Wrong county designation disrupts Medicaid coverage
A woman contacted the Ombudsman Office because her Medicaid coverage stopped unexpectedly.
When she contacted the Montgomery County Department of Jobs and Family Services, she was told that her case had been transferred to a neighboring county because her home address was in the other county. She was directed to contact the other county’s department of Job and Family Services in order to restore her coverage.
When she followed the instructions and contacted the department in the other county, she was informed that her address was not in that county. Confused and dismayed, she contacted the Ombudsman for assistance in restoring her medical coverage.
Ombudsman Office staff investigated the matter, bringing to light a series of problems. The first was that the property where the woman lives is in Montgomery County, but has a postal address that is in the other county.
Some of the houses on the woman’s street are in Montgomery County, and some are in the neighboring county. The woman’s case had actually been transferred to the neighboring county’s office of Job and Family Services last year, but the woman had not known the transfer had taken place.
The other county had then mailed a request for bank statements and proof of income in order to complete a recertification of the woman’s eligibility. The woman did not respond to the request from the neighboring county, because she did not understand why the other county was requesting the information. The transfer of the case, with the subsequent lack of response to income verifications, led to the woman’s case being closed.
The Ombudsman recommended that the Montgomery County Department of Job and Family Services request the case be returned to them. The case was returned and the woman submitted the required income verifications. The woman’s medical coverage was restored.
The Ombudsman then explained to our caller that the business about which he was concerned was deemed an essential, and that was because it did carry items for the public which met the definition of essential. The Ombudsman encourages members of the public to report suspected conditions of violations of the Essential Business order so that our local agencies can investigate and work to keep our community as safe as possible from the COVID-19.