Paperwork
Posted on | February 22, 2012 | 9 Comments
These last few days have been spent wading through the mountain of paperwork for the medical insurance plan.
The first hurdle was choosing a managed care program. Apparently Kentucky no longer has a one-size-fits-all Medicaid program, there are three choices to choose from with benefits ranging from a free cellphone to gift cards if you perform certain preventative steps.
I don’t consider myself stupid but I felt really dumb looking through the benefits spreadsheet. For one, which plan did I look at? Were we under the Family plan or the Global? Which ones had doctors in our area? How much copay does an adult have to pay for procedures like fillings or is it a blanket charge? When they say only one dental visit a month does that mean that you can only get one filling cared for a month? And what does ANY of this have to do with cell phones or gift cards?
After puzzling over the information I did what any intelligent person would: I called the hotline number to start asking questions. That was when things got “really” interesting.
I was informed that we had been placed by default into a plan that didn’t have doctors in my area; I needed to be on Coventry, which was really the best for both adults and children in my area, especially since that was the only one my local hospital takes. She rambled on a bit, using terminology that sailed right over my head as she clicked on the keyboard, telling me that I would be on the new plan starting March 1.
Suddenly she stopped. "When did you get this information?” she asked.
“Today,” I replied.
“Strange, we have Katie here under another plan and not scheduled to switch. I’m going to have to turn this over to a supervisor. You will get a call in a few days. Until then I’ll send you out the handbook for the plan you are currently registered on. Thank you!”
So I received a big booklet for the current plan, which apparently doesn’t have any doctors in my area. I’m not sure, but from what I understand that means that if we DID need to go to a doctor we couldn’t because it would be out of network because we didn’t have a primary care provider here before getting on this plan.
So here I sit awaiting a phone call, hoping that someone contacts me that can explain all of this to me because I don’t have a single clue.
And that my friends is the current state of affairs.
Has anyone else dealt with Medicaid in Kentucky? I could really use a translator for this stuff.
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February 23rd, 2012 @ 5:19 pm
The cell phones and gift cards things, those have nothing to do with medicare and it’s really strange. If you cannot see a doctor, at least, you’ll be able to enjoy some free stuff…
even if it wasn’t exactly what you need. Enjoy the gift cards on my behalf please.
Could it be actively a stimulus to the US economy?
February 23rd, 2012 @ 6:48 pm
The cell phone thing is some kind of program nation wide for low income to ensure everyone has a phone for emergency use if they meet certain criteria. one of the criteria is medicaid….it’s kind of like my daughter automatically qualifying for medicaid without having to recertify each year as long as she qualifies for so much as a $1 of SSI because of my income levels and her autism diagnosis…not sure if that made sense.
February 23rd, 2012 @ 10:06 pm
Oh, the bureaucracy! I was going to say too that the cell phones are for people who can’t afford a phone of any kind. Annie, this is all going to just make you stronger in the end! Wondering if your ex had already enrolled your daughter in a plan and didn’t tell you…
February 23rd, 2012 @ 10:08 pm
This infrequent blog looks like it might have some information and resources that could be helpful: http://kyvoicesforhealth.com/blog.php
February 23rd, 2012 @ 11:43 pm
Thank you Karen! I appreciate the link!
February 23rd, 2012 @ 11:44 pm
He may have done just that Karen, especially if he were illegally drawing benefits on her. All I know is that the insurance card he gave me was worthless and I *had* to make sure she was taken care of.
If he was getting illegal benefits, it will come out in the end.
February 23rd, 2012 @ 11:46 pm
It makes sense Laurie. To me it is a surprise because I still consider cell phones to be a luxury you know?
It is so easy to use Google Voice or MagicJack to make calls for almost nothing that I wish these agencies would help teach others about that instead of giving away cellphones, you know?
February 23rd, 2012 @ 11:47 pm
I’m not sure what the items are for Sunny. I think some of it may be incentives to make sure that patients receive preventative care but the wording was rather confusing. I’ll figure it out.
February 24th, 2012 @ 7:24 pm
I know what you mean about it being a luxury. I can remember being out in the middle of no where having to walk because I broke down and I didn’t have a cell phone at all. Of course I didn’t have a house phone either so being able to call home wouldn’t have done a bit of good. LOL!