Thursday, March 22, 2012

Another Update on Medicaid

I've said before that my adult handicapped son is on SSI. When he turned 21, our insurance company kicked him off the insurance. When I called to ask why, saying didn't Obama make it to where you could have your kids on your insurance until they were 26? They answered only if they're a full time student. I have Tricare Prime, which is in essence government health care. I explained about being his legal guardian, yada, yada, yada. If I wanted to keep him on my insurance, I had to find a Pass and ID office that had a certain form (they don't mail you one) and gather up all the proof that he is my son, he is handicapped (letter from a doctor, who won't see him now that he's been kicked off the insurance plan) proof of who he is, etc. And yet, the government gives free health care to illegal aliens.

So, I started using the Medicaid that he qualifies for through SSI. Well, last August, he came out of his room on a Saturday crying in severe pain. He's Down Syndrome and autistic. I have to know the right questions to ask him, I can't just say, "What happened?" All I could get from him was he hurt his wrist, and it was swollen, and it had something to do with his 20 pound dumbbell. He lifts weights while he watches TV. You wouldn't believe the upper body strength of that kid. Good thing he's good natured.

Being a Saturday, we took him to the nearest emergency room to see if he broke his wrist. I asked in the ER if they took Medicaid, and they said they have to take whatever insurance we have. They didn't even get his Medicaid information until AFTER the visit.

I got a bill from Baylor, Garland and I ignored it. He has Medicaid, so I figured they'd file like they do with Tricare. I got another bill saying my insurance denied the charges and I owed $1248.89. I called. They said Superior Health had denied the charges and were refusing to pay. I called Superior Health. After jumping through the hoops of their phone system, and getting a real person, I was asked how I got that number. Frankly, I had pushed so many buttons, I didn't know. I said I answered all their little questions and that's where I ended up. Apparently it wasn't the right place, so she transferred me. I explained the situation and they said they'd review it.

The next month I get another bill. It was a Saturday, so first I verified they had his Medicaid number and weren't trying to bill Tricare. They did. That Monday I called again. They said Superior had determined it wasn't an emergency. So now, they can diagnose through the phone/mail? I would like to know when they think I got my medical license that I can tell a sprain from a break. After jumping through all the hoops again, and getting transferred, and 45 minutes on the phone, my only option was to file a complaint with the State of Texas. I was told Baylor doesn't accept Medicaid. I thought all emergency rooms were supposed to take whatever insurance you had? I was also told that I should have either known this, or called to verify. When you call the number on the back of the card, the first words you hear are if this is a true emergency, you should hang up and proceed to the nearest emergency room, which is what I did. I explained about his disability. If the lady hadn't been Hispanic, I would have asked if all the illegal aliens have this problem. It's not like I use the ER for a doctor, taking my kid when he has a sniffle. I THOUGHT HE HAD A BROKEN WRIST! I told her if his wrist had actually BEEN broken and I had waited until Monday, they would have taken him away from me for being negligent. Or accused me of breaking it.

Then a couple days ago, I get another call for more information. I was told that if there was any doubt, I should have called the free 24-hour nurse hot line. I said there wasn't any doubt as to whether it was an emergency or not. My mom is a nurse, I know the only way to determine if a bone is broken is to x-ray it. A nurse on the phone is not going to tell me if his wrist is broken or not. I reminded her that the first words I hear are if this is a true emergency, please hang up and proceed to the nearest emergency room. I also explained about the way I have to get information from him. I suppose next time, I'll have to put the phone on speaker and let them try to question him. Again, I got a Hispanic woman, or I would have asked if all this information is something I'm supposed to just know, like a 3rd generation welfare recipient, or is it written down somewhere? And why are government rules for getting care so much different than common sense? Oh, wait, I answered that in the first part of the sentence: government health care. It's not about service to the community, it's about making the public say, "Please, may I have some more, please?" He's the only one in my household on Medicaid, so therefore, my taxes are paying for his health care. What about all the people who every member is on Medicaid? I pay for their health care too.

So, this is how Obama plans on paying for his Obamacare? By denying services and making you pay the hospital yourself? That will save a lot of money for the government. All you people who expect a handout better sit up and take notice. Unless you think it's only going to happen to me, or people who have a job and pay taxes.

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