This blog is dedicated to things I've written of a non-journal-esque nature, i.e. poetry, advice prose, essays.

Friday, January 13, 2012

The Top 11 Things You Should Know Before Applying to Medicaid

I finally wrote this up after a recent phone call from Medicaid reminded me of how confusing their process really is. Enjoy!

1. There’s a hierarchy for who will be accepted to Medicaid coverage. Children from poor families are the easiest to get on. Next easiest are pregnant women who are either very poor or became pregnant before having health insurance. Men are pretty much impossible. Even if you apply as an entire family, they will choose who deserves to be covered. Even if you make next to nothing, your husband might not be able to be covered. Here is a to the income limit chart, which will help youhttp://www.blogger.com/img/blank.gif at least get an idea of whether you and your family has a chance at getting covered.

2. To be under the income limit is one part. Another part is having your assets analyzed and added to the “asset limit”, which is $3000. This includes savings and assets, including 401Ks and cars. There is a $12,000 allowance for a first vehicle, and any additional vehicles will be included in the calculation of your assets. For example: Our truck is worth about $6000, our Corolla, according to Medicaid, is worth about $4000. The truck, since it is worth more, goes under the allowance, and the Corolla pushes us way over the asset limit because of its value. Our Corolla is definitely not worth that much, so we were given the option of having it appraised by one of their approved car shops and turning in the appraisal to have it lower our asset level, so that's another option you have. Unfortunately for us, it's still worth too much to balance our other assets out to below that asset limit, so it's basically a lost cause.

3. If you make little enough to qualify, but have too high assets, you can still qualify with a required “spenddown”. This is basically a one-time premium. If your income increases, you may be charged another spenddown.

4. Every now and then they’ll have open enrollment for their Primary Care Network, which is one way you can get men covered. It’s slightly easier to qualify, the application isn’t as extensive, but just know that if said man is a student at a university which offers health insurance (i.e. BYU) he does NOT qualify. Even if they let you on for a few months, they’ll kick you back off again.

5. The timing of your application is very important. Once you apply, you have 10 days to schedule an interview. During the interview you’ll get more information about what types of documentation you still need to submit, and you’ll have an additional 20 days to complete the submission of that documentation. Sometimes your interview will come sooner than the 10 days, as sometimes they call you instead of waiting for you to get your letter and call them. Either way, from the time you apply you have 30 days to submit documentation. If you are unable to get everything in on time, they will give you an additional 30 days for straggling documents. HOWEVER: it takes 3-4 days from the time you scan/fax your documents until they are actually received at the imaging center. So plan accordingly. Keep in mind that some things may take longer than you expect to receive. I needed employment verification from one of my jobs, and it took over a month for them to get it to me. I faxed it in the day before my 60 days was up, and it wasn’t early enough. For this reason, it is a good idea when you start your application to apply retroactively. That way you’re covered for 90 days before you applied, no matter what goofy stuff happens. Just save yourself some headache and do it right the first time.

6. Just a tip on some of the identification you need to bring: A passport can work instead of a birth certificate, and if you are applying as a pregnant woman you need a note from your doctor stating that you are pregnant. I just got a prescription sheet that said “Jill-Marie is pregnant with an EDD of 5/25/2011” which was signed by my doctor, and that was plenty good enough for them. You also need immunization records and a birth certificate for any children who are applying with you. Some documents you can fax or email (I wouldn’t trust the email, it has never worked for me), but the ones described in this paragraph must be brought in to your local DWS office so they can scan them directly into the system.

7. You need to keep basically EVERYTHING that is any part of your application/acceptance process. Do this for several reasons, but mainly in case you have to re-apply or if they ask for any verification. Keeping all of your documents in one folder or file will make it easy for you on days where you have to run out the door and might have time to stop by DWS on your way home. Additionally, you’ll need to keep your Medicaid cards once you start receiving them, so it might be a good idea to put together a binder or folder where you can keep track of everything.

8. You will need to verify your employment. This is easy if you are a W4 employee, but if you’re a 1099 or self-employed at all it gets a little complicated, so the rest of this paragraph is only talking to 1099 or self-employed persons. When filling out your application, do NOT say you are employed. This will just cause confusion and you’ll have to change information and it may not get changed properly at HQ and it’s just a big mess. So don’t say you’re employed, say you’re self-employed. As part of the process, you’ll receive a letter stating that you need to submit documentation for your self-employment, and they may tell you that the forms can be found online. They cannot. I looked, I asked. They’re not there. You need to go to your local DWS and ask for a “Self-Employment Ledger” and "Self-Employment Information Sheet". They are very nice and will print one for you, then tell you to use their copy machine to make as many free copies as you need. You need one of each of these forms for each month that you are self-employed. Yeah. This is why I recommended a binder. It’s a good idea to fill out all the basic information on the first sheet before making copies, and then you can adjust the other information, such as specific months and amounts, as needed. You need to fax EACH of these pages to DWS, and they may not all go through, so again I’m going to suggest keeping them all together in one place.

9. The best way to get in touch with someone about questions you have about your Medicaid application, case status, or general questions about the process, is through their online chat. Hold times are ridiculous (I’ve never had one less than 30 minutes). If you get on the chat in the early morning, before 9 am, you’ll get an answer very quickly. All you do is go to jobs.utah.gov then click on “myCase” under “Assistance”. Scroll down and at the bottom right there’s a button that says “Let’s Chat!” Just click on that, type in your question, and wait for a response.

10. Once you get on Medicaid, you’ll have to go to a class to choose which plan you want coverage through. Yeah, I don’t get it either. I thought Medicaid WAS my plan. Anyway if you have doctors you like, you need to check with them personally and ask if they take Medicaid, and if so under which plan. Additionally, you’ll need to know which plan goes with which hospital. For example: I wanted to keep my OB/GYN, so I had to check with him and found out he only takes Molina. This also means that instead of having the option of delivering at UVRMC OR Mountain View, I now HAVE to deliver at Mountain View. To keep my doctor, I chose Molina coverage. This also means that if I want to go to the local emergency clinic I have to go to the one in Spanish Fork instead of the one in Springville. Red Tape. Gotta love it.

11. Keep in mind all the other great programs that are connected with your Medicaid application. Medicaid is ridiculous to get onto, but if you qualify you should do it. In addition to that, you can get on Food Stamps, which is basically a credit card that they load up for you to buy food with. I’m not on this program at present, so that’s about all I can say. If you make too much for your family to qualify for Medicaid, you can at least get your kids covered through the CHIP program. This costs a manageable yearly fee, I think it’s near $75 a year per kid (possibly less, don’t quote me on that), and the coverage is I think quite comparable to Medicaid.

Be Come by Jill, May 2006

The Spirit of the Lord speaks to me
It fills my heart
It fills my soul with truth

I am close to God in the quiet hours
I am close when I seek
to do good
to do right
to help others
to be at peace

I feel His love in those who surround me
They fill me with love
And show me the way

I search his words
I search myself
And I can see the things
that are good
or bad

I know I have to change
to come to Him
And with Him dwell

I need to grow
I need to be
I need to come
to Him.

Sabbath Peace by Jill, March 2006

Hymns of praise to Him
Whose life for me was giv'n
Lift me up and fill my soul
with the sweet peace
of the Gospel of love

I love the Lord
I love His Spirit in my heart
I love the gift of Eternity
Given to me

He paid a price He did not owe
He bought my soul with blood
And I in humility go forth
To share His light
through my deeds
and my thoughts
and my joy

Joy that is full this day
Knowing He watches over me
guides me
loves me
and sends His sweet spirit
to fill me up
lift me up
and guide me home.

One by Jill, January 2006

One
Reason
for Life

One
Reason
for Love

Two to Share
Both to Dare
Born to Care
for the Other

Others
Live
Differently

Others
Love
What they See

One
Loved
Perfectly

For All
For Us
For Me

One
Reason
for Life

To Love
As He

I Pray by Jill October 2005

Before I sleep
each night
Before I set out
for each new day
I pray for all to be well

With me
With friends
With those I don't know

I pray for help

for those who stray
for those in need
for those I love

I pray for happiness
I pray for joy
I pray for comfort
I pray for peace

for all

Missionary Heroes by Jill, October 2005

When I wrote this, I thought it was a sonnet. I guess it's really not. Oh well.

Truth is found for me through those who know
The bath of truth, the way we all must strive.
Faith from strength of others helps me grow;
It's there for all to hear - that they might live.
I ache for those who say they can't believe,
Who turn away from truth, from love and peace.
Those who go forth, comforts and friends they leave
Cause my heart to swell, my pride increase.

The word of God makes my heart to sing.
I want to be a part of this great work.
From far and wide members are gathering
To hear that which will guide them from the murk
of the world, the darkness all are in
Save those who grasp the rod with all their might
And lead their fellow men back to the light.

Let's kick off the poetry section with some LDS Literature!

I've been having an interesting discussion with some friends on Facebook about LDS Literature and its lacking-ness. From that discussion I've reached the conclusion, once again, that nothing will change unless I do something about it myself. That goes for the rest of you, too, so quit griping and get producing!

I have noticed, at least in my own life, that Sundays are usually the only day for spiritual aspects to be found in life. What good does that do, deciding on Sunday which parts of life are spiritual but then not noticing them when they actually apply? Back when I was in college I managed to find spirituality everywhere, and I think maybe my busy lifestyle has just made it so Sundays are the only time I reflect on my religion. I was a lot more spiritual before I had kids, let me tell you that. lol. That's not an excuse, and I didn't mean it as one. I'm just saying I need to kick start my life again.

So here goes. I would like to get back to writing poetry. I'm not sure what I've written is any good, and looking back I know much of it isn't. But I'd like to share some of my poems here, and I'd like to start with a few of the religious ones I wrote in college. I'm going to put them in different posts, leaving this one to be an explanation of things to come.

Sleep Training: Some Key Elements and Suggestions

(Originally posted over a year ago)

I wrote this up during work over the past few days. I've just been noticing lately how well Rachel goes to sleep, and felt it would be nice to share my process with other new moms so their children can learn to enjoy sleeping. Feel free to ask any questions or leave any comments you may have.

Sleep Training: Some key elements and suggestions.

This information is culled from several books and online sources, as well as from conversations with family and friends who have had similar success. I’m not trying to say I’m an expert, I just know that this method has worked very well for me (so far) and I want to pass the information along so that others can sleep as well as I have been for the past year or so.

First, the Keys. These are things you should remember throughout the process, which will help you understand your child and give him/her what he/she needs.

1. Babies need A LOT of sleep. Up until they are about 2, they should sleep about 14-16 hours. It is better to make sure your child is getting the right amount of sleep BEFORE attempting to sleep train them, and especially important during the training. If they take the training harder than expected, try to help them catch up during the day.

2. Babies will do better if they set the schedule. Let them sleep when they are tired, and adjust your routine accordingly.

3. Babies understand your contact with them. If you leave them in their crib while you watch them cry, they will only understand that you are nearby but not helping them. It’s better to leave the room entirely and let them figure things out on their own.

4. Babies thrive on routine. Make sure you do the same things AT THE SAME TIMES each day throughout the sleep-training process and beyond. They will adjust SO much better in this way.

5. Once you decide to let a scream fest ensue, you have to carry it out. If you let your child cry for 20 minutes before picking him/her up, he/she will learn that that’s what it takes to get you to pick him/her up. If you let it go for an hour before picking him/her up, you’ll have the same problem. This only teaches your child that he/she needs to scream longer to get you to pick him/her up, and this pattern will continue. If you wait longer than about 15 minutes to pick up your child, you need to wait it out.

Now for the steps to sleep training your child. I’m including my own experience for reference purposes. Keep the keys in mind as you go through these steps, and always keep in mind your child’s needs before your own.

1. Your child needs to learn to go back to sleep on their own. For this reason, it’s best to start sleep training with night weaning instead of bedtime. Your child will find it easier to go back to sleep if they wake up when they should be sleeping to find themselves in a dark room and feeling extremely sleepy to begin with. Once they get the hang of this concept, it will be easier for them to learn how to go to sleep from being wide awake in the evening.

Experience: At the time, my Rachel would go to bed at 7:30 and wake up at 1, 3, and 5 for mid-night feedings, before waking up at 6:30 for the day. We decided to start sleep training around 7 or 8 months mainly because I just wasn’t getting enough sleep due to waking up 3 times a night. We first took out the 3 am feeding, then the 1 am feeding, then the 5 am feeding (we did this one last because since the day she was born she woke up at 5 to eat, so we felt this would be the most difficult).

2. For night weaning, the best thing to do is just leave your child to go back to sleep on his/her own. This will be HARD! The first night it might take an hour, the second maybe half, but after a few days your baby will figure it out and thereon only grumble a little bit before rolling over to go to sleep. Remember that your child needs your love! For the first few nights it is fine to comfort your child, but try not to take him/her out of the crib. Pat his/her back, hum softly, declare your love, but whatever you do DO NOT FEED YOUR CHILD! This will defeat the purpose.

Experience: This was difficult for us as parents because we shared a room with our daughter, and listening to her cry for an hour some nights was not easy on our emotions or our sleep. One night in particular she just could not go back to sleep. After a while of her crying, we took turns rocking, cuddling, and singing to her. In this way we were able to get her back to sleep without feeding her, and she didn’t end up just crying all night, which at the time seemed inevitable. It’s important to use your parenting intuition in cases like this, and remember that YOU decide what your child needs and when. If a book tells you to let her scream for 2 hours, but you feel like that is just out of the question, then don’t do it. The most important thing is to love your child and give him/her what he/she needs.

3. Give your child time to adjust between the removal of feedings. Waiting a week AFTER your child has successfully skipped a feeding will help the next transition go more smoothly.

Experience: We first removed the 3 am feeding, because we felt she could still be hungry at 1 and 5 am. After a good solid week of her sleeping straight through from 1 to 5, we decided to remove the 1 am feeding. We chose this one for the reason mentioned above, that she was very accustomed to the 5 am feeding, and also because I wasn’t getting enough sleep. Give at least a full week of good sleep to your child before removing another feeding, and only do one at a time.

4. Once your child is sleeping through the night you can move on to bedtime. Many books will tell you to sleep-train for bedtime and that full-night sleeping will follow, but I found it easier to TEACH the child to go back to sleep at a time when she was fully tired rather than trying to convince her of something I couldn’t explain. It’s best to have a good set routine surrounding bedtime that is somewhere between 15 and 20 minutes long. If it’s longer than that your child will have an easier time prolonging bedtime, or wanting to. A quick routine teaches them that hey, it’s time to go to sleep, so let’s do our thing so we can get there. It is VERY important to put your child to sleep at the same time every day, so you’ll need to adjust the start of your chosen routine accordingly. If you are still feeding your child right before bed, be sure that this is the FIRST step, not the last, in the routine, so that your child will learn to GO to sleep, not to be FED to sleep. This goes for either breastfeeding or bottlefeeding. It is also important to make sure that all, or at least most, of your decided routine are always present, so that your child understands what happens leading up to bedtime. Later, after your child has the whole “going to sleep” thing down, you can add or remove pieces without too much trouble. Again with bedtime, you need to put your child in bed and let him/her figure out how to fall asleep on his/her own. Even though you’ve done the training for night weanings, it still may be hard for your baby, so you may be in for another night or two of an hour of screaming. It is EXTREMELY helpful if you leave the room for this part, and even better if you can get to a place where you can’t hear your baby.

Experience: Rachel’s bedtime routine currently starts between 8:30 and 8:45 so that she can be in bed by 9. Each night she gets into her jammies, brushes her teeth, and reads scriptures and prays with her parents. On bath nights we start earlier so she can take a bath first. Sometimes we don’t time it right and she ends up with some playtime in between jammies and scriptures, but since the routine was established and followed for so long she still knows what to do at bedtime. After scriptures and prayers she gives Daddy hugs, then I rock her and sing a lullaby. I have found this to be extremely important for two reasons: 1) When we were night weaning her, we sang to her instead of feeding her. She found this very comforting, and we’ve incorporated it ever since. 2) Sometimes with so much play during the day, I don’t get a chance to snuggle with my baby very much. The time I have to rock her is probably more therapeutic for me than for her :D

5. Next is naptime. This is a little bit more difficult, because your child is usually WIDE awake right before naptime. Another complication is that many mothers sleep with their babies while nursing them, and this makes it difficult for both parties. I’m not saying this is bad to do! I’m just saying you have to learn WITH your baby to not do it anymore. I read a lot of things while I was nursing telling me to not nurse my baby to sleep because of all the later complications that would arise from this practice. I also read things telling me not to give my child a bottle or a binky until she was 6 weeks old, but that doesn’t mean I followed either piece of advice, and my child has turned out just fine. I am firmly of the belief that children are SMART and can learn whatever you need to teach them. So go ahead and nurse your baby to sleep. Doing so was essential and wonderful for me. But you have to stop for sleep training to work. It’s as simple as feeding your child and THEN putting him/her down to sleep. One thing that will help in this practice is timing your feedings. Don’t let them go over 5 minutes, and once you can get them down to 3 your child will adjust to staying awake while eating. The same practice works well for naptime as for bedtime: Put your child in the crib and let him/her cry it out for a bit until they figure out to go to sleep. Like I said, this will be harder for them than night/bedtime sleep training, so be patient, and go into another room where you can’t hear them if you have to.

Experience: Naps were hard for Rachel. I had to check on her and reassure her more often than with bedtime, but she eventually got it. Being upset before naptime did disrupt her sleep habits. Instead of sleeping for 2 hours, she would sometimes only sleep for 45 minutes. I always made sure that I rewarded her for GOING to sleep by getting her quickly when she woke up. After a while she adjusted back to sleeping for 2 hours, then for 3 when she downsized to one nap a day. Sometimes she still thinks she wants to wake up after only an hour, but I employ the same practice of letting her figure it out on her own, and she goes back to sleep for the full 3 hours each day. This has been a real blessing for me. Now that she is 20 months old, she LOVES and awaits naptime each day. A routine is also helpful for naptime. She eats lunch, then gets a new diaper, and then it’s naptime. She knows this, and sometimes she points me where to go. She always puts her head on my shoulder and rubs her eyes on her way to bed, and she falls asleep in minutes. Through sleep training she has learned to enjoy her sleep time, and when she has to miss a nap or go to bed late she makes sure she lets us know how upset she is.

So there you have it. That is sleep training in a nutshell. I know that “sleep training” has received a lot of negative connotations in some circles, so please don’t get the wrong idea here. I am a nurturing mother, not a strict disciplinarian, and I just don’t know a better way to describe how I’ve taught my daughter to sleep without calling it “sleep training”. My number one rule is to give your child what YOU as the mother feel he/she needs, so ALWAYS keep that in mind. If this system doesn’t work for you, find something that you feel good about and go for it. Just remember, sometimes you have to do hard things to teach your children. Also please remember that raising children is more work than a lot of people realize, and not because your children make it difficult. It’s more about learning and adjusting as a parent, and it’s a continuous process for you just as much, if not more so, than for your children. You have to be willing to make sacrifices and changes so that your child can have the best learning experiences early on, before it will be truly painful for them.