Guest guest Posted October 21, 2010 Report Share Posted October 21, 2010 Hello everyone. I was considering changing insurance companies to Florida Kid Care for my 3 year old. I spoke to a rep and they will take her pre-existing Autism, however someone told me that CMS, the area that provides services such as speech and OT for special needs children is based off of income. I have left messages with supervisors - I can't seem to get an answer from an authority. Does anyone out there have Florida kid care with CMS? If so, how has your experience been? Were you able to get services for your child? thanks Jeannie Krouch Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 22, 2010 Report Share Posted October 22, 2010 My husband and I were paying 1,000 dollars a month for insurance through his employer and nothing was covered for Autism, not speech, OT, nothing. I switched them both to CMS and they now get speech, OT, hippotherapy, PT and mental health benefits. You will not be denied because of your finances, but the monthly amount that you pay will be determined by your income. Some people pay $20 a month, some pay $160 a month. But there are no copays and prescriptions are free! Hello everyone.I was considering changing insurance companies to Florida Kid Care for my 3 year old. I spoke to a rep and they will take her pre-existing Autism, however someone told me that CMS, the area that provides services such as speech and OT for special needs children is based off of income. I have left messages with supervisors - I can't seem to get an answer from an authority. Does anyone out there have Florida kid care with CMS?If so, how has your experience been? Were you able to get services for your child?thanks Jeannie Krouch------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 22, 2010 Report Share Posted October 22, 2010 Jeannie: Kid Care is income based, depending on income you can pay as little as $15 a month or as much as $100+ a month, from what I know you pick from whatever plans your county participates in. CMS is great, they are able to provide speech and OT type stuff. I am not in broward though so I cant say exactly what happens there, why don’t you search kid care under google and call? It is an easy program to navigate. I know obviously that CMS is reserved for kids with a life long disability, I am not sure what goes into applying for CMS. Clara From: rkrouch1@... Sent: Thursday, October 21, 2010 10:09 PM To: sList Subject: florida kid care/CMS Hello everyone.I was considering changing insurance companies to Florida Kid Care for my 3 year old. I spoke to a rep and they will take her pre-existing Autism, however someone told me that CMS, the area that provides services such as speech and OT for special needs children is based off of income. I have left messages with supervisors - I can't seem to get an answer from an authority. Does anyone out there have Florida kid care with CMS?If so, how has your experience been? Were you able to get services for your child?thanks Jeannie Krouch "What is important in life is life, and not the result of life." - Johann Wolfgang von Goethe Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 22, 2010 Report Share Posted October 22, 2010 Hello there, Im in the process of getting Kidcare myself for my son and my son is in CMS. The number is or . Try that number. Wish you the best of luck. Yesenia florida kid care/CMS Hello everyone. I was considering changing insurance companies to Florida Kid Care for my 3 year old. I spoke to a rep and they will take her pre-existing Autism, however someone told me that CMS, the area that provides services such as speech and OT for special needs children is based off of income. I have left messages with supervisors - I can't seem to get an answer from an authority. Does anyone out there have Florida kid care with CMS? If so, how has your experience been? Were you able to get services for your child? thanks Jeannie Krouch Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 22, 2010 Report Share Posted October 22, 2010 Hi! I had cms for long time and was very good w services this was like 2 yrs ago. I hope this helps!Sent from my BlackBerry® on the MetroPCS NetworkSender: sList Date: Fri, 22 Oct 2010 02:09:59 -0000To: <sList >ReplyTo: sList Subject: florida kid care/CMS Hello everyone.I was considering changing insurance companies to Florida Kid Care for my 3 year old. I spoke to a rep and they will take her pre-existing Autism, however someone told me that CMS, the area that provides services such as speech and OT for special needs children is based off of income. I have left messages with supervisors - I can't seem to get an answer from an authority. Does anyone out there have Florida kid care with CMS?If so, how has your experience been? Were you able to get services for your child?thanks Jeannie Krouch Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 22, 2010 Report Share Posted October 22, 2010 Jeanine is the general phone number 1-. Its true CMS is income based, some families pay 15/20 and others payy the full cost of about 160. They do cover PT/OT etc. Its pretty resourceful. Yesenia florida kid care/CMS Hello everyone. I was considering changing insurance companies to Florida Kid Care for my 3 year old. I spoke to a rep and they will take her pre-existing Autism, however someone told me that CMS, the area that provides services such as speech and OT for special needs children is based off of income. I have left messages with supervisors - I can't seem to get an answer from an authority. Does anyone out there have Florida kid care with CMS? If so, how has your experience been? Were you able to get services for your child? thanks Jeannie Krouch "What is important in life is life, and not the result of life." - Johann Wolfgang von Goethe Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 22, 2010 Report Share Posted October 22, 2010 that is so great to here. We too are paying so much per month -and hippotherapy is covered too! wow - I was going to start that and pay out of pocket fo rit.thank you so muchSubject: Re: florida kid care/CMSTo: sList Date: Friday, October 22, 2010, 9:33 AM My husband and I were paying 1,000 dollars a month for insurance through his employer and nothing was covered for Autism, not speech, OT, nothing. I switched them both to CMS and they now get speech, OT, hippotherapy, PT and mental health benefits. You will not be denied because of your finances, but the monthly amount that you pay will be determined by your income. Some people pay $20 a month, some pay $160 a month. But there are no copays and prescriptions are free! Hello everyone.I was considering changing insurance companies to Florida Kid Care for my 3 year old. I spoke to a rep and they will take her pre-existing Autism, however someone told me that CMS, the area that provides services such as speech and OT for special needs children is based off of income. I have left messages with supervisors - I can't seem to get an answer from an authority. Does anyone out there have Florida kid care with CMS?If so, how has your experience been? Were you able to get services for your child?thanks Jeannie Krouch------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 22, 2010 Report Share Posted October 22, 2010 Anyone can get Kidcare but NOT everyone is eligible for CMS which is what gets you ST, OT etc... We just went through the process and they told us we could get Kidcare for about $160 b/c we make above the poverty level, but we were not eligible for CMS which has an income cap of about 40k per family/per year. We make more than that but we also spend TWICE as much as we make to cover therapies. When I told CMS this they said that they realize this is a problem but that is the rule and they have an income cap that cannot be changed for special circumstances. We even considered my DH getting a lower paying job so that we can get CMS b/c insurance isn't covering therapy and we are going bankrupt and may lose our house. I wish they would take into consideration the added financial burdens of families with children with Autism. We can't qualify for any grants or services b/c of income, but our income doesn't come close to covering essential therapies that we aren't able to give my son. Hope you have better luck! > > Hello everyone. > > I was considering changing insurance companies to Florida Kid Care for my 3 year old. I spoke to a rep and they will take her pre-existing Autism, however someone told me that CMS, the area that provides services such as speech and OT for special needs children is based off of income. I have left messages with supervisors - I can't seem to get an answer from an authority. Does anyone out there have Florida kid care with CMS? > If so, how has your experience been? Were you able to get services for your child? > > thanks > Jeannie Krouch > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 22, 2010 Report Share Posted October 22, 2010 Same w other families. I hope someone could do something to make them see all the expenses and also w single parents. Definitely something to address.Sent from my BlackBerry® on the MetroPCS NetworkSender: sList Date: Fri, 22 Oct 2010 19:47:23 -0000To: <sList >ReplyTo: sList Subject: Re: florida kid care/CMS Anyone can get Kidcare but NOT everyone is eligible for CMS which is what gets you ST, OT etc... We just went through the process and they told us we could get Kidcare for about $160 b/c we make above the poverty level, but we were not eligible for CMS which has an income cap of about 40k per family/per year. We make more than that but we also spend TWICE as much as we make to cover therapies. When I told CMS this they said that they realize this is a problem but that is the rule and they have an income cap that cannot be changed for special circumstances. We even considered my DH getting a lower paying job so that we can get CMS b/c insurance isn't covering therapy and we are going bankrupt and may lose our house. I wish they would take into consideration the added financial burdens of families with children with Autism. We can't qualify for any grants or services b/c of income, but our income doesn't come close to covering essential therapies that we aren't able to give my son.Hope you have better luck!>> Hello everyone.> > I was considering changing insurance companies to Florida Kid Care for my 3 year old. I spoke to a rep and they will take her pre-existing Autism, however someone told me that CMS, the area that provides services such as speech and OT for special needs children is based off of income. I have left messages with supervisors - I can't seem to get an answer from an authority. Does anyone out there have Florida kid care with CMS?> If so, how has your experience been? Were you able to get services for your child?> > thanks > Jeannie Krouch> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 22, 2010 Report Share Posted October 22, 2010 Does Kid Care cover ABA? Re: florida kid care/CMS My husband and I were paying 1,000 dollars a month for insurance through his employer and nothing was covered for Autism, not speech, OT, nothing. I switched them both to CMS and they now get speech, OT, hippotherapy, PT and mental health benefits. You will not be denied because of your finances, but the monthly amount that you pay will be determined by your income. Some people pay $20 a month, some pay $160 a month. But there are no copays and prescriptions are free! Hello everyone. I was considering changing insurance companies to Florida Kid Care for my 3 year old. I spoke to a rep and they will take her pre-existing Autism, however someone told me that CMS, the area that provides services such as speech and OT for special needs children is based off of income. I have left messages with supervisors - I can't seem to get an answer from an authority. Does anyone out there have Florida kid care with CMS? If so, how has your experience been? Were you able to get services for your child? thanks Jeannie Krouch ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 25, 2010 Report Share Posted October 25, 2010 I wanted to email you back because maybe it will help your situation. I called kidcare and CMS today and they both said that kidcare is the one that is income based -we will have to pay the top premium of 160 but that is chump change compared to what we pay now. But CMS eligibility is based solely on medical need. I called back and got someone else and the story was the same, they said that a few years ago, CMS was in fact income based but the laws have changed. I am gonna go for it. Maybe it can help you too. Jeannie Subject: Re: florida kid care/CMSTo: sList Date: Friday, October 22, 2010, 3:47 PM Anyone can get Kidcare but NOT everyone is eligible for CMS which is what gets you ST, OT etc... We just went through the process and they told us we could get Kidcare for about $160 b/c we make above the poverty level, but we were not eligible for CMS which has an income cap of about 40k per family/per year. We make more than that but we also spend TWICE as much as we make to cover therapies. When I told CMS this they said that they realize this is a problem but that is the rule and they have an income cap that cannot be changed for special circumstances. We even considered my DH getting a lower paying job so that we can get CMS b/c insurance isn't covering therapy and we are going bankrupt and may lose our house. I wish they would take into consideration the added financial burdens of families with children with Autism. We can't qualify for any grants or services b/c of income, but our income doesn't come close to covering essential therapies that we aren't able to give my son.Hope you have better luck!>> Hello everyone.> > I was considering changing insurance companies to Florida Kid Care for my 3 year old. I spoke to a rep and they will take her pre-existing Autism, however someone told me that CMS, the area that provides services such as speech and OT for special needs children is based off of income. I have left messages with supervisors - I can't seem to get an answer from an authority. Does anyone out there have Florida kid care with CMS?> If so, how has your experience been? Were you able to get services for your child?> > thanks > Jeannie Krouch> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 26, 2010 Report Share Posted October 26, 2010 Jeannie,Thanks for emailing me this information. Can you please tell me who you spoke with? Or the number you called? I talked to someone about 6 months ago and that is what she told me. Maybe she wasn't updated? I'm so angry b/c we've paid over 60k out of pocket this past year alone! I'm going to call again!Thanks again!ShiriTo: sList From: rkrouch1@...Date: Mon, 25 Oct 2010 18:21:22 -0700Subject: Re: Re: florida kid care/CMS I wanted to email you back because maybe it will help your situation. I called kidcare and CMS today and they both said that kidcare is the one that is income based -we will have to pay the top premium of 160 but that is chump change compared to what we pay now. But CMS eligibility is based solely on medical need. I called back and got someone else and the story was the same, they said that a few years ago, CMS was in fact income based but the laws have changed. I am gonna go for it. Maybe it can help you too. Jeannie Subject: Re: florida kid care/CMSTo: sList Date: Friday, October 22, 2010, 3:47 PM Anyone can get Kidcare but NOT everyone is eligible for CMS which is what gets you ST, OT etc... We just went through the process and they told us we could get Kidcare for about $160 b/c we make above the poverty level, but we were not eligible for CMS which has an income cap of about 40k per family/per year. We make more than that but we also spend TWICE as much as we make to cover therapies. When I told CMS this they said that they realize this is a problem but that is the rule and they have an income cap that cannot be changed for special circumstances. We even considered my DH getting a lower paying job so that we can get CMS b/c insurance isn't covering therapy and we are going bankrupt and may lose our house. I wish they would take into consideration the added financial burdens of families with children with Autism. We can't qualify for any grants or services b/c of income, but our income doesn't come close to covering essential therapies that we aren't able to give my son.Hope you have better luck!>> Hello everyone.> > I was considering changing insurance companies to Florida Kid Care for my 3 year old. I spoke to a rep and they will take her pre-existing Autism, however someone told me that CMS, the area that provides services such as speech and OT for special needs children is based off of income. I have left messages with supervisors - I can't seem to get an answer from an authority. Does anyone out there have Florida kid care with CMS?> If so, how has your experience been? Were you able to get services for your child?> > thanks > Jeannie Krouch> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 26, 2010 Report Share Posted October 26, 2010 Hi Jeannie, I just spoke with the eligibility coordinator for CMS in Broward again, her name is Sonya her number is . She says that unless you qualify for the $15-$20 premium for Kidcare then you do not qualify for CMS. She says that many of the representatives are not well informed but that she is the one that determines eligibility for CMS. She says that you can call her and she can explain it to you. She says there may be a way around it - if you are eligible for medicaid or SSI then you may be able to qualify for CMS. Both medicaid and SSI are income based as well so I don't qualify. You can get on the medwaiver waiting list but that list has a 7 year wait, unless you can prove extreme crisis like documented danger to your child like getting lost (need to show police reports etc). I would check it again b/c I know that it takes 45 days for Kidcare/CMS to kick in and you have to be without any current insurance for a month (I think) before you can quailfy. For us, thats a long time to be without insurance without knowing if you'll recieve coverage. If you hear anything different please let me know!Best Regards,Shiri WeizmanTo: sList From: rkrouch1@...Date: Mon, 25 Oct 2010 18:21:22 -0700Subject: Re: Re: florida kid care/CMS I wanted to email you back because maybe it will help your situation. I called kidcare and CMS today and they both said that kidcare is the one that is income based -we will have to pay the top premium of 160 but that is chump change compared to what we pay now. But CMS eligibility is based solely on medical need. I called back and got someone else and the story was the same, they said that a few years ago, CMS was in fact income based but the laws have changed. I am gonna go for it. Maybe it can help you too. Jeannie Subject: Re: florida kid care/CMSTo: sList Date: Friday, October 22, 2010, 3:47 PM Anyone can get Kidcare but NOT everyone is eligible for CMS which is what gets you ST, OT etc... We just went through the process and they told us we could get Kidcare for about $160 b/c we make above the poverty level, but we were not eligible for CMS which has an income cap of about 40k per family/per year. We make more than that but we also spend TWICE as much as we make to cover therapies. When I told CMS this they said that they realize this is a problem but that is the rule and they have an income cap that cannot be changed for special circumstances. We even considered my DH getting a lower paying job so that we can get CMS b/c insurance isn't covering therapy and we are going bankrupt and may lose our house. I wish they would take into consideration the added financial burdens of families with children with Autism. We can't qualify for any grants or services b/c of income, but our income doesn't come close to covering essential therapies that we aren't able to give my son.Hope you have better luck!>> Hello everyone.> > I was considering changing insurance companies to Florida Kid Care for my 3 year old. I spoke to a rep and they will take her pre-existing Autism, however someone told me that CMS, the area that provides services such as speech and OT for special needs children is based off of income. I have left messages with supervisors - I can't seem to get an answer from an authority. Does anyone out there have Florida kid care with CMS?> If so, how has your experience been? Were you able to get services for your child?> > thanks > Jeannie Krouch> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 26, 2010 Report Share Posted October 26, 2010 Sounds to me like there's a lot of misinformation going around. I can understand that if you qualify for SSI/Medicaid then you would also qualify for CMS - but then, if you qualify for SSI and Medicaid, you certainly don't need CMS. My suggestion would be to go ahead and apply - partly because of the misinformation, and partly because the rules change with alarming frequency. To: deniseslist Sent: Tue, October 26, 2010 10:34:07 AMSubject: RE: Re: florida kid care/CMS Hi Jeannie, I just spoke with the eligibility coordinator for CMS in Broward again, her name is Sonya her number is . She says that unless you qualify for the $15-$20 premium for Kidcare then you do not qualify for CMS. She says that many of the representatives are not well informed but that she is the one that determines eligibility for CMS. She says that you can call her and she can explain it to you. She says there may be a way around it - if you are eligible for medicaid or SSI then you may be able to qualify for CMS. Both medicaid and SSI are income based as well so I don't qualify. You can get on the medwaiver waiting list but that list has a 7 year wait, unless you can prove extreme crisis like documented danger to your child like getting lost (need to show police reports etc). I would check it again b/c I know that it takes 45 days for Kidcare/CMS to kick in and you have to be without any current insurance for a month (I think) before you can quailfy. For us, thats a long time to be without insurance without knowing if you'll recieve coverage. If you hear anything different please let me know!Best Regards,Shiri Weizman To: sList From: rkrouch1@...Date: Mon, 25 Oct 2010 18:21:22 -0700Subject: Re: Re: florida kid care/CMS I wanted to email you back because maybe it will help your situation. I called kidcare and CMS today and they both said that kidcare is the one that is income based -we will have to pay the top premium of 160 but that is chump change compared to what we pay now. But CMS eligibility is based solely on medical need. I called back and got someone else and the story was the same, they said that a few years ago, CMS was in fact income based but the laws have changed. I am gonna go for it. Maybe it can help you too. Jeannie Subject: Re: florida kid care/CMSTo: sList Date: Friday, October 22, 2010, 3:47 PM Anyone can get Kidcare but NOT everyone is eligible for CMS which is what gets you ST, OT etc... We just went through the process and they told us we could get Kidcare for about $160 b/c we make above the poverty level, but we were not eligible for CMS which has an income cap of about 40k per family/per year. We make more than that but we also spend TWICE as much as we make to cover therapies. When I told CMS this they said that they realize this is a problem but that is the rule and they have an income cap that cannot be changed for special circumstances. We even considered my DH getting a lower paying job so that we can get CMS b/c insurance isn't covering therapy and we are going bankrupt and may lose our house. I wish they would take into consideration the added financial burdens of families with children with Autism. We can't qualify for any grants or services b/c of income, but our income doesn't come close to covering essential therapies that we aren't able to give my son.Hope you have better luck!>> Hello everyone.> > I was considering changing insurance companies to Florida Kid Care for my 3 year old. I spoke to a rep and they will take her pre-existing Autism, however someone told me that CMS, the area that provides services such as speech and OT for special needs children is based off of income. I have left messages with supervisors - I can't seem to get an answer from an authority. Does anyone out there have Florida kid care with CMS?> If so, how has your experience been? Were you able to get services for your child?> > thanks > Jeannie Krouch> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 26, 2010 Report Share Posted October 26, 2010 When I applied for Medikids about a month and a half ago,they asked me if my daughter had any disabilities, I told them she has autism. after that I was going to pick Sunshine State thru Medikids since I had it before and it worked ok, but since my daughter had autism they sent a request to CMS, and I just found out that that's the insurance she will get. CMS is better that any insurance you get thru Medicaid just because they give you more therapy hours, my therapist told me yesterday that CMS covers 3 1/2 hours of each therapy a week, and it also covers Hippotherapy and aquatic therapy.. To: sList From: deniseslist@...Date: Tue, 26 Oct 2010 08:16:13 -0700Subject: Re: Re: florida kid care/CMS Sounds to me like there's a lot of misinformation going around. I can understand that if you qualify for SSI/Medicaid then you would also qualify for CMS - but then, if you qualify for SSI and Medicaid, you certainly don't need CMS. My suggestion would be to go ahead and apply - partly because of the misinformation, and partly because the rules change with alarming frequency. To: deniseslist Sent: Tue, October 26, 2010 10:34:07 AMSubject: RE: Re: florida kid care/CMS Hi Jeannie, I just spoke with the eligibility coordinator for CMS in Broward again, her name is Sonya her number is . She says that unless you qualify for the $15-$20 premium for Kidcare then you do not qualify for CMS. She says that many of the representatives are not well informed but that she is the one that determines eligibility for CMS. She says that you can call her and she can explain it to you. She says there may be a way around it - if you are eligible for medicaid or SSI then you may be able to qualify for CMS. Both medicaid and SSI are income based as well so I don't qualify. You can get on the medwaiver waiting list but that list has a 7 year wait, unless you can prove extreme crisis like documented danger to your child like getting lost (need to show police reports etc). I would check it again b/c I know that it takes 45 days for Kidcare/CMS to kick in and you have to be without any current insurance for a month (I think) before you can quailfy. For us, thats a long time to be without insurance without knowing if you'll recieve coverage. If you hear anything different please let me know!Best Regards,Shiri Weizman To: sList From: rkrouch1@...Date: Mon, 25 Oct 2010 18:21:22 -0700Subject: Re: Re: florida kid care/CMS I wanted to email you back because maybe it will help your situation. I called kidcare and CMS today and they both said that kidcare is the one that is income based -we will have to pay the top premium of 160 but that is chump change compared to what we pay now. But CMS eligibility is based solely on medical need. I called back and got someone else and the story was the same, they said that a few years ago, CMS was in fact income based but the laws have changed. I am gonna go for it. Maybe it can help you too. Jeannie Subject: Re: florida kid care/CMSTo: sList Date: Friday, October 22, 2010, 3:47 PM Anyone can get Kidcare but NOT everyone is eligible for CMS which is what gets you ST, OT etc... We just went through the process and they told us we could get Kidcare for about $160 b/c we make above the poverty level, but we were not eligible for CMS which has an income cap of about 40k per family/per year. We make more than that but we also spend TWICE as much as we make to cover therapies. When I told CMS this they said that they realize this is a problem but that is the rule and they have an income cap that cannot be changed for special circumstances. We even considered my DH getting a lower paying job so that we can get CMS b/c insurance isn't covering therapy and we are going bankrupt and may lose our house. I wish they would take into consideration the added financial burdens of families with children with Autism. We can't qualify for any grants or services b/c of income, but our income doesn't come close to covering essential therapies that we aren't able to give my son.Hope you have better luck!>> Hello everyone.> > I was considering changing insurance companies to Florida Kid Care for my 3 year old. I spoke to a rep and they will take her pre-existing Autism, however someone told me that CMS, the area that provides services such as speech and OT for special needs children is based off of income. I have left messages with supervisors - I can't seem to get an answer from an authority. Does anyone out there have Florida kid care with CMS?> If so, how has your experience been? Were you able to get services for your child?> > thanks > Jeannie Krouch> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2010 Report Share Posted October 27, 2010 I totally hear you, as if the situation with our children is not upsetting enough! They told me that if you apply on line it's quicker.Also - a stipulation for acceptance for this insurance is that the child can not have insurance. One of our friends was recently denied because she applied for it but wasn't pulling her kid from current insurance until open enrollment in Jan, Another of our friends fibbed and said that the children had no insurance and were accepted. I don't want to risk being rejected if they check so I am going to pull her, then apply. She will be uninsured for roughly a month but I think it's worth it. These are customer service lines for Florida Kid Care then they will transfer you to CMSeveryone was very helpful. Then, they told me that once she is accepted to CMS, Raquel Padron is the contact personGood luckJeannie Subject: Re: florida kid care/CMSTo: sList Date: Friday, October 22, 2010, 3:47 PM Anyone can get Kidcare but NOT everyone is eligible for CMS which is what gets you ST, OT etc... We just went through the process and they told us we could get Kidcare for about $160 b/c we make above the poverty level, but we were not eligible for CMS which has an income cap of about 40k per family/per year. We make more than that but we also spend TWICE as much as we make to cover therapies. When I told CMS this they said that they realize this is a problem but that is the rule and they have an income cap that cannot be changed for special circumstances. We even considered my DH getting a lower paying job so that we can get CMS b/c insurance isn't covering therapy and we are going bankrupt and may lose our house. I wish they would take into consideration the added financial burdens of families with children with Autism. We can't qualify for any grants or services b/c of income, but our income doesn't come close to covering essential therapies that we aren't able to give my son.Hope you have better luck!>> Hello everyone.> > I was considering changing insurance companies to Florida Kid Care for my 3 year old. I spoke to a rep and they will take her pre-existing Autism, however someone told me that CMS, the area that provides services such as speech and OT for special needs children is based off of income. I have left messages with supervisors - I can't seem to get an answer from an authority. Does anyone out there have Florida kid care with CMS?> If so, how has your experience been? Were you able to get services for your child?> > thanks > Jeannie Krouch> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2010 Report Share Posted October 27, 2010 Do you know if CMS covers ABA therapy? Re: florida kid care/CMS To: sList Date: Friday, October 22, 2010, 3:47 PM Anyone can get Kidcare but NOT everyone is eligible for CMS which is what gets you ST, OT etc... We just went through the process and they told us we could get Kidcare for about $160 b/c we make above the poverty level, but we were not eligible for CMS which has an income cap of about 40k per family/per year. We make more than that but we also spend TWICE as much as we make to cover therapies. When I told CMS this they said that they realize this is a problem but that is the rule and they have an income cap that cannot be changed for special circumstances. We even considered my DH getting a lower paying job so that we can get CMS b/c insurance isn't covering therapy and we are going bankrupt and may lose our house. I wish they would take into consideration the added financial burdens of families with children with Autism. We can't qualify for any grants or services b/c of income, but our income doesn't come close to covering essential therapies that we aren't able to give my son. Hope you have better luck! > > Hello everyone. > > I was considering changing insurance companies to Florida Kid Care for my 3 year old. I spoke to a rep and they will take her pre-existing Autism, however someone told me that CMS, the area that provides services such as speech and OT for special needs children is based off of income. I have left messages with supervisors - I can't seem to get an answer from an authority. Does anyone out there have Florida kid care with CMS? > If so, how has your experience been? Were you able to get services for your child? > > thanks > Jeannie Krouch > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2010 Report Share Posted October 27, 2010 The CMS coordinator I spoke to says that they are in the works of getting aba coverage very soon since right now it is covered only for specific circumstances.To: sList From: zandersmom99@...Date: Wed, 27 Oct 2010 12:53:54 -0400Subject: Re: Re: florida kid care/CMS Do you know if CMS covers ABA therapy? Re: florida kid care/CMS To: sList Date: Friday, October 22, 2010, 3:47 PM Anyone can get Kidcare but NOT everyone is eligible for CMS which is what gets you ST, OT etc... We just went through the process and they told us we could get Kidcare for about $160 b/c we make above the poverty level, but we were not eligible for CMS which has an income cap of about 40k per family/per year. We make more than that but we also spend TWICE as much as we make to cover therapies. When I told CMS this they said that they realize this is a problem but that is the rule and they have an income cap that cannot be changed for special circumstances. We even considered my DH getting a lower paying job so that we can get CMS b/c insurance isn't covering therapy and we are going bankrupt and may lose our house. I wish they would take into consideration the added financial burdens of families with children with Autism. We can't qualify for any grants or services b/c of income, but our income doesn't come close to covering essential therapies that we aren't able to give my son. Hope you have better luck! > > Hello everyone. > > I was considering changing insurance companies to Florida Kid Care for my 3 year old. I spoke to a rep and they will take her pre-existing Autism, however someone told me that CMS, the area that provides services such as speech and OT for special needs children is based off of income. I have left messages with supervisors - I can't seem to get an answer from an authority. Does anyone out there have Florida kid care with CMS? > If so, how has your experience been? Were you able to get services for your child? > > thanks > Jeannie Krouch > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2010 Report Share Posted October 27, 2010 Any idea what those specific circumstances are? Re: florida kid care/CMS To: sList Date: Friday, October 22, 2010, 3:47 PM Anyone can get Kidcare but NOT everyone is eligible for CMS which is what gets you ST, OT etc... We just went through the process and they told us we could get Kidcare for about $160 b/c we make above the poverty level, but we were not eligible for CMS which has an income cap of about 40k per family/per year. We make more than that but we also spend TWICE as much as we make to cover therapies. When I told CMS this they said that they realize this is a problem but that is the rule and they have an income cap that cannot be changed for special circumstances. We even considered my DH getting a lower paying job so that we can get CMS b/c insurance isn't covering therapy and we are going bankrupt and may lose our house. I wish they would take into consideration the added financial burdens of families with children with Autism. We can't qualify for any grants or services b/c of income, but our income doesn't come close to covering essential therapies that we aren't able to give my son. Hope you have better luck! > > Hello everyone. > > I was considering changing insurance companies to Florida Kid Care for my 3 year old. I spoke to a rep and they will take her pre-existing Autism, however someone told me that CMS, the area that provides services such as speech and OT for special needs children is based off of income. I have left messages with supervisors - I can't seem to get an answer from an authority. Does anyone out there have Florida kid care with CMS? > If so, how has your experience been? Were you able to get services for your child? > > thanks > Jeannie Krouch > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2010 Report Share Posted October 28, 2010 Jeannie, I called the first number you gave me yesterday, and at first the Kidcare representative said yes we get CMS. Then I said, are you sure? I don't want to take my son off of his insurance for the required month since he has medical issues and allergies, without knowing for sure that he qualifies for CMS. Then she puts me on hold for 15 minutes to speak with a specialist, who proceeds to tell me that if I don't qualify for the lower $10-15 premium then I don't qualify for CMS (we qualify for the full $160 premium). Then I thought maybe it might be different for different age groups? She says no, it the same for all age groups up to 18. Then I think maybe I'm in a different county in Florida? No this law is enforced in all of Florida. The only thing I can think of is maybe we have a different diagnosis? I know this board is for all special needs, my son's dx is Autism. I can't figure out why I keep getting this different information. I asked the specialist why the other rep gave me different information, and other people are getting different information, she says that the regular kidcare reps do not know all the details about CMS just for kidcare. Yes CMS is based on medical diagnosis, you can't get it unless you have one. But as far as income criteria, this is the answer I keep getting when I ask to speak to someone who specializes specifically in CMS. I also called the 2nd number you gave and got the operator at CMS Broward and asked for Raquel like you said and they said there was no Raquel working there. Very strange, maybe she's at a different office? Please let me know if you are able to get CMS. I personally can't risk taking DS off of insurance for a month or possibly more because of the added medical issues he has. Thanks so much for updating me and Good Luck! Shiri > > > > Hello everyone. > > > > I was considering changing insurance companies to Florida Kid Care for my 3 year old. I spoke to a rep and they will take her pre-existing Autism, however someone told me that CMS, the area that provides services such as speech and OT for special needs children is based off of income. I have left messages with supervisors - I can't seem to get an answer from an authority. Does anyone out there have Florida kid care with CMS? > > If so, how has your experience been? Were you able to get services for your child? > > > > thanks > > Jeannie Krouch > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2010 Report Share Posted October 28, 2010 Ok, I found a document on the Kidcare website which states the rules for kidacare/CMS. It's PDF and I don't know how to attach, so if you want to read it go to www.floridakidacare.org/council.html and then scroll down to the second PDF entitled 2010 Annual Report and Recommendations. After reading and trying to decifer it from what I understood anyone who is NOT eligible for " Title XIX " , which is the subsidized kidcare up to $20, does not get CMS. In other words the " Full pay premium " does not have an option for CMS, they can enroll in the full pay kidcare if they want but not CMS. I copied the relevant paragraph below: " There is not a separate full pay option for the Children's Medical Services Network. Children with special health care needs with family incomes above 200 percent of the federal poverty level may enroll in MediKids or Healthy Kids full-pay, depending on the child's age. " Somewhere else it states that to be CMS eligible you have to be " Title XIX' eligible (can't find it). I might be understanding this wrong, reading these laws makes my head explode! Shiri > > > > > > Hello everyone. > > > > > > I was considering changing insurance companies to Florida Kid Care for my 3 year old. I spoke to a rep and they will take her pre-existing Autism, however someone told me that CMS, the area that provides services such as speech and OT for special needs children is based off of income. I have left messages with supervisors - I can't seem to get an answer from an authority. Does anyone out there have Florida kid care with CMS? > > > If so, how has your experience been? Were you able to get services for your child? > > > > > > thanks > > > Jeannie Krouch > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2010 Report Share Posted October 28, 2010 the 954 number was for the Raquel lady who you can't speak to until you are in. I am going to call again because I work for the schoolboard. We pulled sydney yesterdayand open enrollment is only one more day - we won't be able to get her back on until a year passes if this doesn't work. Subject: Re: florida kid care/CMSTo: sList Date: Thursday, October 28, 2010, 9:38 AM Jeannie,I called the first number you gave me yesterday, and at first the Kidcare representative said yes we get CMS. Then I said, are you sure? I don't want to take my son off of his insurance for the required month since he has medical issues and allergies, without knowing for sure that he qualifies for CMS. Then she puts me on hold for 15 minutes to speak with a specialist, who proceeds to tell me that if I don't qualify for the lower $10-15 premium then I don't qualify for CMS (we qualify for the full $160 premium). Then I thought maybe it might be different for different age groups? She says no, it the same for all age groups up to 18. Then I think maybe I'm in a different county in Florida? No this law is enforced in all of Florida. The only thing I can think of is maybe we have a different diagnosis? I know this board is for all special needs, my son's dx is Autism. I can't figure out why I keep getting this different information. I asked the specialist why the other rep gave me different information, and other people are getting different information, she says that the regular kidcare reps do not know all the details about CMS just for kidcare. Yes CMS is based on medical diagnosis, you can't get it unless you have one. But as far as income criteria, this is the answer I keep getting when I ask to speak to someone who specializes specifically in CMS.I also called the 2nd number you gave and got the operator at CMS Broward and asked for Raquel like you said and they said there was no Raquel working there. Very strange, maybe she's at a different office?Please let me know if you are able to get CMS. I personally can't risk taking DS off of insurance for a month or possibly more because of the added medical issues he has. Thanks so much for updating me and Good Luck!Shiri> >> > Hello everyone.> > > > I was considering changing insurance companies to Florida Kid Care for my 3 year old. I spoke to a rep and they will take her pre-existing Autism, however someone told me that CMS, the area that provides services such as speech and OT for special needs children is based off of income. I have left messages with supervisors - I can't seem to get an answer from an authority. Does anyone out there have Florida kid care with CMS?> > If so, how has your experience been? Were you able to get services for your child?> > > > thanks > > Jeannie Krouch> >> Quote Link to comment Share on other sites More sharing options...
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