Negativity all cleared up now a Kela question

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vincebel
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Post by vincebel » Tue Nov 27, 2007 10:06 am

hi all.
here is my case. I applied for KELA 2 months ago with all the good papers, i gave them to KELA and they told me everything is ok you ll get your card in three weeks.


Three weeks later, a letter from kela mentionned that there was one paper missing. I gave them this paper and they said its perfect , now its good, you ll get your card in three weeks.

Three weeks later, same, one paper missing.

Now i wait for the nest letter or maybe the card-

I know that i didnt have all the papers but WHY did they tell me it wsa ok (2 times) instead of notify me straight and noy after three weeks.
Will I receive the benefits once i get the card or from the date of application?

Thanks all



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blaugrau
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Post by blaugrau » Tue Nov 27, 2007 10:15 am

from the date of application, as far as I know.

hychamaz
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Post by hychamaz » Tue Nov 27, 2007 1:26 pm

I was also told three weeks, it has been 5 now and I am still waiting. My doctor and myself thought that it was from the date of application. But Kela told me when I receive the card!! They give different answers all of the time. I will at least try to get reimbursed for a doctor visit while I have been waiting and see what happens. Anyone else know???

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blaugrau
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Post by blaugrau » Tue Nov 27, 2007 1:43 pm

at least last year on my decision it stated explicitly from what time i was insured, and that was the time I filed the application, not the day I got the decision (the card comes separately from the letter containing the decision). I would assume, though, that you first need to have a positive decision before you can retrospectively claim reimbursements -- that's how I'd interpret Kela's answers, i.e. that once you have the card, you can claim back the costs from the time between your application and the positive decision -- but they won't cover you while the decision about your insurance is still pending.

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blaugrau
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Post by blaugrau » Tue Nov 27, 2007 1:50 pm

vincebel wrote:I know that i didnt have all the papers but WHY did they tell me it wsa ok (2 times) instead of notify me straight and noy after three weeks.
Didn't you say that you changed the grounds on which you applied for being domiciled/insured (girlfriend / child)? This might have had some effects on how your application was processed and delayed the decision etc. Another factor might just be bad luck.

My Kela card decision took 6 weeks. They checked if I was insured in my home country and they told me they didn't get an answer from my home-Kela for a while, which delayed the whole affair somewhat.

hychamaz
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Post by hychamaz » Tue Nov 27, 2007 2:21 pm

Thanks for the reply blaugrau. That makes sense. Do you have any idea why they would send the card separate from the letter containing a positive decision. That doesnt make any sense to me. Also, how long did it take for your card to come after the positive decision. I have to see a doctor and I assume that I wouldnt be covered at the Heath Care Center with the positive decision and not the card??? Or is the positive decision enough to see a doctor with?? Thanks.

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blaugrau
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Post by blaugrau » Tue Nov 27, 2007 2:25 pm

The card came in a separate letter shortly after the decision, maybe a few days apart, I don't remember exactly but it wasn't a long time. I suppose you can go to the doctor from the time you got the positive decision and just tell them your insurance number, if they want to see the card, just show them the letter instead. They normally just need your number to type into the computer (so you need to be in the system), at least I don't remember anyone asking me for the card at the doctor's. The card, on the other hand, is important when you get prescriptions from the pharmacy, without the card you'll pay much more for the medicines.

sammy
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Post by sammy » Tue Nov 27, 2007 2:26 pm

hychamaz wrote:Do you have any idea why they would send the card separate from the letter containing a positive decision. That doesnt make any sense to me.
A wild guess would be that, after the OK and specs from KELA, the card is mailed to you directly from the manufacturer to avoid any extra waiting days (which would result if the card was first sent to KELA and then to you)... or then, they just inform you asap about their decision but need to wait for the card for a few days... a third alternative is that it is against some regulation to put the two into a similar envelope (you'd need to use envelope model EN-006 for one and EN-006B for the other) :)

interleukin
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Post by interleukin » Tue Nov 27, 2007 2:30 pm

Thanks for the reply blaugrau. That makes sense. Do you have any idea why they would send the card separate from the letter containing a positive decision.
The card per se is not so important, it is just a proof that you are "in the computer" (thanks Hank, I love that phrase). So what is more important is to get registered in the Kela computers, sending the card itself is less of a priority.

Also, you can ask to get a Kela card with a photo (to be used as a form of identification), so it makes sense that "getting into the computer" and "getting the card" would be slightly different things.

An example of all of this could be that you "are in the computer" but do not have a card yet. You should still be able to benefit from Kelas help eg. when buying medicines, but you may have to pay it all yourself and then claim the money from Kela afterwards as without the card you cannot prove to the pharmacy that you "are in the computer".

/interleukin
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hychamaz
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Post by hychamaz » Tue Nov 27, 2007 2:50 pm

blaugrau wrote: I suppose you can go to the doctor from the time you got the positive decision and just tell them your insurance number, if they want to see the card, just show them the letter instead. They normally just need your number to type into the computer (so you need to be in the system), at least I don't remember anyone asking me for the card at the doctor's.
Thank you for the reply. Interleukin also gave the example of going to the Pharmacy. Why is it that you can give your insurance number to the doctors office but not at the Pharmacy? Couldnt you just show the letter at both places?? Thanks again

vincebel
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Post by vincebel » Tue Nov 27, 2007 3:02 pm

yeah i understand that you get your money back if you go to a doctor between your application and the acceptation.

But in my case i hink its unfair that they told me two times that everything is ok and then three weeks after that something is missing. They should have told me straight to avoid losing six weeks.

im sure it will happen again next time

i hope not

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blaugrau
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Post by blaugrau » Tue Nov 27, 2007 3:03 pm

The pharmacies actually do not have access to your medical data, thus just telling them the code doesn't tell them anything, therefore you have to show your card so they know you are insured and eligible for the reduced price of the medicines. The doctor has all your data in the computer, so doesn't need to see your card.

I suppose the letter might do in the pharmacy for the time that you don't have the card yet (but it's really not a long time till you get the card once you got the decision)


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