Medicaid Questions

So the social services office sent me some forms for my doctor to fill out regarding my diagnoses, etc to determine if I'm eligible.

Well, I got laid off so I no longer have that doctor and when I call the office, Kaiser says my doctor can not fill out the paperwork if I am no longer active with them.

Social services is well, everyone knows, not very helpful because they want to discourage as much as possible.

What can I do about this? I haven't seen another doctor since my issues started. I need medical assistance. I need to get this stuff figured out. It's not just GI issues, I have 4 brain lesions and neurological issues as well.

Who says the doctor can't fill it out? The insurance company? BS!.....it is for something that was treated by that office......what about your medical records from there? They should still have them - I believe legally they have to retain them for a certain amount of time......

I became inactive at Kaiser on 8/13 after I got laid off from work. I haven't filled out the TASC forms yet for Cobra because I don't know how but we can't afford continuation of coverage anyways. They want like $700 a month! Wow! All of my paychecks were pretty much paying for my medical care.

Yea, the medical records department at the Kaiser center here in Annapolis said that because I'm not an active member of Kaiser, then the doctor can not fill out the forms. I'm like well what about people that lost their jobs without notice?

Should I call Kaiser insurance company and see what my rights are?

I don't understand why people at social services offices are so rude. It doesn't seem logical since it is "social work". Aren't they supposed to be nice and help people? What is this world coming to *frustrated*

I'm almost finished filling out the forms for Medicaid. They want so much information and it's very very troubling for me to re-live my pain on paper. Even though I deal with a ton of disabling symptoms every day, I usually just try to ignore them and keep moving.

It's very emotional for me to tell them how I have to take breaks every 10 minutes and how my husband has to carry me when I'm unable to walk, how I can not walk up the stairs without stopping because my legs hurt so bad, how I am unable to exercise or take hot showers or do dishes anymore because the heat excaberates symptoms.

P.S. I was right in the middle of an MS diagnosis with 4 brain lesions when I was laid off. I'm on these forums because I have a lot of GI problems as well and they suspect colitis.

I can't offer any advice but I definitely feel for you about the frustration of paperwork. I'm in the process of trying to get Family Medical Leave, and my doctor has to fill out like 6 pages and I don't even know what he'll say since I'm still undiagnosed too. I faxed him the paperwork over a week ago and haven't heard anything back, so I called his office today and they couldn't even tell me if he received the paperwork or what - all they could say was that the nurse would call me back. So, the nurse just called and said that she'd show the doctor the paperwork on Monday. Um, so if I hadn't called he wouldn't have even seen the paperwork? And he hasn't seen it yet and won't for 4 more days? How long is it going to take him to fill it out if that's how long it takes him just to see the paperwork?? And in the meantime until I get approved for Family Medical Leave, I can't call in sick or I'll risk losing my job, so it's just great that they didn't even bother to think about showing the doctor the paperwork for almost 2 weeks! Argh!

Okay Cat, breathe.... calm down... breathe....

Anyway, I really do feel for you and know how frustrating it is when you have to rely on others, especially doctors, to fill out paperwork. Is there some sort of patient liason at Kaiser that could work with you? I agree with Paso, they have to keep your records on file, and you're legally entitled to your medical records if you request them, so at the very least make sure you request those. Could you talk to the doctor directly? Sometimes receptionists are so snotty and they have to stick with their script, but nurses and doctors have more leeway with what they let you get away with, so you might have better luck if you can get ahold of your doctor directly - maybe via email if you have his/her email address?

hi Jamilea,
I agree with pasobuff, the doctor are obligated to fill out the medical forms for you, no matter what the insurance company says. You were a patient there and you have the right to you records. If they refuse to fill out the papers then request a copy of your medical records and get the information off that....
I agree the people at social services are indeed rude and act like you are bothering them, when indeed if it wasnt for people going there to get help from the state they would not even have a job... Keep you head up and dont let them bully you.lol

Good luck.

I would march into Kaiser with the paperwork and reqest the paperwork be filled out, while you wait. If they refuse, demand a copy of your medical records...all of them... and while you wait. If your records are anything like mine...they will prefer to fill out the paperwork.

Last time I asked for my records, I was told I would have to make an appointment but I was already at the counter asking for them. I walked off and a lady came after me and said "Wait, I'll take you to my office and get them for you but you'll have to pay". I said "Okay"

She was really nice but when we got to her office, she got to go on the computer and look through my records (even though she said plain as day that they allow patients to go on and look themselves at what they want), I had to sit in a chair from a far and ask her to click on this or that and she kept missing and scrolling and not really listening to what I was saying.

I eventually got tired of being internally frustrated and did not want to take it out on her so I just asked and waited patiently. There were so many links to different things in my record, I really didn't know what all I needed. I got a bunch of print outs and she said "Here, I'll just give these to you without you having to pay" I thanked her and left.

I don't know if I got everything I needed. However, I do have hospital records, discs of my brain MRIs and stuff from other facilities. I think I pretty much have what they have but Medicaid requests that a doctor fill out a certain form to be considered.

So, is it my records that I need or the doctor's handwriting on the form like Medicaid asked?

I did ask the doctor through email if she would fill out the forms because she had told me previously that she would if I am applying for Social Security. But she told me then that it would have to go through medical records. Maybe medical records just doesn't know. I'll call Kaiser Member Services tomorrow and see.

My husband made me quit doing the forms earlier today. He requested that I do something that I enjoy for the rest of the day. I LOVE when he has the day off. He makes me give myself grace. :shantel:

Your current Dr can get everything he needs to fill our the form for you by requesting your records from Kaiser...and it won't cost him a cent. You just have to sign a release.

I don't have a current doctor. That's why I'm trying to get Medicaid so I can have a doctor again.

In that case, I would contact your State Medical Board and let them know that Kaiser is preventing you from recieving social services you need to get medical attention for a serious illness. They may be an insurance company but they are also a medical hospital/facility.. and all of their doctors take the hippocratic oath too.
I am woman hear me roar!!!!

lol Well then I will call Kaiser company first, not just the Kaiser center I was going to in order to see a doctor, tell them what that specific center's med records people said and ask them if it's possible to have the doctor fill out the form for Medicaid. If they say no, I will try and persuade them. If they still say no, I'll call the state board and do what you suggest. Thanks.

Social services made me feel like I'm not disabled from work because I'm not deaf, blind or legless. They are AWFUL! Maybe I should call the governor if they don't approve me lol

I have Medicaid & I'm hoping I still get to keep it even though I am back to work BUT only 2 days a week & I make less than $300 a month, which doesn't even cover my supplies.

At the time I got it, I was too sick to work and they review your eligibility every year to determine if you still can get it. I don't make enough to live without it and it's great, covers my hospital bills for the most part, my meds, my supplies, I need that desperately. My Mom helped me fill out all the forms when I was too sick & they requested my medical records which are about 5 inches THICK, I kid you not. lol They read like a Stephen King novel.

Good Luck my friend...I will be interested to know how things work out.
Have you been to the invisible illness site?
It is actually National Invisible Illness Awareness week coming up...Sept 13-19. Google it.
With regards to your social dorker:
My facebook status today is....
"In the practice of tolerance, one's enemy is the best teacher".
Dalai Lama
( in case you were wondering...yes I mispelled it on purpose...hee hee)
:hang:

This link may be useful to you, I just found it when I was looking just now & wondering myself about it.

http://www.iidc.indiana.edu/disabilitybenefitsandwork/medicaremedicaid.htm

Wow, invisible illness week? Awesome! Thanks for the link. I shared it over at the World MS Forums for people struggling to get a diagnosis or those who just want to be encouraged.

You are protected by the 1990 disability act. They can not discriminate you because of your illnesses. Can you just call the MD and bypass Kaiser's main number??

What about human resources? Can they offer any assistance? Did they give you any information on health insurance coverage when they let you go or any contact names and numbers to contact in cases you had questions?

I was given plenty of information when I had to quit due to serious health issues and I worked for a hospital. If all else fails, what about going to legal aid and asking them for advice or if you belonged to a union maybe a union rep ? There should be someone you can talk to at the company for employees who were laid off. That is what HR is for.

Good luck.

Thanks Earth Angel. I live in Maryland and have been on their website. Maybe I should ask the county for a case manager or advocate that will help me get approved. I wonder if they have those?

yes, call and see what your rights are as well.

I don't know Gutless Wonder. I was only told by HR that I would receive papers in the mail from TASC to opt for Cobra.

I can not afford to have Cobra.

The Kaiser MD told me she would fill out the paperwork but that it would have to go through Kaiser medical records. I don't want to get her in trouble. She's really sweet.

And I don't know if I'm protected under the ADA, I haven't received a definitive diagnosis yet. I was in the middle of an MS diagnosis when I was laid off.

I just feel like I need help. The paperwork is unbelievable and I'm afraid that being too honest will not get me approved lol

I don't wish to be dishonest so...

I wonder if there is some sort of thing I can find in Maryland where I can get an advocate who will help me do this stuff or something...

The lady at the Medicaid office tried to tell me that I have to apply for Social Security in order to get Medicaid. Is that true?

Can I just request a different case manager?

you are already protected because it doesn't matter if you have 1, 2, 3 or more disabilities. you already have Crohn's disease and they can't fire you for having that. they have to make reasonable accomodations for workers who have certain disabilities or they'd get fined.

They have to assist you w/obtaining coverage for a certain amt. of time (COBRA) and provide information (ex-name, address, phone #, contact person) in case questions come up for those that are laid off. Human Resources is usually the dept. in charge of that stuff.

You don't have to be too honest, just short, sweet, and right to the point. The MD should be filling out the medical part where it says MD. I'd call HR first before jumping the gun and see what they have to say. Then try legal aid in your town. better yet, contact the CCFA chapter in your area and see if you can talk to someone there at their support meeting. There may be some members who work for a lawyer or even a lawyer who has IBD and can offer assistance. you never know.

I live in NY state. that I don't know. are you applying for disability as well?

I'm going to. I contacted an MS disability lawyer in Chicago who is nationwide. He asked me to call his office tomorrow.

People in MD can apply for Medicaid without having SSI. I read it on their website so I don't know why that lady said that. I shouldn't have filled out an online inquiry for Medicaid. There were too many things that didn't give options to explain so maybe my ducks weren't in order. I should just go down to the office and speak to them in person.

a lawyer is your best bet. definitely go see him.

I will call him tomorrow morning for sure. I've been waiting to speak to him for almost a month now. He is Rich Feingold. Well known amongst the MS community as he has MS and is in a wheelchair.

OK, I live in Maryland and my sons and I all have Medical Assistance and it was not that complicated to do. What forms have you filled out and submitted yet? Are you in Annapolis or just Anne Arundel County? I also was with Kaiser before getting MA and never had to have a form filled out by the doctor.

Not to get too personal, but how old are you? That might be the difference between why I had no problem and you are (I'm 40 but my kids are young).

Also, not to defend them (because I'm having issue with them in another area) but Social Services are completely and utterly overwhelmed with work and all government offices are currently understaffed and most employees taking furloughs (unpaid time off). It sucks to be them, but it also sucks to be the one who needs help.

Let me know what forms you're doing and I'll see if I can help you out at all.

Oh Thanks. Cool of you.

I'm 26, married and I don't have any children. They are asking my doctor to fill out forms with my diagnosis and that kind of information because I am claiming disability. I think that's why it's so tedious but I don't know. I could be wrong.

I'm in Edgewater, MD.

I just got off the phone with Kaiser member services. They told me that the doctor is able to fill out the forms, that medical records didn't know what they were talking about. They are on lunch right now but she said to call back and have a Kaiser rep call over there and speak to a supervisor for me. So yay!

Right, yep. A lot of times you get people in admin who try to make up the rules as they go along so they don't have to do the work required of them!

Disability is a whole other issue and not one I've had to deal with. But as for MA, I believe, if you don't qualify for outright full medical cover via the State, you would be eligible for some sort of reduced payment insurance (something a good deal less than COBRA which is a load of hooey).

Good luck!

Yea, they have Primary Adult Care program but from what it looks like, those patients don't have access to specialty care and that's what I need the most. I will just apply, submit the information they ask for. Either way, John's Hopkins said they would help me. They just wanted me to exhaust a few resources first, if that's the right way of saying it so they could keep their resources for patients who can not get medicaid, etc. which I totally understand and I think that's great.

It's just forever because I have trouble finishing and getting organized and then I have to wait for my husband to have a day off to get to the offices.

Yes, Maryland is fortunately pretty good about insurance overall and I'm thankful I live here and not some other states! I agree, though, the hoops are a pain to jump through!

I know that our MA covers some services at JHU, but it seems more of it is covered at U of Maryland. My son has great care there.

Yes, best medical care in the world here, I agree. I know what you are saying about the social services offices however I suppose I set standards too high but my mother taught me at a young age that no matter what you are going through, you are to NEVER treat people rudely. When helping someone, always take the best care of them.

And I do so I don't get it when people go into social work, they are taught that they will deal with difficult people and they KNOW they will be over worked. It's no excuse to treat people that way, I don't care what anyone says.

Okay, that was my rant lol but that's how I really think.

Well that sucks. I just spoke with Kaiser again. They were misinterpreting what I was saying. They thought that I was saying that medical records would not give me my records. I told them I'm not asking for the records, I'm asking the doctor to fill out a form describing my conditions so I can take it to Medicaid.

Finally I spoke to a representative that told me if the doctor fills out a form, that means they saw me and nobody is paying for it so they can't do that. All they can do for me is give me my records to take into Medicaid.

Good grief this is ridiculous!

What exactly is the form they want the doctor to fill out?

It's the Medical Report Form 402B. I'm trying to get ahold of the case worker to let her know what Kaiser said. They'll just have to deal with it because the doctor is not going to fill out the form!

Hah. Good luck getting a case worker on the phone. That's been my big problem. :-/

I still think Kaiser is being deliberately difficult in this regard. Surely you are not the only person who has had to get a doctor to fill this stuff out. I'd consider escalating the issue to the Kaiser supervisors and explain that the doc does not need to see you (especially if you have seen him/her recently). Frankly, they should be able to fill out the form from your medical records. Tell them you'd be happy to take the issue to the Maryland Insurance Administration if you all can't come to some sort of reasonable compromise. I can't post the URL as I don't have enough posts on this forum myself so just Google it.

Well get posting lady! lol Thank you so much. I don't know that I want to escalate it that far. Medicaid is just going to have to deal yanno.

The only problem with letting Medicaid deal with it is that they can be even more stubborn than anyone else. They are all so 'by-the-book' now it's sad. I just don't want this to delay you getting the help you need.

Good luck!

Well, hell. I can't deal with all of this. I don't even have a definitive diagnosis yet. I think that will definitely work against me.

If Medicaid says no, John's Hopkins said to call back and they will still help me. Maybe I should just tell them all the problems I'm having.

Urgggggh!

Ah. Sorry I didn't realize you don't have a Dx yet. It might not hurt to let JHU know the problem as they seem to be set up to deal with problems like this already. Take a break from it today and work on the forms over the weekend? As you say, if nothing else, you can just send all your medical notes in lieu of the doctor's form with an explanation that Kaiser refuse to cooperate.

Don't mind me about escalating your complaint. It just really burns me up when insurance companies get all difficult like this!

I know and you're right. I need to stop with this today and do some other things. I'm going to take a bubble bath lol

Thank you for the support.

Go to the office of the ombudsman at Kaiser and tell them you conundrum and they will assist you. I believe that they have a contractual obligation to provide you with assistance with your medical records and the completing of forms for the department of social service. You might suggest to them that a nice little audit of their policies might be in order. They always love to hear the word audit.

This kind of stuff irritates me to no end. If I lived in Maryland I'd take you down there and get you what you needed. I'm an insurance fraud investigator and trust me they would us what you need to get you the help you need.

Sorry I live in California!

I'm so irritated. Kaiser won't do it either way.

The supervisors at the Medicaid office said they will not accept my application unless I have a medical report filled out by a doctor. I said well I do not have the money to go see another doctor and have all these tests run again.

She said well then you can get a medical voucher from us for $100 and have a doctor run the tests again and evaluate you to fill out the form.

I said it's going to cost more than $100. NO doctor is going to accept $100 to take my history, run an MRI of my brain, give neurological exam, an LP of my spine, a colonoscopy, et et et.

I'm SO irritated!

Your best bet then is to see your lawyer and tell him what's going on. He'll be able to guide you in the right direction.

Oh, for folks who have no insurance, all hospitals in the USA have money set aside for ppl like you on a yrly basis. What you need to do is go to the billing/business office. Request an uncompensated care form to fill out. You will need to provide your W2 form, proof of residence and whatever else they ask of you. Then based upon your income, you will be required to pay 1/4, 1/2, 3/4 or none of the hospital bills you incur. It is good for an entire year. All doctors offices have the same form as well. You just need to call their billing office and ask for the government form to fill out.

I used to do billing at a local hospital for 4 yrs. This is how I know and also I saw signs posted in my MD's office stating that those folks who have no insurance can ask the billing dept. for gov't forms who are truly hardship cases.