Life... Health... Reviews...

Monday, September 15, 2008

Mounting frustrations

When my youngest daughter was born she automatically had newborn Medicaid because I had Pregnancy Medicaid. What is supposed to happen is that after the child turns 1 year old they are then put on the regular Medicaid when you do a review around the time of their birthday.

I did my review in April and she turned 1 in May. Despite providing all the necessary paperwork and applying for all the children; she is still the only child without proper health insurance coverage. This has become so frustrating because not only is it already one month past the time for her 15-month check up, but in July I had to take her to the emergency room (not realizing at the time that she wasn't covered) and received a bill for the visit for about $250 plus the doctor's fees of almost $200.

I have been trying to get this situation straight while rescheduling her check up each time. I took her in for a sick baby visit to the tune of $85, but the well-baby visit will be quite a bit more costly plus a separate cost for the immunizations she'll need.

About two weeks ago -- after repeated phone calls, leaving messages and being re-directed -- I went up to the office pulled a number and waited to talk to a customer service person. My case file was checked, determined to be open and I was told to call the change center to add the baby.

I went home, called the change center, waited on hold for about 15 minutes only to be hung up on by a rude operator who would not look up the file like I was trying to tell him to. That is even a long story, but it involves the fact that I have two files under my social security number. Every time I go to the office and they put in my social security number they always come up with a file dated from about 1996 or 1997 that is under my maiden name.

I have to explain that I changed my name six years ago and for some reason when I applied again in a different county the worker created two files. Instead of merging the files the old one always pulls up. Then they have to search my name and birth date to get both files to come up.

Well, the operator said there was nothing there and when I tried to explain the problem he hung up on me. I was going to get into my car and go back up there but I called back and asked for a supervisor. The lady nicely inquired whether she could help. I told her what had happened and she found all the information I needed (and that she needed to help me), and spent about 20 minutes filling out the forms and updating my record.

She said the baby would be added and all I needed to do was send in her shot record by a certain date. She was mailing the letter for me to know where and when to send it. I received the letter and faxed a copy of what she needed. To ensure that it made it I also mailed a copy.

Today, I get a call from the pediatrician saying AGAIN that my youngest daughter isn't covered and to go to the office and talk to someone about it.


I tried calling again... the line has been busy all morning. I tried a different number and couldn't get anyone. I even checked the eligibility line to make sure -- yup, no coverage. And I don't see the point in going back up there again to do the same thing I did two weeks ago.

So, I applied online for a different health program and hope that it goes through quickly. When the government laments about a system put into place to help those who need it and to ensure that our children are medically covered; they fail to mention the substandard service and care. They neglect to mention the hoops you have to jump through.

They don't care if you've been simply fallen on hard times and need a little help to take care of your family. All that matters is that they make it sound good. Low income = shit outta luck.


  1. I hope that the request you filled out online works out! Sorry you have to jump through so many hoops :(

    The Egel Nest

  2. Wow that's horrible! It's when I hear about problems like that I'm glad I live in Canada and we all have free medical care.

  3. Stories like this are all too common. I don't understand why bureaucracy has to stand in the way of service. I hope things work out for you eventually.

  4. Oh, Petula, I feel your pain! How frustrating! How scary not to be able to take your child to a doctor without the fear of how much it will cost you! I hope you can get through to someone who will truly help you. Write letters, make phone calls, make visits. I know it all takes time, but maybe someone will finally figure it out. I'm behind you!!!

    If it is any consolation, having "good" healthcare coverage with my husband's job isn't any better. Our insurance didn't want to cover my anethesiologist or anethesia for my hysterectomy last year. I didn't think anethesia was an option during surgery. Apparently they did. I made TONS of phone calls and FINALLY won. This isn't because of your financial situation--it is healthcare today!!!

    Go! Fight! Win!

  5. I FEEL your pain. I have an ambulence bill that Medicaid never paid from when Marisa was 18 days old and rushed to the hospital because she stopped breathing / got choked and I couldn't get her breathing right again.

    And those irritating review forms - GRRR.

  6. Im sorry you are going through so much! I hope all works out and you stop having to jump through hoops! My thoughts and prayers are with you.

  7. I understand how the Medicaid system works, but I could never truly understand how it's a hassle for a mere child to recieve what should be obviously given, at least long enough to get her necessary treatments i.e. newborn shots, checkups. etc.

    Free Healthcare would solve mad issues. Good luck, Petula.

  8. I know first hand how frustrating it can be. I was lucky enough that when my youngest was born, we had insurance. Compared to my first two, who I had on medicaid, it was heaven having insurance.


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