By: Brittney P., Miami-Dade County
My husband and I have been blessed with two beautiful little boys that we have adopted through the Foster Care system. Most parents who have gone through this process can tell you that the process is full of paperwork, legal hoops, and lots of interviews. In the end, though, it’s all worth it. Our sons are our pride and joy. Their health, safety, and wellbeing are our top priority. Both of our sons have Medicaid for health insurance. Navigating the Medicaid system has been a difficult and disappointing journey since the time they were babies.
My oldest son was adopted in June of 2018. We have had the same Medicaid health services for him since he was in Foster Care. Right after his adoption, Medicaid sent us a new Medicaid insurance card with his new legal name. Immediately we noticed that the Medicaid provider had been changed. With the new provider, our son’s primary care physician was no longer “in network.” Turns out his new provider was actually the provider he had before joining our family. We only found this out when we took our son to the doctor for a sick visit. We were able to get his provider changed within the next month. But it bothered me that the Medicaid office would arbitrarily change providers for a child who has a chronic health condition without first ensuring the providers were part of his new network. There was no communication from the Medicaid office explaining their decision. It was left to me and my husband to figure out.
Our difficulties with Medicaid did not end there. My youngest son did not initially pass the newborn hearing test and had to retest at eight weeks. During his first year we spent some time in Audiology and with an Ear Nose Throat (ENT) Specialist trying to diagnose the issue. At 18 months, had tubes placed in his ears. After additional evaluations and improvement in his hearing capabilities, we prepared to go to speech therapy to increase his communication. We finalized our son’s adoption in between medical appointments and tests. Once his name was legally changed, my husband and I knew that we had to renew the referral for him to continue seeing the ENT specialist. Since his new birth certificate had not yet arrived, I provided the adoption filing paperwork to the doctor’s office to get a new referral. However, because the referral came straight from the provider, the office staff were unable to manually make the name change – even with all the information. I called the provider, and they stated the change could only be done by the community healthcare provider. I was able to contact (what was at the time) Our Kids of Miami Dade and Monroe County. They completed the name change and said his name would update in their system within 24 to 48 hours. Since this was within the timeframe of his actual appointment, I provided the fax number to the specialist, and we were told to go to the appointment. We arrived at our appointment only to be turned away. Turns out that, even though the Our Kids’ data system is updated within 48 hours, Medicaid only updates information from the agencies once a month. So we had to wait another 3 weeks just to get the name corrected and another month for services because we had to rebook the appointment, get assigned another therapist, and see what slots would be available to take him. Now our latest saga is that after being out for 6 months with the facility closed for COVID, the specialist is no longer “in network” and we have to change services all over again.
The Medicaid system is complicated enough. As a parent, it would be extremely helpful if there was good, clear communication from the Medicaid office.