This morning went off the rails right at 7am with a call from the doctor saying we were showing no coverage as of Jan. 1st, 2019 and how did we want to pay for today's visit for the four year old!
After a lengthy call with Maryland Health Connection I'm told we no longer qualify for MCHP. There's no way to appeal even though research online shows we are well below the max income requirement for a 6 person household and the person I spoke to can only repeat like a robot "but the computer says you no longer qualify".
In November, I had to go in and make an address change from our recent move, and I updated our income slightly but not enough to go beyond the stated max for a family of 6, but we think that because we've separated ourselves as parents to go through a non-insurance route, and only had 4 kids in the program, maybe they couldn't count us as a family of six.
We are still within a 90 day window to apply for a QHP (qualified health plan) so I made a chart to compare their lowest plan VS putting all the kids on Samaritan Ministries.
It breaks down like this:
I'll miss that $68 MCHP plan that covered everything and it sure was a blessing to have it for four years, but we'll also be fine with Samaritan Ministries. It's amazing how this blow waited to happen until right after we had paid off ALL debt (except our mortgage). One year ago it would have been more devastating. Our montly impact is approximately $250 per month which was a car payment last year.
It forced me to dig deep and make sure Samaritan Ministries is really the right plan for our entire family, I called the kids doctor/dentist/vision offices to get a better understanding of cash payment prices and I even called Samaritan to better understand sharable bills. It turns out that anything dealing with a sickness over $300 is generally sharable. This helped me to budget $200 per child as they seem to each get sick enough once per year to visit the doctor. I haven't included prescriptions yet as I'd need to update those on a case by case basis but they are generally paid out of pocket.
I called the ortho pediatric office and they said no insurance will even cover the kids for braces until they have all baby teeth gone, so for this reason I decided to not put the kids on a dental plan for the next 2 years.
Samaritan Ministries covers broken teeth from accidents (not from eating), and any bone surgeries but they consider most dental care outside their list of covered issues.
It's unexpected, but we'll be fine.