Client Spotlight: Ensuring Access to Care for a High Risk Pregnancy
Three years ago the “Sato” family lost a child to ectopic pregnancy. Newly expecting again, they feared a similar result when Riko had unexpected vaginal bleeding. The doctor at the emergency room wanted them to return to the hospital in two days for an ultrasound and blood work, but the Satos lacked health insurance and could not afford the $400 follow-up visit.
Desperate to get the care needed to maintain the health of their unborn child, the Satos turned to PHLP for help. They had been denied Medicaid a month before and submitted a new application when they were at the hospital earlier in the week. However, their calls to the county welfare office, to explain the urgency of their situation, went unanswered.
PHLP intervened and learned that the family’s application had been transferred from Montgomery County to Butler County as part of an arrangement to spread case volume among counties. An administrator at Butler County explained that Medicaid couldn’t be authorized because they lacked information on Riko’s immigration status and because they appeared “over-income” due to Riko’s husband’s work as a drug and alcohol treatment counselor.
Communicating quickly with the family, PHLP resolved the immigration status issue by providing the welfare office a copy of Riko’s Lawful Permanent Resident card (“green card”).
Discovering that the Satos cared for Riko’s 18 year old step-daughter, PHLP counseled them to claim her as a dependent. Because many Medicaid programs now follow tax rules, this increased their household size for Medicaid eligibility purposes and made Riko “income-eligible.” PHLP faxed a statement declaring the Satos’ intent to claim the step daughter as tax dependent to the welfare office.
With PHLP’s intervention, Riko had Medicaid coverage authorized the same day she had contacted PHLP. She was able to get the follow up care she needed for her high risk pregnancy the very next day.
This is just one example of PHLP's work protecting the rights of vulnerable Pennsylvanians. To help clients like Riko, consider a donation to PHLP today.