M.A.

have a ton of health problems... enough where I could get SSI disability if I wanted it but it's not enough to survive on, so I have a work-at-home job that does offer health insurance. Unfortunately it's expensive, has hefty copays and deductibles, and I cannot even afford my prescriptions - which I have plenty of! And, oh yeah, they won't pay for surgery. No exceptions. My employer excluded it.

Bottom line, I need M.A. Are they going to automatically deny me when I tell them A) I have a job and B) it offers health insurance? Do I lie through my teeth and say I got laid off or something? What can I do? I can't afford to even take my kids in for checkups and they both need umbilical hernia surgeries, etc. and I can't afford any of that at all as a single mother.

What can I do? Last ditch effort, all I can think is to quit my job, go on SSI, try to find section 8 housing... but right now I'm self-sufficient except for needing medical help. I would hate to not be depending on myself.

A cousin recommended having my PCP write a letter to M.A. asking them to just cover the surgery but that's doubtful too.

Help!

You have a lot going on, but make sure you think things through. You might want to consider Minnesota Care. They have income limits, but they are not as stringent as MA. Section 8 has a waiting list up to a year or more depending on where you live, so be careful there. Also, you may have to move at that time. DO NOT LIE on your application. When they find out, and I do mean when, you can be arrested and charged with fraud, and they are very tough on penalties for that in MN. As far as having a job, no, Minnesota care does not count that against you, in fact it  can be a good thing. You may even qualify for some MFIP programs, you would need to talk to a worker at the county, but then you can also find out about MN healthcare programs. You can also go on the Minnesota DHS website, it has the income guidelines there. Also, SSI is one heck of a process to get approved on, and it can take a long time as well. As a rule, they will deny you the first time you apply, and you will have to resubmit again and challenge it, and then they may approve, but like I said it is a long process. I work for a Domestic Violence shelter, so I have a lot of experience helping people with assistance, health insurance, and SSI, and just wanted to make sure you know about how long all of this takes. Hang in there, and as a parent, you will be more likely to qualify for Minnesota care, and the kids can get health insurance for really low cost or even free until they are 21. I would definately look into it! Good luck.

Hi Nicole, I have nothing to add other than I thought you gave Amy a very helpful response to a complicated problem.  It sounds like she has a lot to deal with and you gave her a few places to start.  If I were in Amy's shoes, this would help me.  A lot of times that is what a person needs.  Someplace to start. Thanks.  

Will MNCare pay for surgery?

N/m... I don't qualify... :

? Not have other health insurance now or have had health insurance (including Medicare), for at least four months except for Medical Assistance enrollees whose health insurance premium was paid for by Medical Assistance.

? Not be able to get health insurance through an employer who offers to pay at least half the monthly cost.

Well, there goes my chances of ever having surgery. I guess it's back to the drawing board.

I work for the State (MA and MN Care; Managed Care) and don't lie! that will get you into a lot of trouble.  You said that you didn't qualify but please call or talk to someone in person as if you have assets or debt that might help you get some assistance.  Also you can have income and assets but your premium will just be a little higher.   Yes MNCare pays for WLS.   Good luck.  Call and just talk to them it can't hurt.

Even if you can't get the insurance yourself. all children in MN are eligible for low cost insurance through the state. You said your children need hernia surgeries, so this is a start. Be persistant about insurance options. The more calls you make and advocate for yourself the better the chances you will eventually talk to the right person. It doesn't hurt to talk to someone at the county as well and find out what other options you can pursue. Remember the squeaky wheel gets the oil.

Thanks everyone for your help. Unfortunately my employer offers insurance and I've had insurance for the past 4 months so I doubt I would qualify for MNCare. My only option is to quit my job and find another one, which is hard because right now I work at home and if I quit, I couldn't afford daycare either and there is a wait list for help with that.

I am sorta stuck between a rock and a hard place right now.

I'm upset because I've been wanting this surgery for 5 years now and been denied by two different insurance companies three times. It's getting old.

I'm sorry you are dealing with all of this stress. I am going through the same type of thing. I haven't been able to work since May 2006 due to my health and it too****il January 2007 to be diagnosed with my illness (because its a rare condition). I have been in the SSI disability process for about a year now. I'm UNABLE to work because of my illness. That is what they really look at, you have to PROVE why you CAN'T work. How your disability prevents you from working and you just said that you are working. I just wanted to let you know that SSI disability isn't a quick process and you will be (most likely) denied at first and have to appeal a couple times. It is quite a drawn out process. And you should  look on their website and see if you have any illness / condition that makes you eligible to receive benefits. I would suggest that you don't lie to the Government to try to get MA, because that is fraud and punishable by jail time.  Try looking into Minnesota Care. They insure you based on your income level.  Good luck with everything.

Thanks. I've been on SSI in the past and know the whole process. It's difficult, I know. My psychiatrist actually suggested that I quit my job... I'm having a hard time holding it, actually but I'm holding on because I know SSI money is no gift... it's barely enough to survive on. I couldn't even pay my rent or take care of my two babies with that. Unfortunately I can't go the MNCare route... my employer offers health insurance and I've been insured for the past 4 months, so I'm unable to have surgery.

I wish you all the best on your surgery journeys! I guess it just was not meant to be for me.