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Decline in health insurance coverage
The government will ask for an adjustment in poverty level requirements to avoid participants leaving the program
Published Monday, April 1, 2019
by Marga Parés Arroyo

Por El Nuevo Día

Maribel Martínez (semisquare-x3)Maribel Martínez. (Vanessa Serra Díaz)

Five years ago, Maribel Martínez received news that one of her children had an inflammatory bowel disease and had to take five tablets a day, at a cost of $15 per tablet.

 

 

"I left the gastroenterologist´s office in tears because, even though I work, I'm a single mother and I thought all this was going to cost me more than (paying for) the house," recalls Maribel, a lab technician.

Martínez and her three children had a private healthcare plan, but it only covered generic drugs, and the one prescribed to her son was not available in that plan yet.

She was recommended to apply for the Government Health Plan. Martínez thought she would not be eligible, but she decided to apply since she was told that, in addition to income, items such as medicine expenses were considered.

 

And she was eligible for the program and that included the four family members in the same plan. 

Maribel (44) decided to keep her healthcare private plan, for $220 a month.She would use her private coverage as the primary and the Health Reform plan as a supplementary option.

But, like the deductibles, her private health plan climbed to nearly $400 a month, an amount she couldn't afford in 2017. So she dropped that plan and decided to keep the Government Plan. 

However, that picture became worse on March 5, when, during a re-certification appointment at a Medicaid office, she was told that income standards and deductibles changed. 

Only her son with an intestinal disease would remain in the program.

"Net income changed to gross income. Before, if you paid for a car, it was deducted but not anymore. They also took medicine costs out of the income, now they only deduct cost from the person taking the medicine, and the $90 deduction only applies to one participant. In addition, my income was credited to everyone, when that is shared (among the family members). Only my son with the intestinal disease was eligible. My other two children and I were not eligible,” she explained. 

Without a healthcare plan, Martínez has been unable to continue