will most likely do better with it. I am assuming there is an orthopedic problem? Again if your son qualifies for the state aid, it will probably cover this too.
    Hope you can get that state coverage. I would start the process right now.
  3. tpcmom

    tpcmom New Member

    Thank you for your answers.

    I have elected to get the Cobra benefit for him, I had just 2 days left to elect it!!!

    I kept praying for guidance and I really feel that this was answered with just 2 days left to deciden. His bio dad said he would help, keep fingers crossed on that he has been known to back out of stuff.

    So I feel at least 4 months coverage should do this, it is expensive, but I don't think there are any alternatives. I'm still going to put him on the waiting list for the state insurance. At least he'll have something later down the road.

    why don't kids realize how important it is to make sure you get a good education, find a decent job that has good benefits! They don't understand how important this stuff is.
  4. OTE

    OTE Active Member

    FYI: in most states the hospitals have what they may call "charity care" or "financial assistance". Your son would have to apply himself just as he has to apply for state medicaid. But the hospital (including the phsyical therapy dept at the hospital) would add up all their bills, just keeping a running tab. There would be a financial aid (or whatever they call it in your state) office in each hospital which may or may not be part of the billing dept. This office after they approve his application based on his income and assets would reduce the bill to the amount they deem he has to repay. And you could then pay that for him. Obviously as you've now gone ahead with the COBRA the situation is different. But financial aid would also apply to the deductibles and co-pays. So it's still worth asking the hospital SW about for him.

    Yes, PA hospitals do it. Here's something I found on the rules for hospitals in PA re charity care: