Florida Kid Care/CMS

[Guest guest]

I don't know why there has been such mis information going on.

 

Does anyone on this list pay full price for Healthy kids (meaning they pay $126 or more montly, PER child covered) and get CMS for their child as well?

I'm thinking that there just isn't going to be anyone who says yes to that question.

We've been on both sides of the HealthyKids/KidCare premiums and when we were paying $256 per month for 2 children, I tried to get my younger daughter (prior to her ASD dx) on CMS because she has Epilepsy and was taking multiple medications and had several set backs due to prolonged seizure activity. The answer was plain and simple, No. They said they wished it was different, wished they could help out but that they just couldn't there was no law written yet that allowed them to be a provider.

 

Now years ago there was no option to buy into KidCare, ( ages 1-5) Only Healthy Kids for ages 5 and up. It was a crack in the system for sure because our income was just over the limit for the low premium and we had to pay $126 (or something like that) for my older daughter because she was 7 or 8 at the time and on Healthy Kids, but for , the one with Epilepsy, being just over one and being dropped from Medicaid for being over one, couldn't get onto KidCare because the law hadn't been written yet to allow for those over the income limit to 'buy into' the coverage at the full price.

Now at that time since had NO coverage at all, CMS did step in and wrote up a coverage plan that would cover her for anything related to her disabilities. So if she got sick with a cold/flu, then we would have to pay all the bills, if she broke her arm, we would have to pay... but if she had a seizure and had to have treatment or be seen to change medications or whatever then they covered that. She also has what is called Arnold Chari Malformation and it has to be monitored as she grows with an MRI, and that was covered as well.

But once the law makers wrote the law and allowed for parents to buy into the Kid Care coverage at full price then our CMS coverage was terminated and we were told to get the KidCare. We went for a couple years paying full price and not having access to the amounts of private therapy needed because we couldn't get CMS.

 

Thankfully (or not depending how you look at it) my husband had a cut in pay/hours and while it hurts us in bills and making ends meet, it did drop us below the income limits and the girls now have the $20 a month premium and CMS.

 

I would say that if your considering dropping your child's coverage in the hopes of getting on CMS, don't do it unless you know  you'll qualify for the reduced premium and get approved. I've heard of people getting denied because they ask if your employer offers coverage for your children and if so, how much is it. A friend filled it out honestly and was denied because her employer DOES offer to cover the children and the cost, while more than kid care, was not enough more than Kid Care for them to approve the application. She later re-applied saying they don't offer coverage and they were approved.

 

 

Hope that helps someone,

Theresa