As my lovely readers may have figured out, things have been a little less than rosy around here...
I can't really say it's lookin' up.
Monday, I got a notice from Medi-Cal that my Share-of-Cost coverage was terminated as of the 1st of October.
Ummmm, come again?!
I have a SURGERY scheduled on Friday. THIS FRIDAY.
Immediately filled with the urge to vomit, I tried not to panic. There's was nothing I could do until the next morning...
My fervent hope is that I would call Medi-Cal and it would all be some silly misunderstanding...
Ooops! "Silly Us!" They would say.
Yeah, NOTSOMUCH.
My insurance is canceled. As I am no longer pregnant, O is no longer an infant and I happen to be married, we no longer qualify for squat.
Our income is "too high" (tell that to our bank account) and we are an "in-tact" family, therefore ineligible for aid.
Since when is being a stable family a bad thing?
It is in the eyes on Medi-Cal.
I was able however, to skim under the radar somehow, and since my surgery was already approved, it will be covered with the $2000 co-pay.
BUT, any medical care costs or anything related to the surgery/post-op that occurs AFTER the 31st of October will be our responsibility 100%.
Yippee?
Please cross your fingers for me that the surgery goes smoothly and is laproscopic, so it can be considered an out-patient procedure. If they have to go in all Mash-style, I'll be laid up in the hospital for a few days, and we don't have that kind of scratch....
Hey, did I mention that we also need a new car? SchWEET.
PS. O's Birthday Bash was Fab! I will post as SOON as I get all the pictures!
Showing posts with label Medi-Cal. Show all posts
Showing posts with label Medi-Cal. Show all posts
Wednesday, October 27, 2010
Wednesday, September 29, 2010
Well, it's better than a poke in the eye with a stick...
I guess.
Here's the update on Gall-Gate 2010:
My ER bill came to $6000.00.
Yes, that's THOUSAND....
After being on the phone forEVER, and basically being told that I was S.O.L. (because my Hubs makes too much, GUFFAW.)as far as financial assistance goes, I found out that I at least qualify for Share-of-Cost Medi-Cal.
Basically, it means that on a monthly basis, I have a certain amount that I have to pay out of pocket if I seek any kind of medical care--My "Share of Cost". After I meet that amount, any other care I receive within that month is covered, as long as I see a doctor that is a Medi-Cal Provider. If a month goes by and I haven't sought any medical attention, than I owe nothing. I only pay for what I use.
Not too shabby, no?
Sure!
Except my SOC is $2000.00 a month.
$2000.00 a month is pretty much our entire monthly income.
So, yeah. FML, right?
RIGHT.
There's a the silver(ISH) lining:
Because I have the SOC plan in place, I only had to pay $2000 of the $6000 bill. Yaaaay!
BUT, because you have to pay your SOC within the month it was used, there was no option to make payments on the 2 Gs. It was all or nothing, baby.
We had to borrow from my ILs. I have no idea how we're gong to pay them back, because I have appts. to have consultations with the 3 specialists next month, and those will all be out of pocket. Chances are, if they agree with my PCP and schedule surgery, I won't be able to have surgery 'til November. We're still trying to recup after the trips to WV.
Where the HELL are we supposed to pull these funds from?
Hubs and I figure that by the end of it all (if we're lucky), we're going to be looking at $6-8000.00 spent, which is WAY better than it could be, but still enough to cripple me with anxiety.
We've been working so hard to financially stabilize, I feel like all of our work is slowly becoming undone.
I can't fathom how we're going to rebound from this. It's already breaking us financially.
Not to mention, O's bday is coming up, and there's the holidays.
Every Christmas is rough for us b/c Hub's company shuts down for a week during the holiday. It's unpaid.
So every Christmas, we sit at home, somewhat appreciative of the little "vaycay," but panicked over the lost income.
It's gonna be a Blue Christmas, kids.
I'm HOPING that I'll go see all of these specialists, they'll run their tests, and sum it up with:
You're fine!
If I'm being honest with myself, I know SOMETHING isn't fine.
I don't feel well, and haven't for quite some time.
We'll see what happens!
Wish me luck thru this process. I need it.
I'll keep y'all in the loop as much as I can!
Here's the update on Gall-Gate 2010:
My ER bill came to $6000.00.
Yes, that's THOUSAND....
After being on the phone forEVER, and basically being told that I was S.O.L. (because my Hubs makes too much, GUFFAW.)as far as financial assistance goes, I found out that I at least qualify for Share-of-Cost Medi-Cal.
Basically, it means that on a monthly basis, I have a certain amount that I have to pay out of pocket if I seek any kind of medical care--My "Share of Cost". After I meet that amount, any other care I receive within that month is covered, as long as I see a doctor that is a Medi-Cal Provider. If a month goes by and I haven't sought any medical attention, than I owe nothing. I only pay for what I use.
Not too shabby, no?
Sure!
Except my SOC is $2000.00 a month.
$2000.00 a month is pretty much our entire monthly income.
So, yeah. FML, right?
RIGHT.
There's a the silver(ISH) lining:
Because I have the SOC plan in place, I only had to pay $2000 of the $6000 bill. Yaaaay!
BUT, because you have to pay your SOC within the month it was used, there was no option to make payments on the 2 Gs. It was all or nothing, baby.
We had to borrow from my ILs. I have no idea how we're gong to pay them back, because I have appts. to have consultations with the 3 specialists next month, and those will all be out of pocket. Chances are, if they agree with my PCP and schedule surgery, I won't be able to have surgery 'til November. We're still trying to recup after the trips to WV.
Where the HELL are we supposed to pull these funds from?
Hubs and I figure that by the end of it all (if we're lucky), we're going to be looking at $6-8000.00 spent, which is WAY better than it could be, but still enough to cripple me with anxiety.
We've been working so hard to financially stabilize, I feel like all of our work is slowly becoming undone.
I can't fathom how we're going to rebound from this. It's already breaking us financially.
Not to mention, O's bday is coming up, and there's the holidays.
Every Christmas is rough for us b/c Hub's company shuts down for a week during the holiday. It's unpaid.
So every Christmas, we sit at home, somewhat appreciative of the little "vaycay," but panicked over the lost income.
It's gonna be a Blue Christmas, kids.
I'm HOPING that I'll go see all of these specialists, they'll run their tests, and sum it up with:
You're fine!
If I'm being honest with myself, I know SOMETHING isn't fine.
I don't feel well, and haven't for quite some time.
We'll see what happens!
Wish me luck thru this process. I need it.
I'll keep y'all in the loop as much as I can!
Monday, March 9, 2009
Great, I'm going to be a Mommy, but I'm still uninsured. Not so peachy.
As I mentioned in my first post, this crumbling economy has not been kind to us. Much like almost everyone else, I'm sure.
This past year has left us pretty broke, both financially and emotionally.
We went from being an engaged couple with a great two-bedroom apartment, two good jobs with potential, and a cute little dog, to a married couple living with our in-laws (who, don't get me wrong, are GREAT, but it's still not the same), one shaky job that we hope lasts, AND we had to give up our dog.
All of this (and more), is why I wasn't immediately over-the-moon about the pregnancy.
Of course, I want this baby; to be a wife and mother is all I have really ever wanted (and somewhere, a feminist cries...), but all I could think about is: How the hell are we going to do this?
Well, in times of crisis, all I know how to do is to go into planning/organizing/fixing mode.
So what's first? How to get insurance for myself and the baby.
My husband has insurance through his job, but it would cost us like $500 a month to add me and we just couldn't afford that.
I used to have insurance through my job, but was laid off. I've since desperately tried to procure private insurance for myself, but no one would take me b/c of my pre-existing conditions, baby notwithstanding.
So after doing some research, and talking to a good friend who'd been in a similar situation, it seemed like my only option was to head down to the local Social Services office to apply for Medi-Cal.
Medi-Cal (as defined by the CA Healthcare Foundation) "is California's Medicaid program. It provides health care coverage for more than six million low-income children and families as well as elderly, blind, or disabled individuals. Medi-Cal is jointly funded by the state and federal government, and administered by the California Department of Health Care Services. People enroll in Medi-Cal through their county social services department."
Now, I know a lot of folks get into an uproar about things such as Medi-Cal, talking about people living off the system, angry b/c they don't want to support other people's families, etc., and I understand that, but I don't want to hear any of those gripes here. I've been working my ass off since I was 14, supporting myself since I was 17, and paying taxes ever since. I've been paying into this system, and now, I need help. If I can get it, You bet your buttons, I'm going to take it.
Off the the Medi-Cal office I went!
If you are in a similar situation (Pregnant and Uninsured), here's what you need to do:
Go to the website and find your local Social Service office
Get there ASAP
The site will tell you that you can download and mail in your app, but it is safer and more effective to go in. You don't need to fill out the application b/c a worker will do that for you when you are seen.
http://www.dhcs.ca.gov/services/medi-cal/Pages/default.aspx
When going to apply for Medi-Cal, two things to know are:
1. be prepared!
2. be prepared to wait, and then wait some more
The Medi-Cal application will require a lot of info of you and if you have one, your spouse:
ID/DL
Proof of CA residency
Proof of Pregnancy (can be obtained from a free clinic)
Birth Certificate or papers
Marriage License
SS Card
Bank statements for all accounts
Pay stubs
Vehicle Registration
Proof of Vehicle Insurance
There are even more documents if either of you own property, stocks, etc., or if either of you pay child support or alimony.
If you receive any other types of state or government assistance, you need to bring documentation of that as well.
None of that applied to me, so I just needed to bring what was on the aforementioned list, and wait to have an interview and then be assigned a worker.
Be warned:
Even with all of my copies and documentation in tow, I was there about a total of 4 hours, AND the income rates are higher than I expected.
Even with our one income and shoestring budget, we barely qualified for anything, and my application is still processing.
Medi-Cal does not care about how much you pay in rent, or how much your student loan payments are. They just care about what's listed on your pay stub.
That being said, I will hopefully be able to get enough coverage to take care of my prenatal visits, my labor, delivery, and hospital stay. After the baby is born, I can then apply for Medi-Cal for him/her separately. All I care about is that my child gets what he/she needs.
It can take up to 45 days for your application to process. If you're like me, this is far too long to go without prenatal care. Here is a back-way into seeing a OBGYN faster:
Go to a free clinic, like a community health care clinic.
(don't tell them that you've already been to the Medi-Cal office, that you already have proof of Pregnancy, or that you have a case-worker)
Tell them that you need a pregnancy test...
Once your test comes back positive, they'll issue you a proof of Pregnancy
They will also give you a Presumptive Eligibility Card. This entitles you to 45 days of coverage with Medi-Cal so you can start the application process, but you already have, so score on for you!
Once you have the PE card, call your worker and get the physician referral number. Your worker may have already given it to you during your interview.
Call that number and find a OBGYN in your area.
Call the OBGYN, tell them that you have a PE card, and that you've already turned in your application for medi-cal. They will then schedule you for your first prenatal appointment. Victory!
Whew, that was a lot!
More to come....
This past year has left us pretty broke, both financially and emotionally.
We went from being an engaged couple with a great two-bedroom apartment, two good jobs with potential, and a cute little dog, to a married couple living with our in-laws (who, don't get me wrong, are GREAT, but it's still not the same), one shaky job that we hope lasts, AND we had to give up our dog.
All of this (and more), is why I wasn't immediately over-the-moon about the pregnancy.
Of course, I want this baby; to be a wife and mother is all I have really ever wanted (and somewhere, a feminist cries...), but all I could think about is: How the hell are we going to do this?
Well, in times of crisis, all I know how to do is to go into planning/organizing/fixing mode.
So what's first? How to get insurance for myself and the baby.
My husband has insurance through his job, but it would cost us like $500 a month to add me and we just couldn't afford that.
I used to have insurance through my job, but was laid off. I've since desperately tried to procure private insurance for myself, but no one would take me b/c of my pre-existing conditions, baby notwithstanding.
So after doing some research, and talking to a good friend who'd been in a similar situation, it seemed like my only option was to head down to the local Social Services office to apply for Medi-Cal.
Medi-Cal (as defined by the CA Healthcare Foundation) "is California's Medicaid program. It provides health care coverage for more than six million low-income children and families as well as elderly, blind, or disabled individuals. Medi-Cal is jointly funded by the state and federal government, and administered by the California Department of Health Care Services. People enroll in Medi-Cal through their county social services department."
Now, I know a lot of folks get into an uproar about things such as Medi-Cal, talking about people living off the system, angry b/c they don't want to support other people's families, etc., and I understand that, but I don't want to hear any of those gripes here. I've been working my ass off since I was 14, supporting myself since I was 17, and paying taxes ever since. I've been paying into this system, and now, I need help. If I can get it, You bet your buttons, I'm going to take it.
Off the the Medi-Cal office I went!
If you are in a similar situation (Pregnant and Uninsured), here's what you need to do:
Go to the website and find your local Social Service office
Get there ASAP
The site will tell you that you can download and mail in your app, but it is safer and more effective to go in. You don't need to fill out the application b/c a worker will do that for you when you are seen.
http://www.dhcs.ca.gov/services/medi-cal/Pages/default.aspx
When going to apply for Medi-Cal, two things to know are:
1. be prepared!
2. be prepared to wait, and then wait some more
The Medi-Cal application will require a lot of info of you and if you have one, your spouse:
ID/DL
Proof of CA residency
Proof of Pregnancy (can be obtained from a free clinic)
Birth Certificate or papers
Marriage License
SS Card
Bank statements for all accounts
Pay stubs
Vehicle Registration
Proof of Vehicle Insurance
There are even more documents if either of you own property, stocks, etc., or if either of you pay child support or alimony.
If you receive any other types of state or government assistance, you need to bring documentation of that as well.
None of that applied to me, so I just needed to bring what was on the aforementioned list, and wait to have an interview and then be assigned a worker.
Be warned:
Even with all of my copies and documentation in tow, I was there about a total of 4 hours, AND the income rates are higher than I expected.
Even with our one income and shoestring budget, we barely qualified for anything, and my application is still processing.
Medi-Cal does not care about how much you pay in rent, or how much your student loan payments are. They just care about what's listed on your pay stub.
That being said, I will hopefully be able to get enough coverage to take care of my prenatal visits, my labor, delivery, and hospital stay. After the baby is born, I can then apply for Medi-Cal for him/her separately. All I care about is that my child gets what he/she needs.
It can take up to 45 days for your application to process. If you're like me, this is far too long to go without prenatal care. Here is a back-way into seeing a OBGYN faster:
Go to a free clinic, like a community health care clinic.
(don't tell them that you've already been to the Medi-Cal office, that you already have proof of Pregnancy, or that you have a case-worker)
Tell them that you need a pregnancy test...
Once your test comes back positive, they'll issue you a proof of Pregnancy
They will also give you a Presumptive Eligibility Card. This entitles you to 45 days of coverage with Medi-Cal so you can start the application process, but you already have, so score on for you!
Once you have the PE card, call your worker and get the physician referral number. Your worker may have already given it to you during your interview.
Call that number and find a OBGYN in your area.
Call the OBGYN, tell them that you have a PE card, and that you've already turned in your application for medi-cal. They will then schedule you for your first prenatal appointment. Victory!
Whew, that was a lot!
More to come....
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