Welcome to my
Perfectly Imperfect Life..........

Saturday, April 19, 2014

A Rare Appearance on the Soap Box!

I am SO fed up with this 'new improved health care system'. ..........After dealing with Medi-Cal & CoveredCA......there is not one person that knows their job or even cares to.
T turned 26 in Dec and went off biological fathers insurance. Since he is disabled he applied for Medi-Cal. Was told he did not qualify. And to apply for CoveredCa, he was accepted and signed up for Blue Shield. Everything was fine until mid February when he was told he did not qualify for CoveredCa, that he qualified for Medi-Cal and there would be a penalty come next year in taxes due to receiving CoveredCa when he didn't qualify. Huh??? Nothing had changed in 3 months in our household, wth?   He was told he would be receiving a letter in the mail, that by the time he received said letter he could call Medi-Cal and find out when his card would show up...My concern was he would run out of meds...you know how fast slow things move Letter arrived, he called Medi-cal, they said you do NOT qualify for Medi-cal, you have to use CoveredCA. Told them what he was told and he was told, he was told wrong. Called CoveredCA, he was told he did NOT qualify for CoveredCA, he qualified for Medi-Cal, that they were wrong. I could see a meltdown coming. That's when I took over....either that or the phone was going thru the window!  
 3 days later after waiting for 2-3 hrs. at a time and being ping ponged back and forth, I told Medi-cal that when his meds ran out I would not hospitalize him but bring him down to them and they could care for him while he was off meds and continue to care for him until he received them and once restarted, it takes approx. 6 weeks for his medications to build back up in his system to work. 
~~~~ He had a paper stating he was Medi-Cal eligible the next day in the mail. That the actual State card would arrive in 4-6 wks. Amen, finally we were done. Knew things had gone too smoothly back in Dec/Jan......ha!
March arrives, payment for CoveredCA was taken out of my account. I called Blue Shield, they had no idea that his policy had been cancelled. OK should have known the left hand doesn't talk to the right. I cancelled his policy stating he was told he did not qualify by CoverdCa. They wanted to know why...I said " I dunno, when do I get my money back?" Was told I would have a reimbursement check in 3-4 weeks. Of course, they just can't reverse the charges, that would be too easy now wouldn't it? I have yet to receive that check.
April comes. Another payment was pulled. I called Blue Shield who  again had no idea his policy was cancelled and wanted to know why. I asked why was it not cancelled when I called in March? Response: "I dunno". Asked when I would received my money back? Response: In 3-4 weeks. I waited 10 days and called back to check the status of his policy. I was told his policy was in full effect, payments were current and to use it without worry.
He went from not qualifying for Medi-Cal or CoveredCa to qualifying for both!
Now I have spent too many hours on hold for too many days to care anymore. It is not my job, I am NOT the professional, just a lowly housewife......scratch that. .....single Mom. I am Not the one being paid to keep Medical/CoveredCA Accounts up to date. So I guess he now qualifies for both???!!! I give! I have done my due diligence.
SO.....I figure T can go back to his regular Drs. that he has had for 20 yrs. His disabilities were severely exasperated due to having to lose his Psychiatrist and the thought of losing his Primary Care Physician due to the Insurance change. We are lucky enough to have a Primary Care Dr. who actually cares. He has been treating T and also acting as his 'Psychiatrist' due to the reasons stated above. And hey, with Medi-Cal his Rx's are free.
He lost his psychiatrist because she doesn't accept Medi-Cal. This has exponentially increased his symptoms. I called and made an appointment  with her since he is still ''covered'' by CoveredCa. Why does he have to suffer and degrade due to their incompetency. Oh and yes it much be those violent games that make people take their frustrations out in violent ways.
I have yet to receive any reimbursement for the months his policy was supposedly cancelled. Don't think I ever will.
OK, I'm stepping off my soapbox. I rarely step on to it and consider myself to be quite a patient person and always do what I am told, a BIG default in my personality. Example: my 39 year marriage.......
 I THINK I FINALLY FIGURED OUT HOW TO WORK THE SYSTEM ! albeit accidentally and unknowingly.

So when we end up in jail for using the wrong/right/wrong/right?? Insurance, can someone bake us a file in a cake!


Blog Widget by LinkWithin