Insurance Just Screwed Me

[Anonymous]

Hi OP-- it's me DCHF poster, haha and maybe the only one still following this thread.
On DCHF own website here, click on the 11th FAQ down

https://www.dchealthyfamilies.com/Member/FAQ.aspx

It specifically says, 1 month income. How is what you made last year going to matter at all now?
People can have a multitude of things happen in the course of a year to their finances.

I'm not sure why I am so angry about this but I am!

I still believe that if you filled out the correct application and gave the supporting documentation that their own website asks for that you will be approved.

I JUST had to recertify 2 weeks ago, and mailed in my stuff, again they asked for my last 30 days of income.
I doubt there have been such drastic changes to the program since then.

I would call DCHF and ask to speak to a supervisor, explain what happened at Taylor St, that they don't seem to understand the requirements and to make sure your application was received.

I'll be looking for an update OP!

[Anonymous]

Op here. This is crazy! I don't know what to do. The supervisor yesterday at Taylor Street told my caseworker to get last year's taxes. I told my caseworker that would have no bearing because my husband sold part of his business last year and had a bigger "take" than we will this year. I said "Do I need to wait until I do 2011 taxes?" She said no. She was helpful in trying to get by that supervisor taxes for 2010 BS. She looked up the code and it said that they use last year's taxes unless there is extenuating circumstances.

The caseworker said she would submit as-is and that if the processor wanted more info they would send me a letter. Otherwise, I would get my cards in the mail in 2 weeks.

I'll call them and see what they say.

[Anonymous]

unbelievable

[Anonymous]

I called. Like 100 times. I kept getting morons at DC Healthy Families. Got hung up on. Was told there was "no supervisor." Got someone who couldn't understand English. Finally got someone who referred me to IMA who apparently reviews these applications. Called them and they told me to call back in 2 weeks when they have my application. Told them they DID have it - I put it in yesterday. She told me to call back. I repeated what I said 2 more times and she finally said "I'll give you the caseworker's number."

Gave me the wrong number. Finally found the right number.

Called the caseworker and left her a voicemail.

PP - consider yourself lucky. If I have to go through this crap again next year I will probably just cry mercy and put up a white flag.

So much for having these programs as there is no one who can administer them properly.

[Anonymous]

Oh - and PP - the people at DC Healthy Families don't take complaints like that. They told me that they are only the insurance brokers.

[Anonymous]

Oh...I'm hoping the PP who told me about Healthy Families is on here!

I never got any response from my several calls to the case worker, so I figured I'd wait to see if I was approved. It's been 3 weeks now and I have received nothing in the mail. I'm not sure what I should do at this point - there seems to be no one to call. They told me I should know in 2 weeks because I'm pregnant - that they would expedite.

Am I going to have to go down there again to find out what happened and wait in line all day? Oh no!

[Anonymous]

Jesus call your council member already!

[Anonymous]

So sorry OP, this is the poster who told you about DCHF. They legally have up to 45 days to process an application, I have no doubt that they said they would expediate it, but somehow doubt they actually did/will. Also the holidays and all definitely are a slower time to get anything done. You do have your receipt (stamped with the date and a signature) right? I think they can look up something with that. Honestly the recertification program is easier, so hopefully you will just get approved and then once a year just drop off your paperwork, get your receipt and go.

While I don't personally know anyother family who has it, we do!
So don't give up hope. I would probably try to call someone at the Department of Health, someone in charge of oversight of these programs, call the Mayor's hotline to try and get a name. And calling your council member is a good idea too, the more noise you make the better.

You may have to wait the 45 days, but I know there is some type of action you can take then.

I will try an do done research for you and post this evening if I find out anything.

[Anonymous]

Thanks PP! I'm glad you are still reading and saw this!

I called Healthy Families today and they had no record of my social in their system. I hoped that they might. They referred me to Taylor St again. I called them a few times and actually got someone on the phone - just a clerk as she told me, and she could only tell me that they were "working on it." I asked her about the 2 week thing and she said to call back next week as no one is really in the office this week.

When you recertify, you only have to mail or drop info off? You don't have to wait there?

[Anonymous]

OP, your friendly PP DCHF poster here--

Check this out
https://www.cms.gov/LowCostHealthInsFamChild/downloads/CHIPStateDirectors.pdf

This is a list of the directors of the CHIP program for every state and DC. Unfortunately it is only current as of August 12, 2009.
Please try though!

And yes, you only have to drop off or mail in for recertification. I only drop off (don't really trust the mail!) and get a receipt!

[Anonymous]

OP here.

Can you believe I have not heard a word? I've been phone stalking them, all their voicemails say "we return all calls in 24 hours." Sure. I have yet to get one call back. Someone today told me my application hasn't even been processed. What a nightmare. I applied 12/6. Totally nuts.

[Anonymous]

What about your insurance? Did they ever find your phone calls? Have you totally given up on that battle? I am so sorry for you! I will never complain about my insurer again (tri-care).

[Anonymous]

Hi OP, this is the DCHF poster. Did you try to contact the head of the CHIP program for DC in the link I posted a couple of posts back?
Legally they only have 6 days left to give you an answer, 45 days. Remember you do have rights. You need speak to the director of the program, his name is listed below.

Here is some more info, this is directly from a letter from DCHF saying that we have been approved for another year--

DC Healthy Families:
6856 Eastern Ave NW Suite 206
Washington, DC 20012

Phone: [phone]
Complaint line: 800-788-0342

Wayne Turnage:
Director, DC Dept of Health Care Finance.

[Anonymous]

Department of Health Care Finance

dhcf.dc.gov
Phone:    [phone]
899 North Capitol Street, NE
Washington, DC 20001

This is Wayne Turnage's office location and office phone number. He is the person who "signed" my letter saying we have been approved for another year.

Please try to contact him.

[Anonymous]

OP here. To 1:32, Insurance. LOL. They were supposed to call in 24 hours to confirm the fax I sent of the labor and delivery coverage in my Book of Benefits. No call. They were also supposed to call in 7 days to confirm they listened to the phone calls. No call. We wrote a letter outlining all of this and also appealed the claims denied thus far. The letter was delivered by certified mail and arrived 12/9/11. There was supposed to be a response in 30 days. Guess what?

No response.

So we're working now on the DC Insurance Commisioner letter. I hate CareFirst. They manage to send me a f*cking bill on time every month, but they don't answer any communication at all.

I did call the CHIP number and got someone on the phone who then had to call Taylor Street. She said they don't know what happened (obviously) but will work on it. She said if I don't have anything by next week to call, but that because I'm pregnant It was supposed to be expedited.

I then told her how bad this program is to get into - and so now I know where to send my complaining letter when all this is done. Phew.

Thanks for all your help with this- -I never would have gotten as far as I have without you and the other posters who recommended fighting the insurance and going to the commission. I'll update you guys in a few days.