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HELP..Insurance question!

Discussion in 'Parents of Children with Type 1' started by Mom2asweetdiabetic, Dec 29, 2015.

  1. Mom2asweetdiabetic

    Mom2asweetdiabetic Approved members

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    I am hoping that someone could give me some insight for I am SO lost and confused. We recently were told that our BCBS of IL plan was being discontinued and that we would be booted to a new plan for 2016. After getting the info in the mail I went to talk to my husbands work insurance agency and after trying to select a new medical plan was told that with our family size and my husbands income we were all eligible for Medicaid and because we were we were not going to be offered a subsidy on any BCBS plan if we chose to keep private insurance. After reviewing the plans, the premiums were OUT OF THIS WORLD expensive, 1400 a month and the deductibles and out of pockets was something we just could not afford. Long story short we chose to go with the medicaid as our primary insurance only to find out today that we do not qualify after all and that we need to select a private insurance plan. After logging onto the marketplace I found out that our Diabetic son qualifies for medicaid but the rest of the family does not. The insurance agent told me that he could not be on 2 insurance plans, meaning the medicaid would be his only insurance. Has anyone heard of this? I dont understand why they would just pick one of my children? I now have to make the decision of paying extremely high premiums (we wont qualify for subsidy if we choose to put him on private insurance) or keep him on the state insurance. I know nothing about medicaid nor what they pay for. He is on an insulin pump and a CGM which I am worried now that we wont get coverage for and have to pay out of pocket for. Does anyone have experience with this or have a state insurance as a primary? I did a search and only could find it being used as a secondary? Any advice would be GREATLY appreciated

    Thank you in advance!
     
  2. MomofSweetOne

    MomofSweetOne Approved members

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    A friend's child has been/is on Medicaid. She's talked about limits on test strips, pen caps, Omnipod & Dexcom not covered. Probably others here can tell you more. Why was your plan discontinued?
     
    Last edited: Dec 30, 2015
  3. msschiel

    msschiel Approved members

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    Here in PA, we were eligible for Medicaid as soon as he was diagnosed, as is most any child with a medical condition, I believe. We use it as our secondary insurance, which picks up any extra costs (except CGM's and Omnipod) that our primary insurance doesn't cover. Also in PA, if any child, regardless of income, doesn't have insurance they automatically are covered by CHIP (Children's Health Insurance Program) for either low or not cost. My dh's company got new insurance a while back and a co-worker's son was on allergy shots and they were going to be around $100 a week for shots, when they used to be only a co-pay of around $20, or something like that. He immediately pulled them off the work insurance and they were covered by CHIP. We have been debating doing this for our other two since we pay the same amount for the family plan no matter how many kids we have on it. At least then we would get vision and dental coverage, where was we pay OOP for those things now.

    I would definitely check to see if you have a program like CHIP for low or no cost. Without over time, we still qualify for the no cost plan here in PA. I hope you are able to figure something out. I am really not sure how my parents paid for my dad's diabetes supplies all these years, sometimes even without insurance!
     
  4. Butterfly Betty

    Butterfly Betty Approved members

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    My kids have been on Medicaid for a few years, after my husband lost his job and there went our benefits. Medicaid covers her 300 strips a month, fifteen pods for her OmniPods, and paid for her new pump. They also cover her insulin. Now that hubs is making more, we've been moved to CHIPs, which still pays for everything. We have a $5 co-pay on her insulin, but everything else is still 100% covered. The only problem we've had is how slow they are to process renewals. I have to stay in them like glue.
     
  5. Mom2asweetdiabetic

    Mom2asweetdiabetic Approved members

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    Thank you so much for the responses. We are not sure why BCBS dropped the plan we are on. Its something that I noticed lately they do every couple years if not every year these days. Seems like when we find a plan that kinda works for us, they change it :(
    I will look into the chip insurance for sure. Hopefully that is something that we can get him on to help out further.

    Thank again for taking the time to answer
     
  6. hopefaithlove

    hopefaithlove Approved members

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    We live in ohio. I carry private health insurance on my son but because he has diabetes, he qualifies for BCMH as a secondary insurance that picks up the expense of his diabetic supplies, copays, hospitalizations or whatver related to his diabetic care. So my primary is billed first and then bcmh. We are extremely thankful for this program. He's in dexcom and omnipod with no problems, just need PA from doctor. This is a form of medicaid in ohio, bureau of children with medical handicaps. I would check into this in your state, our childrens hospital got us started with the application. I hope everything gets figured out!!
     
  7. Nancy in VA

    Nancy in VA Approved members

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    Our insurance plan changes every year through my husband's company. For the past few years, its been through the same insurer but before that, we had something different. We have never had an open enrollment that didn't result in a plan change, whether it be insurers themselves or just premiums, deductibles, etc.
     

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