Rose, and her two children, have been on Medicaid since Spring 2017. While her circumstances remain the same, she was abruptly terminated from Medicaid in April 2023, with no justification as to why. Luckily, her children remain covered.

Despite requesting to receive all notices regarding her Medicaid benefits electronically and in Haitian Creole, Rose received a written notice dated April 14 from the Florida Department of Children and Families (DCF) at her home, in English. Unable to understand the letter, she reached out to a local Miami organization. They informed her that the notice said her Medicaid was being terminated as of April 30, 2023. However, there was no reason provided in the notice explaining why DCF had decided she was no longer eligible for Medicaid. Instead the notice simply stated “YOUR MEDICAID FOR THIS PERIOD IS ENDING.”

Rose did not understand why her Medicaid was ending or that she had a right to appeal. So, with the help of this same organization, Rose filed a new application for Medicaid. After 2 months she was denied, despite meeting all criteria for coverage. This time a “reason” was given–but the reason was completely wrong. The notice said Rose is ineligible for Medicaid because she is not a citizen. In fact, Rose is a citizen, and prior to gaining citizenship, she was a lawful permanent resident for many years. She has appealed this denial.

“I have been suffering from significant pain but I cannot see the necessary specialists because I am uninsured.”

Furthermore, as a non-English speaker and immigrant, the prospect of a hearing is daunting for Rose. While she meets the legal criteria to receive coverage, she has considered dropping her appeal out of fear of the system. However, it is important for Rose, someone who was wrongly terminated for her ongoing Medicaid coverage for no reason and then denied her new application for an erroneous reason, to pursue an appeal. First, “squeaky wheels” tend to get fixed first. Second, without an appeal of her erroneous denial, she will not be able to get reimbursed for medical care while her case is being fixed. Although children in Florida are entitled to retroactive Medicaid coverage, adults (and their medical providers) are not entitled to reimbursement for medical costs unless the adult appeals an erroneous denial.

*Rose is a pseudonym of a Florida resident who wanted to share her story without using her real name

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