Anyone know about state benefits in Washington?

suzannekearney · #1 06-09-2012, 12:01 PM

We are considering moving from California to Washington and were wondering if they have similar state disability benefits there. Right now we get some money for me (Mom) for home care, we get health insurance premiums paid, and we qualify for nursing (but currently don't use it). Are there similar benefits in Washington state and how do you access them? Timothy has a trach and g-tube and needs regular surgeries but has no cognitive impairments.
Thanks,
Timothy's Mommy

Ainsley's Mom · #2 06-09-2012, 05:34 PM

We are on the medically intensive waiver. Ainsley is developmentally delayed, so I'm not 100% sure how easy it is to get on if your circumstances are different. It is based on the income of the child (not parents). So Ainsley gets Medicaid(which for us is secondary to our primary insurance), and is approved for 10 hours per day of nursing (again she's 5 and needs total assistance so different situation). I've always heard SSI is income based and so we wouldn't qualify. I haven't heard of anyone in Washington getting paid to take care of their own child. Could be wrong.

I've heard it's easier to get on the waiver if it is secondary, again not sure if that's true. I think it's also easier to get on (or at least nursing approval), the more involved your child's care is but I think most kids with trachs would qualify, just that it's fast when it's really obvious.

Anyway, good luck. I hope you're ready for some rain.

suzannekearney · #3 07-24-2012, 12:05 PM

Hi Susan, Does Ainsley get any help with paying for DME or insurance premiums or copays? We get this in CA. I'll send you a PM as well, this is a pretty old thread.
Thanks,
Suzanne

Quote:

Originally Posted by Ainsley's Mom

We are on the medically intensive waiver. Ainsley is developmentally delayed, so I'm not 100% sure how easy it is to get on if your circumstances are different. It is based on the income of the child (not parents). So Ainsley gets Medicaid(which for us is secondary to our primary insurance), and is approved for 10 hours per day of nursing (again she's 5 and needs total assistance so different situation). I've always heard SSI is income based and so we wouldn't qualify. I haven't heard of anyone in Washington getting paid to take care of their own child. Could be wrong.

I've heard it's easier to get on the waiver if it is secondary, again not sure if that's true. I think it's also easier to get on (or at least nursing approval), the more involved your child's care is but I think most kids with trachs would qualify, just that it's fast when it's really obvious.

Anyway, good luck. I hope you're ready for some rain.

Ainsley's Mom · #4 07-24-2012, 03:20 PM

So what I replied previously is what we get. For us no I don't get paid, we don't get insurance premiums paid (though perhaps I should look into this since my husband's job changed and now we pay out of pocket for insurance) but I suspect not. We are on the waiver for medically intensive kids, but as I said Ainsley is also disabled. I really can't be sure how easy of a time you would have getting onto the waiver. The waiver gives you Medicaid coverage (called Provider One). Since we have primary insurance it picks up anything our insurance doesn't pay. Which included DME costs above the portion paid, nursing, and co-pays as well as annual deductables etc. But the trick, probably like California, is that you have to find providers willing to accept Medicaid payment (which typically pays them less).

If you have further questions about it please post here or e-mail me at ainsleyblog@comcast.net Thanks.

davidsmom · #5 07-24-2012, 03:38 PM

I just found out that we could get paid for insurance premiums and just recently applied. Search for a Health Insurance Premium Payment Plan in your state, I think each state is required to have this plan. However it has to be cost effective for the state, meaning it would save the state money if they paid you for the insurance premium as opposed to paying for the entire bills that your private insurance is covering. I never realized there is such a thing. I hope we get approved.

Ainsley's Mom · #6 07-24-2012, 05:50 PM

Quote:

Originally Posted by davidsmom

I just found out that we could get paid for insurance premiums and just recently applied. Search for a Health Insurance Premium Payment Plan in your state, I think each state is required to have this plan. However it has to be cost effective for the state, meaning it would save the state money if they paid you for the insurance premium as opposed to paying for the entire bills that your private insurance is covering. I never realized there is such a thing. I hope we get approved.

That kind of makes sense. I knew it wouldn't be out of the goodness of their hearts. My husband's premiums are $850 a month but it includes spouse and children. There is no option to pay per child, so I don't see how we could convince them to pay the insurance for the whole family.

suzannekearney · #7 07-24-2012, 08:25 PM

Yes this is exactly what we have in CA.

Quote:

Originally Posted by davidsmom

I just found out that we could get paid for insurance premiums and just recently applied. Search for a Health Insurance Premium Payment Plan in your state, I think each state is required to have this plan. However it has to be cost effective for the state, meaning it would save the state money if they paid you for the insurance premium as opposed to paying for the entire bills that your private insurance is covering. I never realized there is such a thing. I hope we get approved.

suzannekearney · #8 07-24-2012, 08:31 PM

They don't pay for the whole family; they only pay what they think is your child's portion of the total (family) premium.

Quote:

Originally Posted by Ainsley's Mom

That kind of makes sense. I knew it wouldn't be out of the goodness of their hearts. My husband's premiums are $850 a month but it includes spouse and children. There is no option to pay per child, so I don't see how we could convince them to pay the insurance for the whole family.

suzannekearney · #9 07-28-2012, 05:25 PM

I'm slightly surprised WA doesn't offer to pay parents (though I do believe you). In CA parents can choose to get paid themselves in exchange for declining some hours of nursing. It saves the state money in that they pay me $9 per hour instead of what a nurse charges plus the margin the agency takes. Oh well it was worth the asking.

Ainsley's Mom · #10 07-28-2012, 06:59 PM

Quote:

Originally Posted by suzannekearney

I'm slightly surprised WA doesn't offer to pay parents (though I do believe you). In CA parents can choose to get paid themselves in exchange for declining some hours of nursing. It saves the state money in that they pay me $9 per hour instead of what a nurse charges plus the margin the agency takes. Oh well it was worth the asking.

It's possible a program like that may exist but nobody has told me and we are on the waiver.