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Healthcare for or children. Need you advice.

I am very sorry for the long post yet I need to hear your thoughts. Please read the following and give me your advice. I'm not sure where to send this or, please, help me tweek it, it involves our children afterall. Thank You!

Healthcare for our children!

I believe I have a possible solution for our children of divorced or single family households Healthcare Problem.

And as Glen Beck would say..Let me tell you how I got there.

I was divorced a few years ago with four children to support. During this time my ex-husband was not working, my employer did not offer health benefits, and by the way, still doesn’t. As a working mother I did have to depend on Medicaid for the children. I thank God it was there.

Now during this time I had absolutely no problems with Medicaid covering their routine medical, dental, optical, and emergency visits. After approximently 1 year their father got a job with insurance. That’s when my problems started.

According to the state of Ohio I, the non-custodial parent is responsible for the first $100.00 per year per child , co-pays, prescriptions, and the like. I would fulfill my obligation yet their father would not. Resulting in the children being denied regular exams and even ER follow-up care until he paid his portion that was not covered by the insurance. Not to mention on numerous occasions he would refuse to give me any insurance information because he didn’t want me to take them to the doctors and cause more bills. At this point I shouldn’t have to mention the embarrassment and headaches this caused for us.

I am not offered medical benefits at work so switching them to me and asking for more child support to compensate is not an option.

I know that there are other custodial parents as well as myself in this situation that can move our grievances to the court, however that takes time and would be more expensive than just paying the bill ourselves so they, our children, can receive the care they need. We as custodial parents can ask the courts after the fact for reimbursement. But why take up the courts time and spend more money trying to get blood out of a turnip? We need the money to support our children and the court needs their time prosecuting murders, rapists, and the like.

My possible solution? Now please keep in mind I am not a Politian or an accountant. I do not have any scientific data or studies. I am just a parent looking for a better way to be a responsible parent.

Let’s just say John and Jane Doe divorce with children. Jane is the custodial parent. John is ordered to pay $100.00 a week in child support and to provide health care for his children. His private insurance company charges an extra $50.00 a month per child (there’s four) for coverage. Therefore John pays approximately $637.00 a month including healthcare.

Now of course, I know from personal experience, there will be glitches. Co-pays, prescriptions, and deductibles that will go unpaid and will result in refusal of non-emergency care.

(These figures are rounded out)
The point:

John is ordered to pay $100.00 a week in support he is also ordered to pay an additional $50.00 a week for medical benefits. The local child support enforcement agency deducts $150.00 from John’s pay as ordered by the court. The agency sends the custodial parent $94.00 and $50.00 to the states medical program. The state covers the children for their medical, dental, and optical care within the same guidelines as they due now for any other child on Medicaid.

Result:

The children of divorced or single parent households receive the care they need.

The non-custodial parent would be fulfilling their obligation to provide medical care their children.

The custodial parent is fulfilling their $100.00 an obligation for medical care.

The State receives the money to pay for it.

Now I do know this idea would not be a cure for our children’s healthcare crisis. It could very well be a stepping stone. It could be a win-win situation; our children would get the glasses they need to see the chalkboard. The non-custodial parent would be fulfilling their obligation, and the custodial parents would not have to find a new doctor, pharmacist, or optician every few months because of unpaid bills that they can’t cover. Or because the other parent refused to give them the medical card.

I don’t know if this idea has been looked into before or any outcomes it may have had. But I believe it’s worth a shot.

created by Eastsider on Jan 28, 2008 at 01:49:18 am     Comments: 17

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Comments ... #

Iatrogenesis for kids?

Jesus didn't need pills and witchdoctors for health or moneychanger copays nor a broken record playing via radio waves to tell him how to think.

I think he did alright for himself. Homemade bread, Mrs. Paul's fish sticks, wine, some good conversation with friends like Judas, some productive/playful exercise with his sidekick Babe...all u need.

posted by charlatan on Jan 28, 2008 at 08:10:00 am     #



I think you may have something there. Contact Marcy Kaptur's office
Ohio Office
One Maritime Plaza - Sixth Floor
Toledo, Ohio 43604
(800)964-4699 | Tel: (419) 259-7500
Fax: (419) 255-9623

or our State Representative:
Senator Wagoner
Address:Senate Building
Room #038, Ground Floor
Columbus, Ohio 43215
Telephone: 614/466-8060
Email: sd02@mailr.sen.state.oh.us

Senator Fedor
Address: Statehouse
Room #051, Ground Floor
Columbus, Ohio 43215
Telephone: 614/466-5204
Email: fedoroffice@maild.sen.state.oh.us

Good Luck!

posted by ToledoLatina on Jan 28, 2008 at 01:47:42 pm     #



Charlatan...Don't be silly. Jesus didn't need healthcare we all know he could heal himself.
Thanks for the info Latina.

posted by Eastsider on Jan 28, 2008 at 02:47:37 pm     #



I agree with ToledoLatina about contacting the legislators. I think it is a great idea.

posted by corky on Jan 28, 2008 at 04:21:42 pm     #



You probably have to be at bit militant or inquisitive as to what you let your kid mow on. Especially if you really cared abut health care both in and of itself and economically.

Cow Milk, power drinks, soda pop, common bread, mystery meats, pre-made treats, ready mix cooking gunk.... all probably wouldn't pass the litmus test for a truly concerned parent.

posted by charlatan on Jan 28, 2008 at 09:42:22 pm     #



Just in case you weren't aware...you were entitled to receive information directly from the insurance company regardless of whether your ex-husband "wanted" to give it to you or not. The insurer could have sent copies of insurance cards, copies of EOBs, etc. directly to you, as custodial parent.

(I only mention this because some people honestly aren't aware that they are entitled to receive direct communication from the ex's insurer if there are minor children on the policy - all you have to do is send a copy of the document listing you as custodial parent to the insurance company. They have to list you as a contact on the policy, and carbon copy you on any mailings sent regarding your children...whether your ex-husband "wants" you to receive the info or not.)

(BTW - your estimate of $637 a month for your children's healthcare is leaving out a big chunk of the equation...you're leaving out the portion of the premium that your ex-husband's employer would be kicking in. They may only charge an extra $200 a month to the actual employee, but the employer is likely kicking in anywhere from another $250-400 on top of that. In the formula you set up, the state would be end up paying that extra portion to cover each child. If you're serious about proposing that plan to legislators, you'll have to address some way to fund that additional expense that is presently being picked up by the employer.) :)

posted by mom2 on Jan 28, 2008 at 10:32:46 pm     #



mom2..That's a very good point. What about averaging out what the state pays now per child. I'll see if I can dig something up on the "internets".
And yes I did know about the direct communication bit, however, you can't have direct communication if you don't know who to call.
LCSEA can get the info for you from the employer and have it mailed. But what good does that do when you have an ER or need scripts right away?

posted by Eastsider on Jan 28, 2008 at 10:58:50 pm     #



(These are just thoughts off the top of my head that a person developing a plan like you recommended might want to consider...just planting seeds for contemplation, this is definitely not meant to be in depth analysis. My head is too tired for deep thought right now.) ;)

Are you proposing this suggestion for all divorced families, or just a specific set of divorced families? (i.e. - the ones where the custodial parent is low income and the children would end up on Medicaid if the non-custodial parent didn't uphold his/her responsibilities)

If I were seriously developing a proposal for a plan, I might consider trying to figure out some sort of eligibility criteria, rather than implementing it for all divorced families. (Reason being - it may make sense for the state to help with a plan if the recipients are kids who would otherwise qualify for Medicaid anyhow. But do we want tax dollars to be used to fund care for children of divorced affluent families, who would never otherwise be at risk of going without care or ending up on Medicaid?)

posted by mom2 on Jan 28, 2008 at 11:39:10 pm     #



Yes, that was my initial thought. If insurance is not available for the custodial parent and they would qualify for medicaid. And not just for divorced families but for single parent households. These days you don't have to have been married to be responsible for your children.
I really do appreciate your input.

posted by Eastsider on Jan 28, 2008 at 11:51:18 pm     #



Oops...you're absolutely correct. I shouldn't have necessarily used the term "divorced" families, because the custodial issue also applies to families who were ever married. Just an error in terminology on my part - not an intent to exclude children who's parents never married and therefore can't get divorced. :)

posted by mom2 on Jan 29, 2008 at 12:05:35 am     #



Just in case you weren't aware...you were entitled to receive information directly from the insurance company regardless of whether your ex-husband "wanted" to give it to you or not. The insurer could have sent copies of insurance cards, copies of EOBs, etc. directly to you, as custodial parent.

*******

Not if that insurance is through Blue Cross of Arkansas. My son's father is living there and thats where his inusrance comes from. When I called them asking for just the booklet or what ever they have explaining his benefits including how it covered out of state Drs (since we're in Ohio obviously) the person I spoke with told me in no uncertain terms that "Hippa" prevented him from giving me any information about my son's coverage because I am not named on insurance. The guy was actually quite nasty about it.
So unless your ex is carrying you, getting information about your kids coverage maybe harder then you think.
The father (and I use that term loosely) ignored my requests for the same information so I'm basically shooting blind in the dark for what it covers and doesn't cover.

posted by OhioKat on Jan 29, 2008 at 06:49:28 am     #



Regarding OhioKat's post.
This is one of many reasons we need to do something.

posted by Eastsider on Jan 29, 2008 at 10:13:19 am     #



I have found the average cost Medicaid pays per child.
http://www.childrenshospitals.net/AM/Template.cfm?Section=State_Medicaid_Tool_Kit&Template=/CM/ContentDisplay.cfm&ContentID=1833
This information estimates the state averages $33.00 a week per child. which leaves my estimate shy by about $372.00 a month.
Any Ideas?

posted by Eastsider on Jan 29, 2008 at 10:44:53 am     #



OhioKat - have you sent Blue Cross of Arkansas a copy of the court papers showing that you are the custodial parent?

If not, I'd recommend that you do so.

It is correct that, if you haven't provided the court documentation to them, they can't give any info to you because of HIPAA. But a copy of court documentation showing that you are the custodial parent of a minor child would take care of that.

I'd recommend that you provide the custodial parent papers to them as soon as possible. Once they verify the validity of those documents, you'd be entitled to any information about the policy regarding the minor child (benefits, copies of insurance cards and EOBs, the right to discuss his claims, etc.).

posted by mom2 on Jan 29, 2008 at 09:53:54 pm     #



There are none because we were never married.
There was no custody hearing, just a drawn out child support thing that was handled though child support and was finally set by a court in Arkansas.
When he first left I contacted a lawyer to see if I needed to get a custody order and was told that because we were not married its a given that I am the one with custody and if he wanted any rights in that matter he'd have to come up here and file in court to get them.

posted by OhioKat on Jan 29, 2008 at 11:52:29 pm     #



OhioKat

With the experiences you have had, What do you think.
And quit honestly, I'm catching a-lot of flack over on swampbubbles.com

posted by Eastsider on Jan 30, 2008 at 12:40:00 am     #



OhioKat - I'm surprised that your lawyer didn't take medical issues into consideration, especially if your ex is required to carry insurance on your child. Sorry that you received such bad advice in that regard.

If you could provide legal evidence of your custodial relationship to the child to Blue Cross of Arkansas, you'd be entitled to full disclosure directly from the insurer about anything relating to your child on the policy.

Without either legal documentation or a signed authorization from the cardholder (your ex), the insurer's hands are tied. They have no other way of verifying that you are who you say you are, and that you have a legal right to the info. Its a shame your lawyer didn't take that into consideration.

Is there anything in your child support documentation that might reference you as custodial parent? Did you obtain a general child support order, or did you specifically obtain a QMCSO (qualified medical child support order)?

A QMCSO is supposed to be federal protection for children of divorce. Its that both your ex's employer and insurer would receive ordering that your child must be enrolled on the benefit plan. It would also list your name as the custodial parent, which would also require your ex's employer and insurer to communicate directly with you regarding your child's medical insurance needs.

Frankly, I'm surprised that your lawyer didn't obtain either custody papers or a QMCSO for you...either would have protected you in this case and entitled you to info directly from the insurer.

An added bonus of the QMCSO...if the insurer were going to reimburse for any of your son's medical expenses, you could receive the check directly instead of your ex/the cardholder. (As it stands right now, if your son had a medical claim that should be reimbursed to the patient, the check would go to your ex. Whether or not he ever passed it on to you. A QMCSO would protect you from that happening.)

Here's some more info on what a QMCSO is:
http://www.divorcenet.com/states/missouri/mo_art11
http://www.dol.gov/ebsa/publications/qmcso.html

Sorry that your lawyer didn't advise you of any of this - the child support agency may be able to draw up a QMCSO for you, it could be worth checking with them.

(You might also want to see if you have any other documentation that would be acceptable for Blue Cross of Arkansas as an alternate document proving that you have custody. I know that they would absolutely have to accept custodial parent papers or a QMCSO...I can't speak for them as to whether there's anything else they'd allow.)

posted by mom2 on Jan 30, 2008 at 06:59:32 pm     #