Re: Health Insurance Questions

[Guest guest]

Thanks, --looks like I'm stuck with group coverage--at least for

now. I really don't want to move to individual coverage since the benefits

are not as great.

I am working with our nonprofit management center here to develop an

affiliation group so that more nonprofits can go in on the same pool for

insurance. I hear so many of the same complaints--too much insurance, high

risk pools, etc.--and we think this may help. We're still in the

researching phase and it could take another year to pull it all together.

Ray, mother to Tabitha (age 6), Autumn, age 4 (IgG def., asthma,

chronic sinusitis, and allergies), and Duncan (9 months)

[Guest guest]

Hi ---

Are you going to school at Wash U??? I'm originally from St. Louis and was just

curious.

Thanks,

---

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[Guest guest]

I'm glad that someone else had a clearer idea of what TEFRA is about. I

had thought that it was kind of an interim insurance program, but yesterday

received a healthcare bulletin in the mail that mentioned TEFRA and the

fact that a child can get medicaid coverage regardless of parent income

based on exorbitant medical costs pertaining to child's health. I also

thought it strange that they considered the child's income rather than the

family's...guess there are some rare cases of trust funds, inheritances

etc. that could apply and make a difference to some people. Anyway, it

sounds like a great program, which may keep people from being stuck in a

low income bracket to qualify for state insurance, as a few of us are.

I wanted to bring it up again, though, more to encourage anyone whose state

has such a program to be very outspoken about the need to keep it funded.

One of the cautions in the bulletin that was sent to me was the fact that

the Arkansas state government is looking at places to cut funding to meet

the budget. They are currently looking to cut TEFRA benefits unless there

is enough people that speak out as to how important it is. It sounds like

the one option some of us would still have in the event that there is a job

loss resulting in loss of insurance coverage, which is becoming an all too

frequent event with so many businesses closing during the recession.

Please let your congressmen know how important this program is.

God bless,

Wenoka

At 04:00 PM 02/24/2002 -0000, you wrote:

>Hi!

>I wanted to let you know the name of the Waiver is called

>Beckett. Or when you get in contact with someone ask for info. on

>the TEFRA Waiver. Blake has had this since he was 4.

> We went through the DSS here in SC where we live. it had to be

>proven that Blake was better off being cared for at home, and we had

>to do this by getting all of his Drs. to write letters to the DSS

>telling them that all Blake's " problems " were as real as they were

>and that we in no way could afford the left over bills after the

>insurance paid.

> Another factor with this, is they consider the child's income. T

>Which I beleive that there are not too many 4 yr. olds working in the

>work force right now. They don't worry about your income. All you

>need to do is go to your local SSI office fill out the form to get

>SSI. When they send you the form saying you are denied coverage

>through them, go to DSS and ask for the TEFRA form. This waiver is

>updated by your local DSS office every 2 years. Then they get Voc

>Rehab. to look and deem it nessary to continue with the waiver for

>the particular child. That is the one down fall of all of this. The

>voc. rehab. can turn the child down if they even think the child can

>work with his condition as an adult. Another reason for doing this is

>to prove it will be cheaper to treat the child at home rather than in

>an institution.

> I was floored when they first turned Blake down saying that as an

>adult with his problems he would be able to " manage " as an adult.

>Well needless to say I appealed the decision. I wrote a letter

>discribing life with Blake as a 4 yr. old. What really helped was he

>was in a program for children that wer born prematurely with numerous

>developmental delays. Blake was also in several therapies. I told

>the Judge at the hearing that Blake was just as stressed as his

>parents were about dealing with all the stuff he goes through on a

>daily basis. We also had several letters form Blake's Drs. and

>teachers about his daily activities. We also had to show how hard it

>was on Blake to miss so much school because of the thrapies and

>traveling back and forth to the hospital with him. We had even

>enrolled Blake in a regular class for children his age, but had to

>put Blake back in to the other class because he could not cope or

>keep up with the other children his age.

> Well this year when Blake went up for review, they never questioned

>his coverage. They saw how much school Blake missed and then how he

>had to be placed on complete homebound because of his immune system,

>plus, Blake spent 15 weeks in the hospital for a rare bone

>infection. He was given automatic coverage without questions asked.

>

> This program, Beckett, is named after a girl in Nwe York.

>She was living on a ventilator and could not get SSI becaues she had

>insurance coverage and her parents both worked and had too much

>income to get the SSI for the child. But all the family wanted was

>medical assistance for . They were not interested in getting

>a " check " for her, just some help in covering her medical expenses.

>They had it palced into law I beleive in '68 or '70. I'm not quite

>sure.

> You know every little bit helps when you have to face the day to

>day routine all of us her a sparents of a PID child face. It does

>not hurt to try and get the best help for theses little ones.

> Well I need to close. I hope everyone has a good day.

> (Mom to Blake a PID child)

>

>

>

>

>This forum is open to parents and caregivers of children diagnosed with a

Primary Immune Deficiency. Opinions or medical advice stated here are the

sole responsibility of the poster and should not be taken as professional

advice.

>

>

[Guest guest]

I wanted to post this link that I found today. Thought

it might help some people.

http://cmc.mcg.edu/handbook/financial_resources.htm

Ursula Holleman

Macey's mom (6 yr. old with CVID, asthma, sinus

disease, GERD, kidney reflux, Sensory Integration

Disorder, Diabetes Insipidus)

http://home.att.net/~maceyh/

[Guest guest]

Canon wrote:

>

> Hi ---

>

> Are you going to school at Wash U???

Hi -

Yup! I read in your intro message that you'd seen great peds when in

St. Louis.... I was curious at the time, but forgot to ask if it was

anyone I knew. I'm glad you've found a good group of docs in OK,

though, and I hope that you can get more answers and help Kaylin to feel

better soon. If there's anything I can do, let me know.

Take care,