It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Health Insurance Issues Message Board
Post New Thread   Closed Thread
LinkBack Thread Tools
Old 12-12-2011, 08:31 PM   #1
Senior Member
(male)
 
Join Date: Mar 2007
Location: Barstow, California U.S.
Posts: 132
Steven45 HB UserSteven45 HB User
Unhappy What is the magic trick to speak to a LIVE person at the Medicaid office?

Hi everyone

I am what's called a "dual-eligible" which means that I am on both Medicare and Medicaid. I have been on Medicaid for a decade and a half. However, my Medicare just kicked in about 4 months ago.

Recently, my doctor ordered bloodwork done which turned out to cost around $700.00. A short time later I was sent a bill for nearly $500.00 from the lab and discovered that Medicare only paid $50.00 of it (a few hundred dollars was taken off for an "insurance discount").

Anyway, I made some phone calls to the lab (and also Medicare) trying to find out why Medicaid had not picked up the difference and was told (by Medicare) that I needed to contact my local Medicaid office and tell them to do a "crossover" so that what portion Medicare did not pay would automatically be picked up by Medicaid.

When I tried to contact Medicaid, it was a nightmare. No matter what number I pressed or how many menus or sub-menus I went through, I was always instructed to visit their website. Speaking things like "agent", "customer service" or "operator" didn't have any affect, nor did pressing zero. I am disabled, housebound, no vehichle, FAX machine, etc and have no way of dealing with this other than a phone call which I seem unable to make.

My question is...is there some combination of numbers you have to push or magic words you have to speak into the phone or a certain day/time you have to call in order to speak to a live person?. Amazingly, several times I called the number and was actually told that the number was "out of service or disconnected". Other times I would get a busy signal. The dozen times I was able to get through, I got nowhere.

While I'm at it, has anyone ever heard of this "crossover" thing?. I thought something like this was done automatically anyway. I was told by both Medicare and the Lab not to worry about geting stuck with the bill because Medicaid would pick up the tab but that I had to call them. I don't understand how I can do this when the entire system seems designed to prevent you from doing just that.

Thanks for any help, advice, input on this!.

- Steve
__________________
Every new day is the very first day of the rest of your life. Take nothing for granted.

 
The following user gives a hug of support to Steven45:
pme (12-13-2011)
Sponsors Lightbulb
   
Old 12-13-2011, 08:13 AM   #2
Senior Veteran
(male)
 
Join Date: May 2010
Location: Clearwater Florida
Posts: 1,163
vann04 HB Uservann04 HB Uservann04 HB Uservann04 HB Uservann04 HB Uservann04 HB Uservann04 HB Uservann04 HB Uservann04 HB Uservann04 HB Uservann04 HB User
Re: What is the magic trick to speak to a LIVE person at the Medicaid office?

Quote:
Originally Posted by Steven45 View Post
Hi everyone

I am what's called a "dual-eligible" which means that I am on both Medicare and Medicaid. I have been on Medicaid for a decade and a half. However, my Medicare just kicked in about 4 months ago.

Recently, my doctor ordered bloodwork done which turned out to cost around $700.00. A short time later I was sent a bill for nearly $500.00 from the lab and discovered that Medicare only paid $50.00 of it (a few hundred dollars was taken off for an "insurance discount").

Anyway, I made some phone calls to the lab (and also Medicare) trying to find out why Medicaid had not picked up the difference and was told (by Medicare) that I needed to contact my local Medicaid office and tell them to do a "crossover" so that what portion Medicare did not pay would automatically be picked up by Medicaid.

When I tried to contact Medicaid, it was a nightmare. No matter what number I pressed or how many menus or sub-menus I went through, I was always instructed to visit their website. Speaking things like "agent", "customer service" or "operator" didn't have any affect, nor did pressing zero. I am disabled, housebound, no vehichle, FAX machine, etc and have no way of dealing with this other than a phone call which I seem unable to make.

My question is...is there some combination of numbers you have to push or magic words you have to speak into the phone or a certain day/time you have to call in order to speak to a live person?. Amazingly, several times I called the number and was actually told that the number was "out of service or disconnected". Other times I would get a busy signal. The dozen times I was able to get through, I got nowhere.

While I'm at it, has anyone ever heard of this "crossover" thing?. I thought something like this was done automatically anyway. I was told by both Medicare and the Lab not to worry about geting stuck with the bill because Medicaid would pick up the tab but that I had to call them. I don't understand how I can do this when the entire system seems designed to prevent you from doing just that.

Thanks for any help, advice, input on this!.

- Steve
If I were you I would go down to your states dept. of human services and talk to them person to person. Trying the phone method is useless. Remember they are swamped because of the sheer #'s of people wanting public aid and also they are probley short handed due to state cutbacks fom budget cuts at the state level. This is also why decisions on disability claims take forever because of state cutbacks. Remember state workers take care of the first 2 steps of a disability not the ssa.

 
Old 12-13-2011, 08:37 AM   #3
pme pme is offline
Senior Member
(female)
 
pme's Avatar
 
Join Date: Mar 2011
Location: Missouri
Posts: 273
pme HB Userpme HB Userpme HB Userpme HB Userpme HB Userpme HB Userpme HB Userpme HB Userpme HB Userpme HB Userpme HB User
Re: What is the magic trick to speak to a LIVE person at the Medicaid office?

Quote:
Originally Posted by vann04 View Post
If I were you I would go down to your states dept. of human services and talk to them person to person. Trying the phone method is useless. Remember they are swamped because of the sheer #'s of people wanting public aid and also they are probley short handed due to state cutbacks fom budget cuts at the state level. This is also why decisions on disability claims take forever because of state cutbacks. Remember state workers take care of the first 2 steps of a disability not the ssa.
He mentioned in his post that he is housebound, also no vehicle. He said phone is his only option.

 
Old 12-13-2011, 09:10 AM   #4
Senior Veteran
(male)
 
Join Date: May 2010
Location: Clearwater Florida
Posts: 1,163
vann04 HB Uservann04 HB Uservann04 HB Uservann04 HB Uservann04 HB Uservann04 HB Uservann04 HB Uservann04 HB Uservann04 HB Uservann04 HB Uservann04 HB User
Re: What is the magic trick to speak to a LIVE person at the Medicaid office?

Quote:
Originally Posted by pme View Post
He mentioned in his post that he is housebound, also no vehicle. He said phone is his only option.
Well he will never get through by way of phone then his only option is to find someone to take him. I'm sorry but that's really the only way to get this taken care of. I have tried to contact my DHS when I was only getting ebt bennifits by phone but no luck I had to go down there in person and wait 3 hrs to talk to someone the place was packed wall to wall with people also waiting to see someone.

 
Old 12-13-2011, 12:47 PM   #5
Registered User
(female)
 
Join Date: Dec 2008
Location: California
Posts: 1,777
mscat40 HB Usermscat40 HB Usermscat40 HB Usermscat40 HB Usermscat40 HB Usermscat40 HB Usermscat40 HB Usermscat40 HB Usermscat40 HB Usermscat40 HB Usermscat40 HB User
Re: What is the magic trick to speak to a LIVE person at the Medicaid office?

Hi Steve,
I understand your frustration! Medi-cal will pick up the extra amount, that is what should have happened in the first place. Once this is all straightened out, I don't think it will happen again. Since you have Medi-Cal, you will also have a social serivices worker. Call your local Welfare Department, they will direct you to your worker. Talk to your worker about this , he or she may be able to handle it through the computor. If not tell him you are not able to call Medi-CAl directly and ask the worker to do it for you. It sounds like all they have to do is link your Medi-Cal to your Medicare. Since you have both this should not be a problem for them to do. Once they transfer yo to your worker you might need to leave a message. Be sure to do this , and give them your phone number to call you back, you call tell them it is urgent or a emergency. Every person who has Medi-cal, food stamps, or cash aid has a worker . Since you live in California I know this is correct information. I also have Medi-Cal , and Medicare.

Last edited by mscat40; 12-13-2011 at 12:51 PM.

 
The Following User Says Thank You to mscat40 For This Useful Post:
pme (12-13-2011)
Closed Thread

Similar Threads
Thread Thread Starter Board Replies Last Post
Not even clear about what is wrong with me allDkingshorses Disabilities 2 04-28-2011 02:01 AM
What services count towards a medicaid deductible? KellyCz Disabilities 1 08-14-2009 09:00 AM
On medicaid but just received medicare NY 1009 Disabilities 7 11-25-2008 08:14 AM
What A Wonderful World mehen20077 Disabilities 1 06-11-2008 06:28 AM
Questions about SS/medi - don't know what to do now sierrabrulee Disabilities 3 01-24-2008 05:03 PM




Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Join Our Newsletter

Stay healthy through tips curated by our health experts.

Whoops,

There was a problem adding your email Try again

Thank You

Your email has been added








TOP THANKED CONTRIBUTORS



Whynowthis (44), youtoo1955 (29), SpineAZ (20), vann04 (17), dismama (10), magicssd (8), Titchou (8), sandiemas (7), Jacki345 (6), minnieme1982 (6)

Site Wide Totals

teteri66 (1180), MSJayhawk (1004), Apollo123 (904), Titchou (847), janewhite1 (823), Gabriel (759), ladybud (754), sammy64 (668), midwest1 (668), BlueSkies14 (610)



All times are GMT -7. The time now is 07:11 PM.



Site owned and operated by HealthBoards.comô
Terms of Use © 1998-2014 HealthBoards.comô All rights reserved.
Do not copy or redistribute in any form!