WHY is getting Medicaid so…

unfortunately difficult?!

BIG NEWS!  My son is now in the Medicaid Children’s Medical Services program of Florida Kid Care.  (I’m not even sure if this is the correct way to describe it).  This process was very confusing and lengthy.  There seem to be so many different parts or subgroups within the Medicaid program itself.  Just last week, I made four phone calls just to find out if he was in fact covered and active and what his member number information was so that I could submit it to his providers.

Here is how the journey to the end result started…I kept asking every provider about coverage, insurance, Medicaid, disability, and Florida kid-care.  I would ask like this…”but isn’t there like a Medicaid for people with disabilities that isn’t necessarily tied to your income?”  “How are other people paying for this?” I would ask my pediatrician because I was trying to find money from anywhere and anyone to cover my son’s ABA, Speech and OT therapies.  She would be like “yeah, you just call them and tell them you want CMS.”

??? What the hell!  Like call who?  At what number?  What is CMS?  Do you know if there are income restrictions?  How do I apply? Will it cover his therapy?

This has been an ongoing inquiry for almost two years!  Last summer and fall, I was reading, researching and applying for any grant or program that was related to ASD and getting the necessary aid and assistance to access the therapists my son needed.  There was one night in particular, I woke up and couldn’t sleep.  I knew the answers were out there and I was just going to find them.  I got up around midnight and researched and read. I found the ACCESS Florida page but it all seemed wrong and not at all what I was looking for.  So, I think…”well, it can’t hurt to apply?”

I was up until about 4am.  I didn’t even get half way through the application!  There were so many questions and documents that were needed.  I didn’t know what to select or what I was really looking for.  I never finished that application that fall or winter.  However, I didn’t give up.  I went back.  More research, more reading, more searching, more guessing until I finished the ACCESS application.  It said I was immediately denied.

Then about a month later a letter came in the mail saying that my son was qualified but only if he had over $6,632 in medical expenses per MONTH.  In order to be eligible he had to meet that amount every month.  I was so confused, I laughed out loud and thought…no wonder no one could help me.

Finally, more letters started coming about Florida Kid Care and my son being eligible as long as I paid a small monthly fee.  Apparently, this fee varies based on a families income and assets?  (still learning)  And lastly, the CMS letter came!  I immediately called; the woman was so nice and talked me through what my responsibilities were and how I should start right away.

Once you are approved, you have to pay online for the month.  The case manager recommended paying an extra month so that you never lapse in coverage if you forget a due date payment.  I had to make multiple calls to find out when coverage started, who was going to be listed as my primary care doctor, and what the plan benefits were.  Then I had to call again to get the number and information because the cards have not come in the mail yet.  So, with all that mess, here are

my tips in getting started with Medicaid.

  1. get started
  2. find all your important documents (financial), copy them, black out the social security numbers and scan them
  3. work on it multiple days, pace out the work and calls. (not possible to do it all in one day)
  4. don’t try to make sense of any of it, it will drive you crazy, just apply
  5. don’t take no for an answer; remind them that your child has _________ and needs medical care and treatment
  6. feel proud when you get your child on Medicaid; Medicaid is to help those in need and you and your child need help to access necessary and appropriate therapies

 

 

I almost forgot!  With the Florida Kid Care and CMS program, my son will receive health, dental and vision coverage.  CMS will also cover 100% of his speech and OT as well as his ABA therapy.

 

#1 Get started:  ACCESS Florida to apply.  Florida KidCare website with apply link.  Information about CMS.

 

NewRuth

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