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No health insurance- in oregon

Discussion in 'Parents of Children with Type 1' started by valerie k, Jul 22, 2012.

  1. valerie k

    valerie k Approved members

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    when I moved to oregon, I tried to get on to the oregon health insurance for the kids. I work part time, and ken still doesnt have a job. So, me getting it isnt an option. Ken was the carrier of insurance till his job was deleted. As I said in another thread, I couldnt get matt into school becouse of the mn dr health form wasnt good enough and needed an oregon dr to fill out the health care for the school, the dr that will be caring for matt.

    I found out friday, we were denied, becouse someone made a typo in our address and we didnt get some form they needed, once denied, all you can do is re-apply. And wait. I have been waiting and waiting. matt hasnt seen a dr since last november. I am running out of supplies. And becouse of someone elses mistake, I am starting back at square one. ONCE DENIED :mad: like it was my fault, its thier fault.

    So, please, any tips and tricks, is there some other form or avenue I should be taking? Is there a federal insurance I should be looking into? I was trying for oregon kids care. I am living paycheck to paycheck, I dont have the money to take him to a dr, and every clinic I have called, is a cash only upfront basis becouse we dont have insurance, Needless to say, I have about a month to get it together. I have no idea what the school system is going to say becouse I dont have thier stupid forms yet. That, and my daughter also needs the whooping cough shot to enter the 9th grade. :mad: they let her slide the end of 8th becouse it was only a month that she was in school.

    there has to be an easier way.
     
  2. Joretta

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  3. sooz

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    Perhaps if you contacted your local state legslative's office in Oregon they might help. Often they can work wonders in cutting through the bs. Just a thought. Also if you haven't done so already meet with your superintendent of schools or some school board members. They are there to help for goodness sake. It must be so frustrating!
     
  4. TheLegoRef

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    I'm not in Oregon, so I can't offer advice on insurance, sorry. :(

    What supplies are you running low on? (specifically)
     
  5. caspi

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    Are you applying for private insurance or public assistance? If it is public assistance, I would go into their office first thing Monday morning and explain the situation - there was a clerical error and you have a son with Type 1 Diabetes that requires medication and a physician ASAP.

    As far as your daughter's booster is concerned, I am sure there has to be a medical clinic that offers free immunizations.

    Good luck! :cwds:
     
  6. Mommy To 4

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    I am in Oregon as well. The public health department offers low or no cost immunizations based upon income. Check your county listings for an office near you for your daughter's booster.
     
  7. Lisa P.

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    This is, in my opinion, one of the toughest things about getting state assistance. Most people wait to apply until they know they really need it, they don't want to apply a second before they have to, and don't realize that it can take forever to get the wheels rolling in the bureaucracy. It's really unfair, it rewards folks who apply on a "just in case" basis and punishes those who try everything else before going to social services.

    O.k., here's my best advice from my experiences, take or discard what you will.

    Get yourself the forms the school needs and send them to the previous doctor, you have already paid that doctor to hold your son's records and it is their obligation to get the information you need to you in the form you need it.

    Find out exactly what the cost is for the doctor appointment, and talk to the billing department. You will probably be first told the appointment is $300 or more, but that number is really just made up, no one actually pays that. You may be able to negotiate them down to $150 -- I'm assuming this is an endo you are talking about. If it's a general pediatrician, you may be able to get it lower, or on payments. Ask how much you have to pay up front. It may be as little as $50. I know when you don't have anything, that's a lot, but sometimes we just assume out of pocket is entirely undo-able and never look into it. Also, talk to their billing departments about how you qualify for state aid but the paperwork hasn't gone through yet, when we were on COBRA a ped front desk person tried to treat us like trash because the paperwork hadn't gone through yet, I called the billing office from her desk and had the person there talk directly to her.

    My understanding is that for Medicaid, you can apply for it up to three days after services are rendered. Tell the office you will be on Medicaid, if that's the case. When they ask, "What is your insurance" just tell them "We'll be on Medicaid, but we don't have the paperwork back yet." That may be all they need.

    Look into other forms of state aid. Food stamps usually are a faster process than other forms of assistance, depending on the state, with less paperwork. If you can get $300 worth of groceries paid for each month, you can apply the money you were spending there to medical.

    Don't forget private charities. If you belong to a church, talk to the pastor. Many congregations are able and willing to help in a pinch, especially if you can say exactly what you need and how much it costs. Groups like Catholic Social Services often have a generic fund for needs, you don't have to be a member of a church, a Catholic, or even believe in God to get help from them, they serve you because *they* are Catholic, not because you are. If you are near a Catholic hospital, call and ask if there is a program there to help you. Call the companies that you use for supplies and ask if they have any programs to help someone in your situation.

    http://www.catholiccharitiesoregon.org/

    I agree with Caspi that walking in the front door with social services is best. My experience with applying for state aid tells me it's a lot of work and sitting around, sometimes you really have to do the job for them.

    I second health departments for boosters, and they may also be able to advise you on the rest. Local pharmacies can give you a booster for under $50, that's still a ton of money but at least you don't have to pay the additional $150 for a doctor appointment. Clinics may or may not be willing to give just a shot, and may be cheaper than Walgreens if they are.


    And, of course, there's all that advice you've already heard -- gold is high now, sell any broken jewelry, ask family for help, if you've got a degree look into substitute teaching, it will get you $80 a day, yada yada. I'm sure you've looked already into ways to scratch together a few bucks for this!

    Best to you sorting through the system.
     
  8. CAGrandma

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    I just took a look at the Oregon Health Plan Handbook (pdf, online) and it does say that you can request an emergency hearing if there is a medical necessity that can't wait - definitely type 1 would qualify. There are phone numbers to use to make the appt. The previous posters are right - you can't wait for the paperwork pushers to get around to you. In person is much faster.
    If you can locate the doctor you would like to have once you get the health insurance, you might be able to talk to their office about accepting the kids as patients and even helping with the paperwork.
     
  9. TheLegoRef

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    I've only seen this once, but I saw test strips at Salvation Army once. You could call around and ask, if you have any near you, depending on what type of supplies you needed.
     
  10. C6H12O6

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    I would say probably someone donated them after a death. I saw a meter and test strips once at a thrift store too though.

    you really don't know how they have been stored though
     
  11. valerie k

    valerie k Approved members

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    thanks for the replys, I have tomorrow off, and will be back at the office to see what I can do, and request one of those emergency appeals. I want to try and leave no stone unturned.

    Im trying to do what I can, I had hoped at least I could get from my job, but I guess not untill sept/oct for open enrollment. THis last year, man, has really taken a toll, with my husbands great paying job going down the tubes, to our looseing our home, and it just keeps flowing. the old saying, without bad luck, I would have no luck at all is true.:p I used to be the one that could help others, to the one needing the help. I still have the faith, this is a test, a hard one, but a test. We will survive. (and I dont care what you say, ramen noodles, suck :p, guess whats for dinner here :D )

    And in todays mail.... an old EOB from our insurance that ken had with his job. The one we used to get matts pump. The one we talked to minimed and found out what we had to pay at the time, and did so... you all know what I am saying... HOwever, the insurance decided that it didnt have to and isnt going to pay 883.00 and that will be our portion. Talked to minimed, and got that great response, well, we just estimated at the time, we really have no idea what your insurance will pay.... and sorry, you will now have that lovely 800.00 bill. :rolleyes: yippee!!! we have had that pump since december... does it really take that long to figure out? And yes, asked about the 500.00 trade in, and without that, our portion would be 1300.00. That light is shining at the end of the tunnel, very faintly, but shining. :cwds:
     
  12. Lee

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    You do not need to wait for open enrollment - you had a life event, which qualifies to get on your insurance policy.
     
  13. valerie k

    valerie k Approved members

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    not according to my work, I should not have waited I would have had to get insurance as soon as kens was out. However, we were moving, I took a leave, then the transfer to oregon, and guess Im out of luck. since I am also part time, when I can get insurance, I can cover me and the kids, I cant cover ken.:mad: and I cant get dental or vision and life insurance. I can get these things if I am full time, which in todays times, is next to non-existant, why hire full time, when part timers do just fine. Less bennies.....
     

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