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Waiting on Medicaid, woman gets help from 2 On Your Side

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BATON ROUGE - A woman's Medicaid lapsed even though she submitted her renewal paperwork in on time. Heather Dillon contacted 2 On Your Side for help after she got the devastating news last month.

Dillon's four year-old daughter Adeline is non-verbal autistic and has been attending therapy where she's made strides with her caregivers. Then in early October they went to a scheduled appointment to learn that their insurance had lapsed.

"They said that my insurance had lapsed and turned her and I away," said Dillon.

It was particularly devastating since the wait to get into therapy was seven months. This meant that Adeline would lose her spot. Dillon submitted her renewal paperwork online in September prior to her coverage expiration date of October 1. She didn't think much of it since she's been on Medicaid for years.

"I mean, I cried, on the way home I starting tearing up - this is heartbreaking!" said Dillon.

That same day, Dillon called Medicaid to inquire about her application.

"They just said it's under review until a caseworker can process it, they said it could take up to 45 days," said Dillon.

She called three times to check on her application and continued to hear the same information. Not knowing what else to do, she contacted 2 On Your Side.

After contacting the Louisiana Department of Health, Dillon heard from them soon after. The caller told Dillon that her application had been processed and approved with little explanation.

During the pandemic, Medicaid renewal was paused. That pause was lived in April 2023 and the unwind process started. Half of renewals are automatically approved, the rest have to fill out paperwork. The Louisiana Department of Health says it receives 155,000 applications a month. When each application comes in it's processed, but can be flagged for review. Dillon was on day 45 when she got the call that her application had been approved.

"If it hadn't been for 2 On Your Side, we'd still be waiting," she said.

Dillon fears there are other people in the same boat as her, waiting for their renewal application to be approved.

"They deserve answers, too," she said.

Insured once again, Dillon is going through the process of getting Adeline back into therapy and hopes she doesn't have to wait as long this time.

The Department of Health does say that according to the Code of Federal Regulations, the determination of eligibility for any application may not exceed 90 days for applicants who apply for Medicaid on the basis of disability; and 45 days for all other applications. During that period a member cannot be without coverage.

Since this deals with Medicaid, the Louisiana Department of Health can't tell us why there was a lapse in coverage after Dillon submitted her renewal paperwork nor why she was approved so quickly after our call.

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