Medicaid Buy-In Nightmare
Red tape frustrates me to high hell
Linda Speaker
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I am a consumer of mental health services. I've been working full-time for over a year and a half, and was one of the first to find out about the Medicaid Buy-In.

I went to my local Medicaid office and when I asked for the Medicaid Buy-In, I was handed the Medicare QMB form, which is not the correct form. The supervisor didn't know anything about the Buy-In either. I was assigned to a representative and finally filled out the right form.

I filled out the required forms. I was told I needed certain documents filled out by my psychiatrist and also by my medical doctor. This document package was about 20 to 30 pages long, and I hand-delivered these documents to the respective medical specialists. After these forms were filled out, the Medicaid office informed me that the work had to be completed within a two-week period, and I had exceeded the time limit. I told them that the type and quantity of information they required could not be obtained in a two-week period. With great frustration, I finally asked the receptionist to forward my documents to the supervisor.

Several months passed and I had not heard from the Medicaid office. I contacted the Medicaid Assistance Program (MAP) and there, fortunately, I spoke with Mr. Nash, the representative from the New York State Department of Health who oversees the Medicaid Buy-In in New York State.

I explained to him what had happened. He told me he would put a tracer on my documents. Later, he contacted me and told me that I would need additional paperwork filled out in order to process my application. I had to go back to my psychiatrist to do this. I could have understood this if I had no history with Medicaid, but I had a spend-down with this particular office since 1996, yet I still had to prove my disability existed.

I then proceeded with my paperwork and was told I had to fill out a HIPPA form to release the same information that was released in the first place through South Beach Psychiatric Center, a state mental hospital that had my records.

I was referred to Ms. Jackson who works for the Medicaid Buy-In program at the Central Medicaid office in Manhattan (at 34th Street). She proceeded to help me fill out the HIPPA form over the phone. I then returned to my psychiatrist with the signed HIPPA forms and she contacted Ms. Jackson herself. She mailed the information that was needed directly to Ms. Jackson and Ms. Jackson forwarded this package of information to Albany.

Months later, I received a phone call from Albany that the medical section of this determination was approved. Then I received another phone call from Albany requesting that I resubmit pay stubs to establish my current financial situation.

After a few weeks had passed, I received a letter stating that I was approved for the Medicaid Buy-In. My coverage was retroactive, dating back to August of 2003.

I want to add for City Voices readers who reside in Brooklyn that I am a benefits advisor for the Brooklyn Works project serving the entire borough of Brooklyn. Based on my personal experience and professional knowledge of the Buy-In program, I would be more than happy to assist you in the application process and to help you face these problems.
To contact Brooklyn Works, please call (718) 368-7910. You may ask for Linda Speaker or another helpful employee for help with the Medicaid Buy-In or other employment issues.
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