IOWA MEDICAID ADVICE NEEDED DESPERATELY!!

My husband just became employed almost 2 weeks ago by Tyson Deli/Iowa Ham in Independence, Iowa. Wonderful news, I know! But, DHS gave us paperwork that Tyson Deli/Iowa Ham needed to have filled out and back to them by last Wednesday. We were told by DHS that as long as that information was returned to them, we would retain our Medicaid insurance for the next 12 months. A gift from God, because Tyson Deli/Iowa Ham has BC/BS insurance and I was told, has an exclusion policy for WLS. When my husband gave the paperwork to his supervisor, he was told that it would need to be sent to the corporate office to be filled out. (The only information that was required was my husband's start date, his rate of pay, whether or not he was eligible for insurance benefits right away, and a Tyson Deli/Iowa Ham representative's signature. Personally, I do not see why someone on-site could not have filled it out.) My husband was assured that the paperwork would be sent right away and would be back to DHS in time for the deadline. I just received a notice from DHS stating that they have not received the required paperwork; therefore, our medical assistance is cancelled beginning 01/01/04. What do I do?!? Has anybody else been through something like this? Can I appeal it, due to the fact that it was not our fault, but the fault of the company. We cannot just re-apply for Medicaid, because of my husband's income, we would no longer qualify. I know that I will be able to get at least some answers either way Monday, but in the mean time, I've been doing nothing but crying. I just need someone to maybe help me with some advice , just to get myself through the weekend. This is my one and only chance for WLS. If I do not get my Medicaid back...I have no chance of having this surgery! Please, any advice or information, or similiar experiences would be very welcome! Sherry

Sherry, The same thing happened to me but they only took my husband off title 19 Call your case worker and ask her if you are cut off as well ...Aslo explian to them the employer has not returned this information and you need assistance ... Most of the time they will help you ....Hope it helps P.s. is tysons still hiring? I live in cedar falls and hope my husband can get in there .......Hope this helps ....Tiffany

Hi Tiffany! Thank you so much for responding to my post, I really appreciate it! I haven't been able to stop sobbing all day! Was your worker really that helpful? I'm just so scared, because this is my only chance for this surgery. The letter was addressed to me, so I think I can assume it means my entire family. I just don't understand why they couldn't fill out the paperwork!! I have all these pre-op appointments scheduled and my initial surgical consultation is 12/29/03. I just am such a wreck. My husband was hired for maintenance, but I do believe that production and clean-up is always hiring. You just got to keep calling once you put an application in. Do I have to go through an appeal or can my worker fix it with a phone call to Tyson? Please e-mail me back! [email protected]

Sherry hon take a deep breath, I know easier said than done. Been there done that with Title 19. Call your worker in the morning & explain what has happened. I have also went into Social Services picked up papers & went directly to my job site & MADE them fill the papers out in front of me & taken them back to Social Services myself. Since that's the only info they need Human Services can fill this out in less than 5 minutes! There is no need to send off to corporate, believe it's just an excuse, but different companies different policies. LOL...Social Services knows how I feel about some of their policies I once told them that I didn't know which was worse being on programs thru them or being married since I had to kiss both of their butts, well that's not the word I used but you get my drift. Chin up it will work out. Be firm. Call your worker explain then go to workplace yourself & make sure you don't leave until papers are filled out. Your worker may even call them for you & ask what the hold up is or ask to get this in the mail ASAP to her. Keep me posted Carolyn

Hi Carolyn! Thank you so much for your advice! I've just been a nervous wreck all weekend. I wish I hadn't gotten my mail yesterday, at least if I had gotten it tomorrow, I could have done something or got some information right away. LOL I'm just so scared because Tyson does have an iron-clad exclusion for WLS. Medicaid is my ONLY chance. I have a lot of my pre-op testing done already, my psych eval is tomorrow (just what I need after this weekend LOL), my initial surgical consultation is Dec. 29th, and my nutritional eval is the 30th. I don't have my gall bladder anymore, and I've already been diagnosed with sleep apnea and have my CPAP machine. I'm also already being treated for hypothyroidism and PCOS and have a pro-WLS letter from my endocrinologist. I thought I had everything going for me, and now this! I am so scared and I haven't been able to stop crying! Can the worker reverse his decision right away, because it was the company's fault and not mine? Seriously, the plant is only 4 blocks from the DHS office. If DHS is willing to play ball, does Tyson have to fill the paperwork out? I'll march my chunky butt right in there tomorrow, I don't have a problem with that. Please email me back Carolyn! Sherry [email protected]

Continue to dispute it until you are sent to the review dept. I went back and forth with them for over a year and they finaly went back after seven attempts and picked up the bills for the time period that I should have been covered and gave be the approval for surgery. Of cours by the time I had surgery I only had a month left of coverage so everything after is on my tab.