The hold music is 12 minutes of reggae, 18 minutes of classic rock, seven minutes of RB, four minutes of…
Enter a human voice over the speaker. I scramble for the phone.
I ask questions. She points fingers. But it’s no disco, more like “Ring Around the Rosie.”
I’m led in a circle, or maybe toward a dead end. I’m lost in the Medicaid Maze.
Half an hour in, I stay committed. “The Gambler” comes to mind — “know when to hold ’em, know when to fold ’em” — even though I felt like running away.
I only wanted to know why.
Why was my 5-year-old son’s Medicaid insurance plan switched without my consent? And why was he assigned a new pediatrician?
I told myself I was lucky. I found out about the switch when I called his insurance plan for an unrelated reason. I found out before making an appointment, taking time off work, showing up, then learning at check-in that they couldn’t see him because he was no longer in the network.
Yes, mine was a lucky accident.
But why was he switched in the first place? Is that normal?
I don’t know, the operator admits. It’s automatic when they turn 5, they get a new plan and the computer chooses a new doctor. You just have to change it if you want.
You mean, you just have to figure it out first, carve out time to stay on hold, and change it.
And maybe it was no big deal.
But as someone who interviewed parents for the Herald-Tribune’s series on Florida’s Medicaid program, “2 Million Kids. $24 Billion Battle,” I thought of those who told me about how their kids’ doctors and plans were changed repeatedly. About feeling like they had no control. About the embarrassment of finding out at the doctor’s office.
You’re his mom. Didn’t you know?
Many parents felt they couldn’t complain about care they’re getting for free. Yet it’s not free. The parents we interviewed for the project worked full time or were full-time students and paid their taxes. Plus, many parents didn’t know they could complain. Before working on the project, neither did I.
In the recent Medicaid settlement reached after a decade-long class action suit brought on behalf of more than two million Florida children who depend on the state’s Medicaid program for their health care, the state pledged to “minimize reassignment of a child … without notice or consent of the child’s parent or guardian.”
As a just-released survey of pediatricians statewide led by the Georgetown University Health Policy Institute found: “Families with children being re-assigned to other managed care plans and/or physicians without their knowledge was cited as a common enrollment problem.”
It’s a common hurdle to access for care.
In other words, what happened to my son shouldn’t happen to more kids in the future. At least there’s that.
Before getting to the bottom of what happened with my son’s insurance coverage, I spoke with four different agencies. All told, I listened to a little over an hour of reggae, classic rock, pop and RB and spoke to just about no one who cared or claimed any accountability for switching my son’s plan and pediatrician overnight.
But still, I’m lucky.
Lucky that I had time to call the doctor who’d been automatically assigned to my 5-year-old son by his insurance company. Lucky to learn we would have been turned away from her office. The doctor does not treat children.