J.R., St. Louis City

J.R. is a mother of three, her children have been on Medicaid since her first child was born, about twelve years ago. Since she has been on the program a while, she has only had to send in yearly updated paperwork and have one check in phone call. After completing both of these tasks this year, she found out her children were kicked off Medicaid when she went to the pharmacy to fill a prescription for her son’s asthma medication. Without Medicaid, her son’s medication was more than she could afford and she was unable to buy it for him, leaving him sick and vulnerable to future asthma attacks.J.R. received no notice of her Medicaid status in the mail and could not get clarity over the phone. She went to the Department of Family Services (DFS) to reapply and was told they would send her a packet in the mail to fill out and mail in. When she asked for resources and advice to find affordable insurance, she was told to “go online” to find an affordable health insurance plan for her family.

J.R. does not know why her children were kicked off Medicaid as nothing has changed in her financial situation or job status. She was not given an answer as to why her kids were kicked off Medicaid and has been waiting for two weeks for the packet to reapply from DFS to arrive.While she waits for the application packet in the mail, J. R. says her only plan for her son’s care is the emergency room. As she states, “my son’s asthma attacks are unexpected and I never know when my daughter may get hurt in school. It is impossible to plan for these things”. J.R. does not qualify for Medicaid and has had to rely on the emergency room for her own asthma attacks. During one such attack, she drove herself to two different urgent care facilities and was denied care because she could not afford the $100 copay. She then had to drive herself to the emergency room where she states, “they couldn’t really do anything. They just gave me the treatment to open my lungs back up and sent me along my way”. This visit alone cost her $1,200. J.R. also has an IUD that is past time to replace. She has called various clinics and the lowest price she can find for this service is $300, a price she cannot afford. J.R. is eager to replace her IUD but feels she has no option but to wait until she can find affordable health insurance. J.R. states, “without Medicaid it is impossible. Medicaid is so helpful; it is a huge relief to not have to worry about medical bills I know I can’t afford to pay. It would help so much if I could get on Medicaid and have it for my kids without all the trouble”.