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.
No comments:
Post a Comment