kicked off medicaid

Discussion in 'General Parenting' started by bon-in-ga, Nov 6, 2004.

  1. bon-in-ga

    bon-in-ga New Member

    This is also in General
    I got a wonderful letter yesterday that my kids are cut off Medicaid. WHY? Well supposedly we make to much now and need to go on medicaid spenddown. We have to have $1869.00 medication bills to become eligible again. Or something like that. I don't even understand the terminology. I called the caseworker who told me to just apply for Peachcare (our state childrens insurance thing)
    Well what do I do til then? There is no insurance at husband's job. I just started getting difficult child the help he needs. We have appts set up thru January. Our bills are $300 less than our income. difficult child's medications alone are $232.00.
    I want to cry so bad. I can't have difficult child not getting treatment. The other two, I can scrape dimes together if they get sick or what not. But not difficult child I can't afford his treatment.
    I am soo sad. I think I may have a breakdown over this. I know the last time I tried for Peachcare we were not eligible, they also told me kids have to be uninsured for 6mths prior to becoming eligible. So if we are able to get it, I just have to let difficult child be outta control til May??
    I am flippin my lid, please tell me what to do.
  2. OTE

    OTE Guest

    I'm referring to medicaid and peach care interchangeably here as both are in essence medicaid.

    Call the worker again and ask if they make it retro. When my kids went on there was a retro period- I could submit bills to be paid that were up to 3 mo before approval date. Also ask if the 6 mo uninsured period applies to kids coming off medicaid- I suspect not. I think this is a rule related to COBRA, not meant for kids coming off Medicaid.

    If the medications won't be covered go to and see if the medications are on pharma co reimb program. Get the apps and rules for each medication on needymeds. Print out the apps and have the psychiatrist sign them and get them in ASAP. Sometimes the psychiatrist office has to do the work in terms of the apps and it can take weeks to get approved and get the medications. So do it ASAP so you have the medications on hand when you need them. There may be some kind of co-pay with some of the medications but it's better than the full bill. And if you make the co-pay and medicaid will pay it later you can submit the co-pay to medicaid later.

    Failing all this you call your church or other local charities and ask them to help with medical costs. there's a LOT of charities that will help with kid's medical costs. They'll each have rules, some may want you to get the medications from the pharmacy they work with and/or pay the doctro directly. But you will find help. If the idea of charity is offensive just pay them back when you can- consider it a loan. Most doctors, since you're an existing patient, will work with you in terms of payment schedules. You can also ask the doctors if they work with some other clinic and could see you in another setting that has a sliding scale fee schedule until you get back on medication insur.

    Take some deep breaths, this is do-able.
  3. terrip33

    terrip33 New Member

    I totally understand. I just found out that my kids will be dropped unless I can come up with 220.00 a month. I was paying 15.00 a month. My 9 yr. old daughter has adhd and possible bi polar disorder. I dont know where to turn? If anyone knows what I can do to help her, please let me know. She currently takes strattera, ritalin and seraquil. all together they equal up to 300.00 a month. plus, counciling and doctors. appointment. help me... I live in florida...
  4. Huntersmom

    Huntersmom New Member

    born in ga-
    Peachcare will kick in soon as you apply, I forgot what the dollar amt is, you pay under $20 per child and it covers same as peachcare. What are difficult child's diagnosis?? adhd/odd? Go down to ssi office and apply, Possible will get medicaid until 18, possibilty of check as well, based on income, they said I MAY get $50 so what. MEDICAID is what I am after. also here in Ga if you don't have ins, they have indigent care fund, if an emergency arises have to go to ER apply for this, they'll just write the bill off. If you have to get over certain $ amt in medicail bills this would be quite easy for me, counslors, speech therapy, psychiatric doctor apts. Do application for peachcare (same as medicaid) ASAP!!!! so there isn't a lapse!! If you can't get medicaid, it's well worth the money!!!
  5. Huntersmom

    Huntersmom New Member

  6. transformtriumph

    transformtriumph New Member

    It definitely should be helpful that he is the stepfather and not bio. Make sure to emphasize that point. Also ask your child's docs if they can wait for payment. Many will wait, especially if they understand the situation.