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My daughters were dropped from Medicaid but our income is within the limits!

I just found out my girls got dropped form their Medicaid coverage. I found out the hard way -- coverage was denied. I didn't get a letter or anything -- apparently it was sent to our old address, and somehow they don't have the address change in the system even though I notified them over the phone. Anyway, they were dropped because I failed to report income from my husband's new job. We had a hell of a lot on our plates at the time and I just hadn't gotten around to it ... our income still falls well below the maximum. They sent me a letter I got late (forwarded from the other address) asking for this info, so I got it in late. And they say our income is over the max, but it isn't, I have calculated and recalculated and it just isn't. My question - I am appealing but I also just reapplied. Does anyone know if they can deny you coverage if your income is within the limits? Like because I was late reporting that before...

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Anonymous

Asked by Anonymous at 8:56 PM on Apr. 15, 2010 in General Parenting

Answers (11)
  • (OP) can they deny me because of those past mistakes? I realize I made a mistake but I don't want my daughters to suffer. They will thankfully be covered by my insurance under my new employer as of August, but my youngest just had surgery and also has a scary allergy that could send us to the ER any day! Thanks for any input, and sorry this was so long.
    Anonymous

    Answer by Anonymous at 8:58 PM on Apr. 15, 2010

  • Yes they can. Medicaid is a wonderful program for those who need it, but because it is Government funded they will look for any reason not to pay and failure to file paper work falls in their bureaucratic realm of reasons for denial. The bright side is that with hard work, lots of phone calls, and more paper work you can get them to pay. It is frustrating but you can make it happen. When I was working this is what I did for disabled individuals.

    Do you have a case worker? On the paperwork you fill out annually for a review (a recertification or a redetermination or whatever they call it in your state) there should be the name of a case worker. Call that person. They may say "I'm just the redetermination worker, you need to contact your regular worker" then you ask them to tell you who that is and ask for a direct line. Write down the name of everyone you talk to and get a direct number for each.
    beckcorc

    Answer by beckcorc at 9:01 PM on Apr. 15, 2010

  • What state do you live in? Send me a private message if you want more advice. You have to speak the language and you have to be persistent.
    beckcorc

    Answer by beckcorc at 9:02 PM on Apr. 15, 2010

  • Look into healthy families..... they are just above the limits of medicaid. See if you qualify.
    I was denied from medicaid once for not sending the info in on time, I just reapplied and was approved.
    Ask your worker (previous worker) if there is anything you can do....
    GL
    sassy_brizzy

    Answer by sassy_brizzy at 9:02 PM on Apr. 15, 2010

  • By "speak the language" I mean the Medicaid bureaucracy language, not an actual language... I realized that didn't sound right.
    beckcorc

    Answer by beckcorc at 9:03 PM on Apr. 15, 2010

  • I did try to talk with my caseworker... she treated me like a sub-human. She hung up on me because of a bad connection and didn't call back, and I haven't her to talk to me since.
    Anonymous

    Answer by Anonymous at 9:06 PM on Apr. 15, 2010

  • What state are you in?

    Call the case worker again. Do not let her talk to you like that, and don't let her hang up on you. If they can get out of talking to you (or working) they will. I have had Medicaid cancel my client's coverage for failure to redetermine eligibility. I've called to tell them that the paper work was filed and they said they didn't get it so they wouldn't reinstate coverage. I sent everything certified mail so I said "I have the receipt for the paper work right in front of me is was signed by so-and-so, I know it was received in time. They put me on hold, came back, and said "Oh it was at the bottom of my pile I'll do it today." Rather then check her in pile they'd just let people's Medicaid expire! This has happened to me NUMEROUS times!!

    You have to make them work, it's sad but true.
    beckcorc

    Answer by beckcorc at 9:13 PM on Apr. 15, 2010

  • LOL! You must live in my county! Not funny really, but bad workers are so annoying. I live in MN. If you by chance live there I can give you a number. Or try googlin Dept of human resources in your state, call them and say your county isn't helping you. They most likely have a "county complait line" and you might be able to get someone that is there to specifically help with medicaid/county problems. You can always ask for your worker's supervisor too. Good luck.....so annoying a stressful!
    sunshine58103

    Answer by sunshine58103 at 9:40 PM on Apr. 15, 2010

  • Workers are like this in every county. I live in CA and to get my worker on the phone, I had to sweet talk a clerk to give me her supervisors name and number (they said they weren't allowed to give it to me??) and then call the supervisor to get her butt on the phone. My situation was handled. They always send my forms late, so of course they get turned in late. I bring in envelopes for them to see and everything.
    Anonymous

    Answer by Anonymous at 10:17 PM on Apr. 15, 2010

  • I wonder if they lowered the allowance and this is the reason why your denied? I don't know . Hope you get it squared away. GL
    MarGeee

    Answer by MarGeee at 11:25 PM on Apr. 15, 2010

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