February 2, 2022 by Natalie Cochran
Connecting TX Kids to Coverage Project Successfully Appeals for Client Denied Children’s Medicaid After Siblings were Approved
11 year old Abby Jones was denied Children’s Medicaid benefits while her three siblings were approved. Her father had applied for Medicaid benefits for his four children. The reason given for denying her was that the family was determined to be over income. This was obviously an error.
Abby’s father contacted the Texas Health and Human Services Commission (HHSC) multiple times before reaching out to Lone Star Legal Aid (LSLA) to appeal. Abby had been to the doctor multiple times and the family was seeing an overflow in bills from these visits because she had no medical insurance.
Elizabeth Green, staff attorney in our Connecting Texas Kids to Coverage Project, filed an appeal and represented the family at the hearing set. Green won the hearing and was not only able to get Children’s Medicaid benefits approved for his child, but Green was also able to get the benefits to cover medical visits back from the months when his child originally should have been approved.
Green told the father that all the medical bills he incurred during the denial period could be submitted to HHSC to be paid. Abby’s father was ecstatic and relieved to finally have health insurance for his child.
*Client name(s) changed to protect their identity.
Lone Star Legal Aid is a 501(c)(3) nonprofit law firm focused on advocacy for low-income and underserved populations. Lone Star Legal Aid serves millions of people at 125% of federal poverty guidelines that reside in 72 counties in the eastern and Gulf Coast regions of Texas, and 4 counties of Southwest Arkansas. Lone Star Legal Aid focuses its resources on maintaining, enhancing, and protecting income and economic stability; preserving housing; improving outcomes for children; establishing and sustaining family safety and stability, health and well‐being; and assisting populations with special vulnerabilities, like those with disabilities, or who are elderly, homeless, or have limited English language skills. To learn more about Lone Star Legal Aid, visit our website at https://www.lonestarlegal.org.
Media contact: Media@LoneStarLegal.org
