Medicaid is such a pain in the butt sometimes...
So DH and I have covered the kids on insurance for years now. ET has kept them on Medicaid the whole time (sometimes potentially fraudulently, but that's a story for a different day and probably a previous blog).
ET hasn't been involved in YSK's healthcare since they moved in with us nearly two years ago. She hasn't given us their Medicaid card, they haven't lived with her, she hasn't mentioned it, and so we (probably stupidly) assumed they no longer had Medicaid.
Apparently they do, and now DH gets to jump through a few hoops with them in order to keep YSK in counseling. The therapist and office manager emailed us stating they had to update care plans but the PCP we told them YSK had didn't match the PCP Medicaid had on file (because, again, didn't know they still had it) and they were worried about sending YSK's medical information to the wrong doctor.
I am not mad at the counseling office. In fact, they've very clearly laid out everything probably more so than they needed to and answered all our questions. I'm just frustrated in general that we're STILL dealing with this Medicaid crap. Apparently DH can request for YSK to be terminated but Medicaid may still not drop them from coverage. So now DH gets to have a fun convo with ET about Medicaid AGAIN to find out if they are still covered and what her plan is. I also hope that Medicaid doesn't pull some BS and make DH take YSK to a different PCP because we have FINALLY got YSK into all the services they need and like. And I'm hoping that we haven't done something wrong by not telling folks they are on Medicaid because, again, we didn't think they still were.
Sigh. So fracking frustrating.
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No Medicare expert here. But,
No Medicare expert here. But, if Medicare doesn't cover, can the office just bill them and then use the denial to bill your insurance?
When my first husband was ill, he had double coverage. I wanted him seen at the teaching hospital in the big city (1 1/2 hours north). His work insurance would not cover him there, but mine would. The hospital billed his first and used the denial to bill mine. Mine paid.
With YSK having both private
With YSK having both private insurance and Medicaid, my understanding is that they bill the private insurance first and then bill Medicaid for anything not covered by the insurance. I asked if they had to bill Medicaid (both to avoid the headache this is causing the counseling office and because DH and I don't qualify for Medicaid so it feels icky using it) and unfortunately they have to since they accept Medicaid. They can't just not bill for YSK but do for others. It ends up looking like fraud, which feels backwards to me because having Medicaid be billed when we have the means to cover their healthcare feels like fraud.
I think I just hate this based on principle, if that makes sense.
ETA: The issue with the PCP is that Medicaid apparently assigns a provider if you don't choose one. YSK was going to a female pediatrician whose office wasn't able to address some issues with YSK. So we got them set up with a family medicine doctor recommended by my hospital. We *should* just be able to tell Medicaid that they are seeing this new doctor without any problem, but having never done that before, I have no idea if it will really be that easy or not.
My skids and DD were on our
My skids and DD were on our state's CHIP program, which ran similar to Medicaid. There were specific qualification rules that took into account who the child lived with, who was in the "tax" household, etc. Because we had 50/50 custody, we were able to keep kids on CHIP (through our household) after BM married the Golden Goose and had a household income that no longer qualified. If you look at the rules and talk to them and find YSK is qualified in his current living/custody situation, then you don't have to worry about fraud or feel bad about using it.
With respect to changing providers, in our state Medicaid/CHIP had you pick from a few HMO options they had. As long as the new provider was in your HMO network, switching was as easy as a phone call. If they weren't in the HMO it was much more difficult, and usually impossible.
My hope is that their new
My hope is that their new provider is covered. I am assuming he is because he practices in an FQHC. I'll just be super miffed if ET has kept them on Medicaid without telling us or providing us with their Medicaid card AND it effs around with their new care team.
ET'S incompetence strikes again
ET reminds me so strongly of our late BM and SD61. None of these people can handle bureaucracy and somebody else (you, me) ends up with the mess. Perhaps its more accurate to say they dont want to handle buresucracy.
I could cite 1,000 examples: BM not taking SD to followup orthodontist appointments (boring), SD letting her car insurance lapse (didn't believe they would really terminate her), BM not working (aggravating supervisors and easier to guilt DH), SD not taking her rx on schedule ( tedious), etc. I could go on for days.
I'm sorry you're dealing with this and hope it irons out fast and easily. You don't need this right now.
oh wow that is aggrevating!!
oh wow that is aggrevating!! Amazing people do that to others probably out of spite!!
You do realize they are still
You do realize they are still on Medicaid because she is most likely collecting other state benefits for them. These have to be renewed & qualified for at least yearly.
Oh of course. That's an added
Oh of course. That's an added layer of frustration to all this. DH nor I have the mental capacity right now to deal with her BS on this front, and I'm so tired of it.
We have never had to deal with Medicare/Medicaid
Though when the SpermClan finally did get the medial insurance for SS that they were COd to provide when he was 2yo and never did provide.. until SS was 13yo, hey tried to get out of paying for half of the premiums for the insurance I had provided through my employer from day one of our marriage. The Judge made them continue to provide the insurance they finally did obtain for SS.. and keep paying for half of the insurance I had always provided.
I would investigate putting BM in prison for Medicaid fraud, etc.... My DW put a number of people in prison for Medicaid fraud in her first job out of college.