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Health Insurance
20110130-kjcjbyhij4457fjwi4jdufc7qx

in-network, ou-of-network, deductables, HSA, individual, group, open enrollment... Google translate will not work on the language of insurance. Better ask.

Answers
  • How do I pay for necessary healthcare when I have no money or insurance?
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    Sadly, many more Washington citizens are uninsured. You may be able to find healthcare through the Washington Free Clinic Association (WFCA). http://www.wafreeclinics.org/clinics.html

    Here’s some information about the WCFA from their Web site: “The Washington Free Clinic Association is a non-profit 501c3 organization whose mission is to strengthen and support the Free Clinics of Washington through advocacy, education and professional networking. The WFCA is currently comprised of 24 free clinic members from across Washington State. Free Clinics are private, non-profit, community or faith-based organizations that provide medical, dental, pharmaceutical, and/or mental health services at little or no cost to uninsured and underinsured people through the use of volunteer health professionals, community volunteers, and partnerships with other health providers. There are currently more than 30 Free Clinics operating in Washington today and that number continues to grow. The WFCA estimates that Washington Free Clinics alone may have been responsible for over 45,000 patient visits in 2009.”

    There is also a large healthcare event on April 30, 2011, which may or may not work for you: “The National Association of Free Clinics (NAFC), in partnership with the Washington Free Clinic Association, (WFCA) will be holding a one-day free clinic on Saturday, April 30, 2011 in the Tacoma Dome. The upcoming C.A.R.E. (Communities Are Responding Everyday) Clinic is an opportunity for the community to come together to provide free primary and preventative health care services to an estimated 1,200 uninsured adult residents of the Seattle-Tacoma area. At a recent NAFC-sponsored C.A.R.E. Clinic in Charlotte, NC, 1,163 uninsured patients were able to receive services in just 6 hours of patient care. More importantly, the patients who required follow-up for serious conditions were connected with local resources for ongoing care. The Washington C.A.R.E. Clinic will offer medical, dental, and vision services, as well as community referrals for those with critical follow-up needs. Uninsured Washingtonians can now call 877-233-5159 to make an appointment for the C.A.R.E. Clinic. This scheduling line is open from 8am-6pm EST.

    By attending one of the free clinics, you may find more information about accessing care.  I wish you well and hope other people can offer more ideas to you. 

Questions
Recent Comments
  • Comment on Russ Campbell, NWEBS's answer…
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    We have our son in a developmental pre-school through the district and are aware of the theoretical resources. He receives services integrated into his normal class and goes for what is called extended day services as well. Unfortunately, the district (SPS) is streched beyond its means, so to get him to the level needed, we use our insurance. Of course, there is never enough to go around.

    What we need is insurance reform with regard to what is and is not covered. I am actually lucky to have any neurodevelopmental benefit at all, as quite a few plans do not have the coverage. Everything else is private-pay as fortunately / unfortunately we make too much to qualify for assistance (but of course, too little to get everything that is needed). A number of other states mandate that there be coverage for neurodevelopmental services. Perhaps one day our collective heads will be removed from our collective rectums in realization that early and full intervention costs so much less than adult care.

    Thank you for the info and banter.

    Matthew

  • Comment on Russ Campbell, NWEBS's answer…
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    Great report, thanks for elaborating the results of your research.

    Again, I urge you to include your local school district in securing appropriate services for your son. He is eligible there even if he is not a public school student (services are available for private school students, but you will usually have to provide transportation and the services are typically available during normal school hours). If he qualifies by their testing using his performance skills as it impacts his ability to learn (educational performance standards), then those services are provided in addition to any private services you may be accessing. Contact your local school district for information.

  • Comment on Russ Campbell, NWEBS's answer…
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    Russ, good point.

    Here's what I found out. There are two worlds when talking about switching insurance. There is an individual plan and group coverage. Group coverage is typically something that you would get when going through an employer and the individual plan is what one purchases on one's own (just to have, or if you are self-employed).

    For group coverage, an employer (according to the lady I spoke with at the insurance commission) cannot deny coverage, however there are possible complications. It comes down to waiting periods. Any waiting period (the time that it takes until one eligible for coverage) greater than 90 days subjects the person to the pre-existing condition clause. So, if there is a gap in coverage of greater than 90 days, my son would be subjected to the clause.

    If switching jobs, research with the new employer how long this waiting period will be and who is eligible for coverage (dependents, spouse, etc.). Signing up for COBRA (Consolidated Omnibus Budget Reconciliation Act) insurance coverage is one way to ensure that the gap in coverage is non-existent or is minimized, however this typically comes at a greater cost (high deductibles, higher co-pays, high co-insurance costs).

    According to the federal health care site, it is not legal for insurance companies to deny coverage to children who have pre-existing conditions at all, ever. This came into effect in 2010 (see: http://www.healthcare.gov/law/features/rights/childrens-pre-existing-conditions/index.html)

    So, all in all I believe that in my situation, my child will be covered and will not be denied coverage. Remember that in 2014, all of these shenanigans go away anyway.

  • Comment on Russ Campbell, NWEBS's answer…
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    If you can make a generalized statement of what you learn in getting an answer for your specific situation (or recommend a particular webpage) then please return and post it.

    Someone in the future may find your question and the later discussion/postings here on Qland and having that elaboration may just provide the right direction or answer for them.

  • Comment on Russ Campbell, NWEBS's answer…
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    Russ - thank you!

    Your link to the office of the insurance commissioner was great and led me to find the answer here.

    I'll back it up with a call to make sure.

    Thanks again!

    Matthew

  • Comment on Sphinx's answer…
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    There are also home care agencies where you can arrange for in-home professional care - not in a facility.

  • Comment on HealOnCapHill's answer…
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    A good thing to know is that there is no limit on how many sessions now. I have likewise and I only pay $30 co-pay for each session. This is a new policy I think since the first of the year