VeeGee's Losing Health Insurance

[AndVeeGeeMakes3]

I've done everything I can, and it's looking like we're at the end of the line. We're going to lose VeeGee's medicaid (in TN - TennCare) on the 25th because of a lawsuit that Tennessee won that grants them the right to take children, even those with a dx like VeeGee, off of their rolls. And, of course, she's scheduled to have surgery and all kinds of stuff in the next month. Of course.

My father owns the company that dh works for, through which we get our insurance, and it will just cost more than any of us can afford to add VeeGee to the group. We're so f*&#d. All of us (my brother has Down syndrome, to add an extended wrinkle).

I just needed to moan a little, as I'm off to do a sleep study tonight . . . the follow-up for which, if there's a problem, we won't have the ability to pay for. Good times.

[KatWrangler]

That really is terrible news.

Is there a high risk pool in TN?

Here I found this.

http://www.covertn.gov/web/access_tn.html

[RheaSilva]

I am so sorry to hear about this situation; and very angry as well. You and your family are in my thoughts.

[2boyzmama]

Happy Anniversary, by the way

And boy that sucks. I don't understand how they can deny medical coverage for a medically complicated kid like VeeGee...how is that possible when "normal" kids from low income families have free medical care? I don't get it...and all of that is just rhetorical, just me musing, I know that you've looked into everything you can to keep her insured.



At the Children's Hospitals that Connor goes to, there are signs hanging up everywhere that say "need help paying for medical bills?" or something like that, and it says that even if a child doesn't have medicaid, under certain circumstances they can help you with bills. Connor has two insurances (a group plan through my work and a state-run secondary insurance for medically complicated kids) so I've never looked into it.

What about through your university...is it possible for you to be brought on full time so you can get insurance through them?

[khaoskat]

Depending upon what his Diagnosis is, you can try to get SSI/SSD for him, and he would therefor qualify for Medicaid.

I am sure that they have only won at the initial level, and that the people who are suing them will take it on to the next.

Medicaid and Medicare are federally funded programs. They receive money from the Federal Government to pay for those programs, or a substantial portion of them.

You are in a precarious position, because if someone gets a hair up their backside, they could go after you for Child abuse, neglect and/or dependence, because you are not meeting his medical needs.

Good luck, and hope things work out.

[karne]

Are there ANY options for insurance?

I find this to be so wrong, wrong, wrong, on a societal and moral level. Your situation could be a front page story to illustrate how WRONG this is.

[AndVeeGeeMakes3]

Originally Posted by khaoskat

Depending upon what his Diagnosis is, you can try to get SSI/SSD for him, and he would therefor qualify for Medicaid.

She does qualify for SSI, in that she has received it in the past, and has been deemed medically eligible. We, however, make more than 250% of the nat'l. poverty average, which then boots us off of SSI in our state. We're in the appeal process for that, since I'm an adjunct (funded by stimulus, ie temporary, funds), but that appeal will not conclude until after the insurance has terminated.

Sam, I'm never going to go full-time where I am because of the silly academic disposition to never hire local, that's even if they were hiring, which they're not. You should read the Forbes article about my city when you get a chance (apparently, the third most "miserable" place to live). Which is why I'm on the job market -- if I can get one of the several jobs for which I'm a finalist (), then all this will be moot. Cross your fingers (You'll hear elsewhere before here I'm sure!).

I am sure that they have only won at the initial level, and that the people who are suing them will take it on to the next.

Nope, it's gone to the Supreme Court - it was a 26 year case.

Medicaid and Medicare are federally funded programs. They receive money from the Federal Government to pay for those programs, or a substantial portion of them.

Right, in most states, however Tennessee has a separate mandate for administering medicaid, which allows them to make these decisions.

You are in a precarious position, because if someone gets a hair up their backside, they could go after you for Child abuse, neglect and/or dependence, because you are not meeting his medical needs.

Believe me, I'm aware of the risks. It's how my daughter came to me in the first place. But, I'm not sure what you're saying about me being at risk in particular. I never said I'm not going to pursue her treatment - just that we're totally screwed.

Thanks so much. Somehow, some way, it'll work out. It's just a damned full-time job having three separate appeals in the air at once, oh, and taking care of a fragile child to boot!

(Oh, and did I mention that I just got diagnosed with Ménière's disease? Good times!)

[AndVeeGeeMakes3]

Originally Posted by KatWrangler

That really is terrible news.

Is there a high risk pool in TN?

Here I found this.

http://www.covertn.gov/web/access_tn.html

Yeah, this is probably what we're going to end up having to do unfortunately. But, we're going to have to pay for it plus the deductibles, plus the fact that there are no publications of what doctors are involved in that program (and we've had a really tough time finding the docs that she needs).

Like I said, I know we'll figure something out. It's just so so so frustrating, so invasive (you wouldn't believe what documentation they require), so demoralizing and, ultimately, may not even provide good care.

Again, I'm just moaning. Now I'll go inflict some pain on my students to make myself feel better

[AndVeeGeeMakes3]

Oh, and just one more thing relative to the morality of this whole debacle: If we had left VeeGee in the care of the state, in foster care, then we wouldn't have to be dealing with this at all. We would get monthly payments of almost $500 from SSI and a FC stipend - IN ADDITION to medicaid. BUT, we gave her a permanent home and a family and took on all of her expenses besides health insurance. Silly us.

[2boyzmama]

Originally Posted by AndVeeGeeMakes3

Oh, and just one more thing relative to the morality of this whole debacle: If we had left VeeGee in the care of the state, in foster care, then we wouldn't have to be dealing with this at all. We would get monthly payments of almost $500 from SSI and a FC stipend - IN ADDITION to medicaid. BUT, we gave her a permanent home and a family and took on all of her expenses besides health insurance. Silly us.

You know, I was wondering about this, but didn't want to bring it up.

My family has adopted several times within the family. In one case, it was a formal adoption (not relative foster care) and yet she still qualified for SSI and FC stipend and medicaid. I always wondered how that worked out... Another was never formally adopted, she remained a ward of the state in permanent relative foster care, and she got other benefits since she was officially an "orphan" (she was not disabled, though, so no SSI).

I wonder how that worked...different state of course, Michigan in this case.

Anyway...I have no doubt that you'll figure it out somehow, you're resourceful like that But this really sucks. And you're right, it's so wrong on so many levels...and I like the thought of VeeGee being a cover story to let the public know about the disservices to children like her. I can just see her beautiful face, her bright red hair, her adorable crooked smile on the cover of a magazine...

[workjw]

Just wanted to send s. We're struggling with TN care right now too, and it's miserable. Hope everything works out for you guys.

[heatherdeg]

Originally Posted by AndVeeGeeMakes3

Oh, and just one more thing relative to the morality of this whole debacle: If we had left VeeGee in the care of the state, in foster care, then we wouldn't have to be dealing with this at all. We would get monthly payments of almost $500 from SSI and a FC stipend - IN ADDITION to medicaid. BUT, we gave her a permanent home and a family and took on all of her expenses besides health insurance. Silly us.

I really wonder if that aspect was tried in the Medicaid trials.

I'm so sorry. Could you go to the media and get people fired up about it?

[MotherWhimsey]

vandy should take the cover TN insurance. Linden was on that when it first started before he got booted off when he turned 1.

Linden doesn't qualify for any state benefits or SSI either. It sucks big time. We pay many many thousands of dollars a year in copays and deductibles etc. He costs a few thousand a month to maintain, and that's without hospital stays, so if we lost our insurance we'd be able to afford basic care for about 2 weeks. It's a very scary thing for me.

[mom2mygirls]

your family will be in my thoughts and prayers

[queencarr]

Really, really for you. I like the idea of a media blitz and cover story, but can only imagine what that would take out of you.

[MotherWhimsey]

Originally Posted by queencarr

Really, really for you. I like the idea of a media blitz and cover story, but can only imagine what that would take out of you.

We kinda did one about health insurance cost for MSNBC and while it was mostly a positive experience, it was very stressful and I will never do it again. The comments on those articles can be pretty darned brutal.