Sixty-one year old Maria Little works part-time at The Hudson Guild Community Center in Manhattan. An insulin-dependent diabetic with high blood pressure, Ms. Little is eligible for Medicaid, yet a Medicaid error led to a denial of coverage, lack of medication, and a subsequent trip to Bellevue Hospital emergency room.
Quick action makes the difference
When Maria Little applied for Medicaid, she was told that she was over income—which was not true. “I had submitted pay stubs from work that showed I was not over-income,” she says. “They just said, ‘Sorry, we can’t fix it.’ I have to take insulin every single day! I was without Medicaid for 90 days because of their mistake.”
“This could have ended in tragedy. Serious mistakes were made,” says Case Handler Shana Bloom of Lenox Hill Neighborhood House LHNH, a partner of CSS's Community Health Advocates (CHA). Adds Maria, “I wound up in Bellevue Hospital emergency room, sick. I had borrowed money from my job to buy insulin, and even got a few days supply from a diabetic friend. Thank God for Shana Bloom, or I’d be dead.”
Shana quickly faxed over verification of Ms. Little’s income eligibility to a Medicaid staffer who could rectify the error. “Our partnership with CHA is incredibly valuable in cases like this. CHA gives me access to key contacts, training and resources that really help make the difference.”
Medicaid staff informed Shana that Maria would have to go through a Fair Hearing, but Shana explained that there was not time for that. Shortly thereafter, she heard from Maria that Medicaid had corrected the error and her diabetes and blood pressure medication would again be covered. “As soon as Shana talked to them, it was all rectified,” says Maria.