August 27, 2008
W.Va. Medicaid recipients don't understand program, survey says

CHARLESTON, W.Va. - West Virginians covered by Medicaid don't understand recent program changes, leaving thousands of low-income children and families without access to critical medical care, according to a survey released Tuesday.

The Direct Action Welfare Group, a statewide organization of people on public assistance, said the state's Medicaid office has mismanaged the program - called Mountain Health Choices - and failed to educate recipients.

Two-thirds of West Virginians on Medicaid said they didn't receive a letter from the state, notifying them that their benefits had changed, according to the survey.

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    Posted By: Anonymous (9:31pm 09-18-2008)
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    A min wage taxpaper that have no medical coverage whatsoever for their children, deserve that their child have medical to, but guess what, THEY DO NOT GET IT!! A working man doesn't have a chance in this world nowdays!! It seems like the lazier a person is the better off they are now in the long run!!

    Posted By: transportation (2:42am 09-03-2008)
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    @OMG if you have the basic plan it eliminates the nonemergency medical transportation.

    Posted By: OMG (2:03pm 08-29-2008)
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    People who recieve medicaid also get non emergency medical transportation. That means everytime they go to the Dr. or emergency room they get a check in the mail. I thinks its about 45 or 50 cents a mile. So the more the go the more they get payed. i used to work for the DHHR and the are not happy when that check is late because the depend on that as part of there monthly income.

    Posted By: think realistically (9:13am 08-29-2008)
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    Plus, I will almost guarantee that you earn either sick leave or vacation leave that can be used to cover your lost work time; minimum wage employees don't have that luxury. Yes, there are some 'welfare millionaires' around here (I know of one who had two houses under HUD in the same area--obviously they didn't screen well) but most of these folks are struggling to get by. I personally believe that after two kids on welfare there should be mandatory sterilization no matter your age, race, or gender--that might control some of the extreme poverty and need that we see here. Ever watched Maury Povich? (I only get two stations at work, so I listen to it.) There was an episode lately where a woman had four kids, two in common with a man who had a total of (sit down for it) TWELVE children. Between the two of them, that's FOURTEEN kids. Now how ridiculous is that? Mandatory sterilization of ANYONE with two would severly limit the amount of aid necessary in this country. And I'm a liberal!

    Posted By: think realistically (9:06am 08-29-2008)
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    @BreakingTaxPayer

    I am a well-employed 37 year old with two teenage children and great Blue Cross insurance, but I find your ignorance appalling. Where do you think a single mom with young kids (especially if they live in Charleston) to find a job above minimum wage that has benefits and doesn't require that she find a daycare? I have customers who work two and three minimum wage jobs without insurance because that is the only way they can put food on their kids' table with the least possible amount of welfare. The welfare system counts everything against you--got a 50 cent raise? Benefits drop. Got a car to get you to work? Benefits drop. Got a computer to go to college online? Benefits drop. Move to a more expensive apartment so your kids are safer? Benefits don't go up and may drop (I mean, if you can afford an extra $50/month rent you must not need foodstamps). There are many reasons why this is such a pervasive culture. I used to be there; welfare is a hand up, not a hand out.

    Posted By: WVserf (4:52am 08-29-2008)
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    @medicine: No I don't "need" to check the bms site, I'm not on it, I have a employer plan...do you?

    Posted By: BreakingTaxPayer (3:35am 08-29-2008)
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    @working mom: If someone is over 25 and making minimum wage, they need to reexamine their lives. Minimum wage is for teens and college students. "I can't get a day off to go to doctor..." I can????? I don't make minimum wage, and I can't afford that, but if I or my children need to go, I take off. Yet, I have to wait for my family doctor to open or spend upwards of $250-$500 for the visit to the emergency room.

    You're not taking care of your kids, you're making us take care of them. If you can't feed 'em, don't breed em...

    Posted By: working mom (10:40pm 08-28-2008)
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    I work hard at a job that doesn't pay nothing but minimum wage. I can't afford to take a day off work and sit around the doctors office if my kid has a high fever. A day off work means the bills don't get paid and we end up on the street. Maybe if the doctors that take a medical card had later hours or something it would be good. So my choice is take my kid to an ER for the 102 fever and vomiting or don't take him nowhere. The system is broke. I don't know how to fix it and I didn't break it. So don't blame me or the other moms struggling to work and take care of our kids.

    Posted By: Former Medicaid Worker (8:19am 08-28-2008)
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    My clients would go to the ER for a rash or a headache - I suffer at home until regular doctor hours because insurance charges you for the ER unless it is a real emergency - medicaid recipients don't want to understand anything but "FREE" they don't care what plan as long as it is free

    Posted By: medication (8:16am 08-28-2008)
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    Children's perscriptions are limited to 4 per month and many other services are limited for children in the basic program. Maybe you should check out the bms site and look at the two programs.

    Posted By: Medicaid (7:52am 08-28-2008)
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    Not all people on Medicaid run to the ER or their Dr.for every little sniffle or cough.The major thing wrong with medicaid is when you have a patient on a medicine that works,then medicaid steps in&says no we won't cover that one anymore but we will cover one that cost more.I was on an acid reflux med.that truly worked good for me that cost $101 for 30 days,then they said no they wouldn't cover that one anymore or the generic of it but they would cover one that cost $187 per month.also I would like to know how you can find out just whom medicaid is paying on the behalf of some recipients when they haven't seen a "REAL" dr.in over 21/2 yrs.but a nurse practioner instead.Is medicaid being billed for the service of a doctor instead of the services of a nurse.It's silly that medicaid would pay for higher priced meds when the cheaper one works even better unless someone is getting a kick-back from the manufacturer.

    Posted By: dd. (7:37am 08-28-2008)
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    The way it is. If I,am going to have to pay for the extra drugs that I have to take, on my SSI How am I supposed to be able to make payments on my computer and my cadillac.?

    Posted By: WV Citizen (7:36am 08-28-2008)
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    The article is not completely true - adult recipients of Medicaid only receive 4 prescriptions per month - there is no limit for children -

    Posted By: Taxpayer (10:41pm 08-27-2008)
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    @Special Needs: But why do you have to point a gun at my head and extract the cost of those prescripts from my pocket???? I'm sorry for the chronic illness, but life is not fair. I'm just tired of the sucking sound everything I get my paystub, I get to pay your medical care, then turn around and have to pay for mine.

    Posted By: Special Needs (10:05pm 08-27-2008)
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    If a child has a chronic illness they can need more then four perscriptions a month.

    Posted By: Read Closer (5:57pm 08-27-2008)
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    I went to the website and read the survey also. If you take a look at the numbers for Raleigh, Fayette, and Summers counties it is a good sample size to extrapilate information about the population at least in those three counties.

    Posted By: check the numbers (5:42pm 08-27-2008)
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    If you go to the WV DAWG website, you will see their full report. Notice that only 354 Medicaid recipients and only 13 providers responded to their survey. The way the article by Eric Eyre is written leads one to believe that all recipients and providers were surveyed, which is far from true. The sample size is too small to apply any of this to the larger population.

    Posted By: Sleuther (4:17pm 08-27-2008)
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    Who in the H is James Davis? Please provide details!

    Posted By: Krisk (3:41pm 08-27-2008)
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    Just a thought: acording to the article: 80% of the recipients are children. If their parents do not respond to the program they get the basic and not the expanded program. Question: do they realy need the expanded program: smoking cessation, weight management and nutrition classes. Does a child realy need more than 4 drugs a month? (ritalin, viagra, cholesterol, and high blood pressure?)
    Just a thought?

    Posted By: Krisk (2:52pm 08-27-2008)
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    If the poor, or a child, get sick they get treated. Sounds simple enough. Why is so much time and energy spent trying to define different programs to treat the poor? People trying to justify their existence and paycheck perhaps?
    How is it that West Virginians average 17.2 perscriptions per person!

    In China, tradition has it that the villiage doctor was only as wealthy as the villiage was prosperous. the villiage was only prosperous if the workers were healthy. Chinese medicine has been around for thousands of years and is even being adopted as alternative medicine by some physicians in the United States, although the treatments are not covered by the majority of insurance in the US.
    In America, your hospitals and physicians only make money if they can justify continued long-term treatment. They do not benefit if you are healthy and productive.
    ...which system would you rather be treated by?

    Posted By: shame (2:29pm 08-27-2008)
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    It is shameful that anyone living in the wealthiest and most technologically advanced nation on earth should get a bill for appropriate and medically necessary care.
    Universal coverage now!

    Posted By: doddie (2:15pm 08-27-2008)
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    I am a recipient of WV Medicaid. I just wanted to say that when it first started in my county (Lincoln), I went to the pharmacy and they couldn't fill my perscriptions because I was over the limit. I called my local office and Charleston. They told me that I was supposed to have chosen a plan. They finally put me on Enhanced. Now, a year has passed and I have received a notice that I am being changed back to Basic and I will have to go again to my doctor and fill out the paperwork again. It is all very confusing because now I am receiving bills from labs and medical places that were supposed to have been covered. I cannot pay these bills. I also want everyone to know that I do work for a living. I have always worked , but my income is still in the 100% poverty level. I do not like having to receive assistance, but I have no choice. I could be drawing disability. I choose to work instead. Receiving assistance is not tradition, it is embarrassing. Being looked down upon hurts.

    Posted By: DavisJms7 (2:10pm 08-27-2008)
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    This W.Va. Medicaid is another one of Manchin's big jokes he is playing on the poor, unemployed, and uneducated people of West Virginia. I am JAMES DAVIS and I am running for Governor and I know who has the best Health Care system in the world and I know how to get it and implement it in West Virginia and when I do that, West Virginia will have the best and most affordable Health Care system in America and you will not have to be educated on how it will work. My Health Care system will be user friendly and user affordable. This November, vote JAMES DAVIS for Governor and I will provide you with the best Health Care America has ever seen.

    Posted By: demopolis (2:10pm 08-27-2008)
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    Mediciad & Medicare act as a support system to offload risk from Private Insurance companies. Medicaid covers high risk populations with low income/serious medical conditions & medicare the elderly.

    Also Medicare & Medicaid act as a safety valve to passify patients & pay off professional healtcare providers. Vital Statistics prove that most 1st world countries have populations which are as healthy or healthier than US citizens for half the cost.

    Posted By: Interested and Employed w/Health Care (1:24pm 08-27-2008)
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    Even if the WV residents don't think it is a good use of their tax money to provide health care w/benefits that recipients can understand, they should still be concerned about the millions of dollars spent to administer this program and it's failure. If recipients are confused, so are providers offices. It is a Medicaid administrative failure as much as anything and if the citizens of WV don't start looking at the failures of this system in the past 6 yrs, it's our own fault. Medicaid is playing it's own game and making it's own rules. Not only are you paying for it by your tax money but also by increased rates because your physician offices must jump thru hoops and hire people just to keep up with Medicaid non-payments, etc. The governor's office and our legislature should be investigating Medicaid's current practice-it is a heirarchy.

    Posted By: Sleuther (1:20pm 08-27-2008)
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    With many folks in WV Medicaid is a "family tradition". They have it down to a fine science. Just take a look at a few counties...Clay...Lincoln...Fayette, etc. Medicaid has provided FREE medical care to some families generation after generation. What's wrong with this picture people? Why work when you can get something free?

    Posted By: care for all (12:22am 08-27-2008)
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    As an advanced civilized nation we should be able to provide all our citizens with basic health care. None of us benefit from the inefficiencies created by the myriad of different payers and plans and the class distinction of public versus private pay.
    Give us all Medicare from birth. Let private insurers compete for providing additional coverage. For most of us the additional taxes and premiums would be less than what we pay for private insurance now. And universal coverage means better preventive care, which decreases emergency room costs and expensive chronic disease care, and lower overhead costs.

    Posted By: Care for the Poor (11:41am 08-27-2008)
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    Grannys Girl the bible teaches us to take care of the poor. I don't have a problem with my tax dollars going to support families who hit hard times. Its better then most of the stuff our government spends our tax money on. Being a good Christian I know it is my duty to care for my brother and especially for my poor brothers. Jesus said what you do to the least of these you do to me.

    Posted By: DAWG member (11:36am 08-27-2008)
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    The organization that is written about in this article had nothing to do with Nitro. This is an organization founded by former welfare mothers who went to college and got off welfare. They help other welfare mothers understand the system and learn how to get off welfare. I think "be informed..." needs to do a little more research. This group is the only one made up of people on Medicaid standing up for people on Medicaid. They are doing the job the state should be doing and trying to educate people on this new program. If the state was doing their job then DAWG wouldn't have to do it.

    Posted By: Hard Times (10:18am 08-27-2008)
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    Before anyone complains abut poor folks and their need for health care, it might pay to look at what was sent to them. I understood the program's choices from news accounts, but when I saw the packet which the recipients received, I understood the problem. Now, someone could have done a couple versions of the packet, convened some current recipients and asked their advice. A better product might have been produced, for not a lot of money. Since DHHR chose to not seek to be understood, they should accept responsibility for the results.
    And for those complaining about their health care, you are right to complain--there should be a common, universal way of getting health care, not this mishmash that serves stockholders and health plan executives. Don't blame the other victims--literally the majority of Medicaid recipients are children.

    Posted By: vashti (9:36am 08-27-2008)
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    medicaid is no longer the sole provider of health care for people who do not work. many of the children covered by medicaid have parents who work. the public THINKS they know who gets assistance and what kind of assistance they get. the fact is i am consistently amazed at what people assume and what is fact. the misconceptions and misperceptions are held by everyone from those who recieve assistance, to politicians, to the regular joe. one should take a look at hte facts before misjudging the system

    Posted By: working mother (9:24am 08-27-2008)
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    I work 2 jobs and my kids have medical cards.My daughter recently lost her benefits because i was $30 over limit.So no , not all people on medical cards are lazy and getting a free ride. I pay into it with my tax dollars and am not ashamed of it. So if anything needs to be changed with the system,its that hard working people that need help get help instead of people that don't work at all.

    Posted By: A Advocate (9:08am 08-27-2008)
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    It is interesting to read some of the previous comments. They exude the same attitude DHHR has. What a leader!

    Posted By: Grannys Girl 66 (8:41am 08-27-2008)
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    WAKE UP - Medicaid has been a free ride for generations of families. They get all the other mail related to their cases (reviews, new services, etc.) I pay premiums for PEIA and they don't pay me for the travel to and from my medical visits, I pay a portion of my prescriptions, I pay a co-pay EVERYTIME I see on of my doctors, so get a life. People need to be responsible for something. The Bible says if you don't work then you don't eat. The only ones that don't have a choice are the kids, but the parents are lazy and don't want to to do anything but sit on their behinds and collect from the hardworking taxpayers of WV. TIME TO WAKE UP and to the group that thinks it is wrong, then you pick up the tab for the millions of dollars that are spent each year for these people that don't understand the fact that things have changed...you have to do something if you want to continue to receive Medicaid.

    Posted By: be informed... (8:33am 08-27-2008)
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    Careful how much value you put into the reliabilty of DAWG. Do your research to see who they are, as I recall it is/was headed up by friends turned mortal enemies who turned the town of Nitro into a three ring circus.

    Posted By: Curious taxpayer (6:59am 08-27-2008)
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    Has anyone seen the survey? DAWG's website is down and I can't find it. I'm interested in the margin of error.

    Posted By: Medicaid Recipient (6:26am 08-27-2008)
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    This survey is dead on. How am I supposed to choose if I don't understand what my choices are. The state sure hasn't done anything to help me understand this. If it wasn't for DAWG getting the information out. I would be one of the thousands in Basic right now.

    Posted By: eyespook4u (5:18am 08-27-2008)
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    I have YEARS of experience in dealing with people on Medicaid. The ONLY thing these people react to is getting a bill for something. As long as it's free...no problem. If they get a bill for ANYTHING they are the first to complain. While the rest of us pay thousands of dollars for health insurnace premiums...plus our own out of pocket expenses for medical care these freeloaders get EVERYTHING for NOTHING. Wake up Medicaid officials! If you want to get Medicaid recipients to understand something just charge them for NOT understanding it. A very simple solution to a never ending problem.

    Posted By: Sleuther (5:06am 08-27-2008)
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    Want to REALLY get the attention of person on Medicaid?
    It's VERY simple...just send them a bill for services received! Watch how fast they react. Their cost for coverage is $-0-...they pay $-0- for their care. What a SWEET deal...just wish I could get the same!!!!!

    Posted By: Taxpayer (2:04am 08-27-2008)
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    Heck, it's not like it matters what program they enroll in, they are going to the emergency room anyway to get their drugs and fix their stratches or colds, all on my dime.

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