Health Insurance Issues

Iridescent - posted on 03/03/2010 ( 4 moms have responded )

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Cassie is on SSI. She is also on MA and is supposed to have continuous coverage. I got a notice on 2/26 that her insurance would be ending 2/28. 2 days notice? Seriously? So I called immediately and spoke with her worker. She said it was sent in error and corrected. Ok. So I go to fill supplies yesterday, and can't get them because she has no insurance, which also means she dropped off her waiver! I called the social worker in charge of her medical, and could only get her voice mail, which hadn't been updated since 2/26. I left a message. I called again and requested to speak with her supervisor. They transferred me to another worker, and again I got a voice mail which was not updated. I hung up and called her waiver manager.



The waiver manager called the REAL supervisor (I had just been transferred to another worker of the same level before, despite my request!), and got yet another voice mail. So she went up yet another level and called that manager. More voice mail! She took Cassie's case and physically went to the office of another worker and looked it up to see what the problem was. Cassie's insurance was NOT due for review (it's due in May) and she was to have continuous coverage. There was no reason given as to why she was dropped, and NO changes had been made to keep it going, despite what the initial worker had stated. The 3rd supervisor finally got the message at the end of the day yesterday and called the first worker at home and told her to get her ass back in the office and FIX THIS because without supplies I have no way to care for Cassie, and she'd have to be dropped off at a hospital until her insurance is active again. The supplies cost $4000, and her daily care costs $1,100 every day at home. I can not afford it. Her initial worker called us at 7:20pm to notify me her case had been fixed and it will never happen again.



Now on to the other issues. I applied for MA for the rest of the family (6 of us) 11/30/09. They have 30 days to determine eligibility and reply. It's been MONTHS! We are still waiting! 2 of the kids were put on it, not the other two and not the adults. She keeps saying she's "taking care of it" yet we see no results. She says she's sent us paperwork to fill out, yet it never comes. I went so far as to file a complaint with the USPS for not getting our mail, and it turns out she's not even sending it (now I have proof)! So I left a message with the main boss for all of them to speak with him today regarding this. I'm so fed up. We do qualify. Our children need insurance. By the time we get our approval and cards, the time limit will be up so we can't even use them! I'm not joking - she did this before. We got a notice in FEBRUARY (a few weeks ago) that my husband has coverage for 9/1/09-11/30/09. What good does that do us when we don't know about it when he's covered??? And renewal forms; I had to write the dates they're due on the calendar because she NEVER MAILS US THE FORMS then drops us off the insurance for NOT SENDING PROOF, when we never received it. I call and ask her about it and she says, "Well, I sent it." No, you didn't! I have proof you didn't! So just do your job and get off the crack!

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4 Comments

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Magen - posted on 03/04/2010

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I have a six month old whos heart stops and stop breathing so he is on an apnia monitor, since he was 36 hours old and we are still fighting to get a diagnosis. Maverick is on Cobra because my hubby lost his job. Well to make a long story some what short we have had so many problems getting certian test done and I have gotten the brush off from everyone, so my mom told me to contact California Department of Managed Health. If you live in Cali and are having problems with anything medical these are the people to talk to they are amazing!!!!! Hopefully we will be at UCSF next week!!! Good luck

Iridescent - posted on 03/03/2010

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Exactly! I was wondering if they do their jobs with Whiskey in one hand and a joint in the other, as bad as it's been!

Jessica - posted on 03/03/2010

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The system is enough to make a person crazy! I have been fighting with them for 3 months to fix a simple issue and finally today got the error resolved (by a secretary, I might add). It took the lady less than a minute to fix the problem, and I have been annoying Riley's caseworker all this time and hearing stupid things like "You have to call this number and talk to this person, etc." and I call the number and its a dead line. Why are they paying these people when they aren't even doing their job?

Ellen - posted on 03/03/2010

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Yes it is sometimes difficult to get all the paper work & case workers; but you did the right thing by continuing to follow up on everything; just keep pestering and following up with the appropriate agencies; persist is the key. When my Daughter Sara was little there seem to be alot of we mail you mail errors that is why when ever a renewal comes up either on her SSI or insurances I personally take all forms and data to the appropriate agency;that way I'm assured that a counslor is advailable. Some times it takes just a little more leg work and persistance. Hope you have come out just fine.

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