Boy holding his sister
Family Life

Insurance Triumph

You may have followed the drama of last week and insurance. You can read it here if you need to catch up! It was exhausting and stressful. The recovery from three days of no ABA was also difficult.

Super fun!

I definitely did not want to spend last week that way. However, if this is what I’m doing I’m going to work to make it as good as possible for as many additional people. After all, I’m trying to get as much good out in the world as possible, and this is one way to try and do that.

E participates in a Medicaid Buy In. This is an income capped, premium required “extra” insurance that picks up where regular insurance falls off. It is designed for individuals who are disabled in some way and need additional support or medical help. In his case, his Autism is a qualifying disability because sleep and emotional control are… let’s use the word sporadic. We had to go through a qualification process, during which time, his insurance didn’t cover his ABA therapy and so we paid out of pocket for 1 session each week. It was expensive. We are still paying off three months of it. Once he was covered, for less than the cost of 1 ABA session, he is covered for as much as he needs.

Right now, as we try to mainstream him and transition him back into a traditional school environment with neuro-typical kids… That’s a lot of therapy. In this family, we practice. The wonderful women who work with E help us with that. (AND IT’S WORKING!)

Anyways, his insurance has a snafooo… Apparently, with three different dates to pay, I chose the wrong one and 13 days after it was paid, they flipped a switch and bye bye Buy In. ::head desk::

I spent over 3 days on hold. It was less than enjoyable and I was in tears more than once. Nothing makes me feel more helpless than not being able to help my kid.

I promised I would update my how handle the Medicaid Buy In and it is…

  1. The Patience of Job
  2. A phone with several hours of battery or the ability to speak while it is hooked onto a charger.
  3. Time – schedule at least a day and a half.
  4. A dirty house to occupy your time with as you wait on hold.
  5. 1-800-221-3943 THIS is the number. With this magical number you will be able to fix your Buy In issue and have it backdated as if it never happened.
    1. However, call in at exactly 8am. Not a minute before.
    2. Follow the prompts for the Medicaid number for an existing case.
    3. DO NOT choose to have the system call you back when your turn in line comes – I’m still waiting on that call 12 days later.
    4. Be super friendly when they come on – these individuals are dealing with people all day and after being on hold for the 1/3 the lifespan of a fly, I’m sure some citizens are cranky.
  6. Thank them and do your happy dance.

I was on day four when this was fixed. You would think that there would be clear directions, but I couldn’t find them.

Now to figure out why the state has taken four months worth of premiums out of my account this month. OUCH.

Insurance is a necessary evil in this country. Healthcare is important and for the value we receive from E’s coverage – I’d do it all over again.

What are your health insurance woes? Do you have solutions?

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