Insurance Just Screwed Me

[Anonymous]

Op, thinking about you? Have you found any solutions?

[Anonymous]

Anonymous wrote:Go give birth in England
Or Mexico?
Canada is also a good option

Yeah, go screw their taxpayers the way illegals screw US taxpayers. Great suggestion.

[Anonymous]

Hi 13:55 - thanks for checking in!


Care first STILL has not responded to me. Surprise. My husband is going to write the mean-letter to their appeals dept. He feels based on the language alone and how confusing it is in my book that we can argue that point alone.

We've talked to insurance at the hospital where I want to deliver and they also said this is nuts and to keep fighting. They gave us a rundown of costs but as we all know - getting a number on this is like hitting a moving target.

A PP recommended yesterday another program DC Healthy Families. We tried to apply this a.m. but they aren't open every Saturday like their website says (shocking.) So we'll go back on Monday. The last 30 days of income are bleak for both of us because we are self-employed, so we should qualify - hopefully.

It's a horrifying work in progress. One I really wish we didn't have to go through. But I know - we could have it worse.

[Anonymous]

Anonymous wrote:Hi 13:55 - thanks for checking in!


Care first STILL has not responded to me. Surprise. My husband is going to write the mean-letter to their appeals dept. He feels based on the language alone and how confusing it is in my book that we can argue that point alone.

We've talked to insurance at the hospital where I want to deliver and they also said this is nuts and to keep fighting. They gave us a rundown of costs but as we all know - getting a number on this is like hitting a moving target.

A PP recommended yesterday another program DC Healthy Families. We tried to apply this a.m. but they aren't open every Saturday like their website says (shocking.) So we'll go back on Monday. The last 30 days of income are bleak for both of us because we are self-employed, so we should qualify - hopefully.

It's a horrifying work in progress. One I really wish we didn't have to go through. But I know - we could have it worse.

Have you contacted the DC Insurance Comission yet??? You really should - the contact info should be on your denial claim from Care First.

[Anonymous]

OP--I am PP who mentioned DC Healthy Families.
It is, to say the least, unpleasant and time consuming to apply, but once you get approved it is pretty smooth sailing from there. I think they have to give you a decision within 30 or 45 days, but we got ours earlier. Also, since you are self employed you can bring in the receipts for any business expenses related to the last 30 days of income that you are showing. So whatever you have, bring in, that will be deducted from your last 30 days of income. We are also self employed and we showed the invoices we billed to our clients that month to prove our income. You also can deduct childcare expenses if you have those. They really aren't in the bussiness of denying people so you should get approved. Hope it works out for you!

[Anonymous]

Anonymous wrote:OP--I am PP who mentioned DC Healthy Families.
It is, to say the least, unpleasant and time consuming to apply, but once you get approved it is pretty smooth sailing from there. I think they have to give you a decision within 30 or 45 days, but we got ours earlier. Also, since you are self employed you can bring in the receipts for any business expenses related to the last 30 days of income that you are showing. So whatever you have, bring in, that will be deducted from your last 30 days of income. We are also self employed and we showed the invoices we billed to our clients that month to prove our income. You also can deduct childcare expenses if you have those. They really aren't in the bussiness of denying people so you should get approved. Hope it works out for you!

PP thanks for this recommendation but I really need your help

I have been getting the typical DC Shuffle on this. I went to 2 offices on the website - both were not in existence anymore. I called and was redirected to H street. I went there and was given an application for Medicare which does ask for assets and bank statements. I was hoping to not have to do that as my cushion in my bank account will possibly disqualify us. Though we have no recent income - that money in the bank has to hold us until spring. I called DC Healthy Families to see if this was the right application and apparently it is. So it may be that they changed the program and it's no longer as easy as it was? Do you know?

[Anonymous]

Sorry - OP again.

PP did you have to go to the office to apply? We got turned away from H street today because they only take applications at 7:30 a.m. or something.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Go give birth in England
Or Mexico?
Canada is also a good option

Yeah, go screw their taxpayers the way illegals screw US taxpayers. Great suggestion.

screwing is over. time for baby to come

[Anonymous]

OP, DC healthy families poster--uggg, I went through the same thing, but trust me, it will work out!
Download the application here:

http://dhs.dc.gov/dhs/frames.asp?doc=/dhs/lib/dhs/ima_policy_manual/appendix_c1/hf_english_application.pdf&dhsNav_GID=1728

Fill it out and go to the Taylor St office to hand it in.

1207 Taylor ST NW

Many of the customer service/social worker/ intake people don't know anything about this program because 99% of the people who apply for Medicaid qualify for straight Medicaid on DC. If they ask for your proof of assests, show them the application, which says nothing about assests, remind them nicely that you are applying for the SCHIP (maybe I heard one of them call it the "short form")

This will probably take all day--get there as early as you can, be prepared to wait--bring everything with you, all your birth certificates, proof of income, everything you can think of.

I promise you will get it. The people who take in the paperwork send it off somewhere to get it approved. It is poorly run, but not surprising for DC!

[Anonymous]

PP thank you. I'd say you have no idea what I've been thru but I'm sure you do!

Tried Saturday to go to the NW location on their website (south of Dupont) and it was closed even though their hours were Sat 8-1. Called and found out they changed to 3rd Saturday.

Went back this a.m. and they were still closed. Called and talked to a person who said to go to 1100 First St. Went there. Couldn't find that address. Asked in several buildings, they all said they had no clue.

Called again, sent to H Street.

Went to H st and was told to fill out Medicaid app. Took that with me, called again on way out and they told me to apply online. Well you can't do that as that part of their site says "coming soon."

Called again. Was told to go to CVS, Safeway etc. Went to Safeway - they had no clue. Went to CVS. Girl had remote idea. Called 4 stores - no app. Told me to fill out medicaid app and just leave the food stamp parts blank. Uh. Okay. So the best help I got today (besides you ) was from The Manager at CVS.

Thanks for this. The medicare app is asking for my bank statement. I really don't want to do that. My balance has to carry me until March - the next possible time I could get some work paid for, and if they see $3000 they will tell me to get lost.

[Anonymous]

Anonymous wrote:The medicare app is asking for my bank statement. I really don't want to do that. My balance has to carry me until March - the next possible time I could get some work paid for, and if they see $3000 they will tell me to get lost.

I'm sure you meant Medicaid. Just so you know that Medicaid does do an assets check and unless your assets fall below a certain level, which I can't recall at the moment, you aren't eligible until you spend down the assets. So, you won't have a choice except to turn over your bank statements. One other thing. Don't even think about giving the money to someone else to hold because Medicaid has a look back period and if you give your money away, the money is still counted as your asset.

Good Luck, OP. I've been following your story and I really feel for you. I hope everything works out with your insurance.

[Anonymous]

Well I've got a small update but not a good one. Spent 2 hours in line at Taylor Street. They told me that they don't take that application anymore for Healthy Families anymore - that it's just a straight Medicaid application. (and yes, I didn't mean Medicare, sorry!)

They told me I would have to go to H Street as they are the only ones who take the app for Healthy Families. I basically said I've been getting the run around for a week, that H street didn't know anything about it as I was there yesterday and I'm pregnat, blah blah and she said fine she'd take me today. So I have to go back there in a bit with proof of pregnancy (so stupid, like you can't see how fat I am?) and they will get me processed.

I asked what I need and she didn't say bank statements so I'm not going to bring those in.

[Anonymous]

Thanks for the update OP--a number of us are hoping it works out for you. Re bank statements: my understanding is that DC doesn't have any sort of asset cap for Medicaid/CHIP, so I don't think you need to worry about that angle (though I could see them wanting bank statements for evidence of hidden income).

I hope you're also still fighting with the insurance company, too (even though the Medicaid work is exhausting enough).

[Anonymous]

Hi OP, PP here with DC healthy families. I'm glad they took you at the Taylor St center. I have no idea why they said they didn't process those applications--like I said--people like our families are rare in DC. "high" enough incomes with maybe some assets so that we don't qualify for Medicaid, but with the extreme cost of health insurance, especially for the self employed who have no benefit options through an employer, it can make health insurance truly unaffordable, like choose between paying your rent or having healthcare. I just think that the customer service centers see so, so few of these applications that they have no idea what to do. One of the first things Obama did when he became president was to raise the SCHIP limits to help middle class families like ours.

Don't worry about the bank statements/assests. They are not part of the SCHIP program. Just turn in everything to get processed, I know it sounds like an impossible right now--but I think it will be OK.

Keep us updated OP!

[Anonymous]

OP here. Home, after a whole day in the service center on Taylor Street. It was sheer misery. They don't let you eat or drink anything, you can't leave because when I went back the "boss" lady was screaming at me for cutting the outside line and made me show her who told me to come back in and blow the line on my return trip. they make you feel like a criminal. It's really bad.

So I sat there all day with nothing to eat or drink. I finally got called back at 3:30. 8 hours if anyone's counting.

They took all my info but the program does seem to be different. They now want your last year's tax returns. Well last year is higher than this or other years because my husband sold part of his business. They added a long explanation of that and said they would try to get it approved without it but to expect a call/letter asking for last year's tax returns.

So I don't know anything yet and it does seem like th program has gotten more strict. I told them it was last 30 days of income but they didn't care.

Sigh. I really really need a drink after this day. And I can't!!!

Thanks for all your help guys!