Sandra, a hard-working mother of three children, relies on Medicaid to provide affordable healthcare for her family. Access to treatment is especially important for her son who is diagnosed with Crohn’s disease and receives monthly injections to manage the illness.

Sandra’s income qualifies her children for Medicaid benefits, so she was surprised to discover an online notice dated May 18, 2023 stating that Medicaid coverage for the entire family would end on May 31, 2023. The reason given was “You failed to complete or follow through with your Medicaid renewal.” But Sandra did not get this termination notice for days. DCF mistakenly sent this notice (along with a notice from April 17 telling her to renew her eligibility within the next 28 days), to her old address in Tampa. Sandra was shocked to discover this. When she moved to Jacksonville 6 months ago, she immediately updated her address in ACCESS, and she fully and rightfully expected that all notices would then be sent to her current address.

Cognizant of her son’s upcoming medical appointments, Sandra urgently tried to renew her childrens’ Medicaid eligibility. Throughout the last two weeks of May, she spent hours calling the Department of Children and Family (DCF). When the representatives were unable to help her over the phone, she took hours off of work to meet with a representative in person to ensure that their coverage would continue. A representative looked at her ACCESS account and confirmed that the notices had been sent to her old address despite Sandra having changed her address in ACCESS shortly after moving six months prior. The representative was also able to see her current correct address in her file.

Sandra diligently completed the renewal process, providing all requested verification and forms BEFORE May 31. Nonetheless, a DCF representative informed her that her application would not be processed before the end of the month because it was not submitted by May 15!

In spite of the fact that her children clearly remained eligible for Medicaid, and DCF had been provided with verification of their ongoing eligibility before the end of May, their benefits were terminated on May 31.

“I had to cancel one of my son’s monthly injections due to the cost,” said Sandra. “It’s just a lot to deal with,” Sandra said about managing the unexpected loss of her family’s healthcare coverage while working and caring for her family.

If DCF’s April l7 renewal notice had been sent to the correct address, Sandra could have completed a renewal before mid-May and her children would have had ongoing healthcare coverage. Or, if DCF had accepted her renewal information, submitted prior to the termination date or advised her of her right to appeal before the end of the month, the children would have remained covered without interruption. Or, if the DCF worker had advised her not to forgo needed health care due to cost because the children are eligible and would be reinstated (and the bills would be reimbursed), her son would have gotten his critical treatment. Instead, Sandra had to take time away from work, spend hours fighting for reinstatement of her children’s Medicaid coverage, and watch her son forgo a month of treatment needed for his serious condition.

Fortunately, with the help of a social worker, Sandra submitted a renewal and her Medicaid coverage has since been reinstated.

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

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