Kids' Medicaid ended at renewal and I never saw a form. Do I really have to start the whole application over?

Found out at the pharmacy today. My daughter's eczema cream refill bounced, the pharmacist said her Medicaid ended September 30. My son's too.

I logged into YourTexasBenefits for the first time since last year and there it all was. A renewal form sent in August, a reminder, and then a notice that coverage ended because they did not get the form back. Nothing came in the mail that I saw. My email on the account is an old one I do not check, which I now realize is the entire problem.

Nothing about our situation changed. Same job, same pay, same two kids. They would have renewed us if I had sent the thing back.

Is the only option to apply again from scratch and wait? And what about her prescription, which she needs this week?

I did exactly this in the spring and I am still kicking myself. There is something faster than starting over, I am almost sure, but I only learned about it after I had already reapplied. Somebody will have the rule.

For the prescription, ring the health center in the morning. Mine saw my daughter on the sliding scale the same week.

Darnell, you do not have to start over, as long as you move now.

The federal renewal rule, 42 CFR 435.916, says that when someone is terminated for not returning the renewal form, the state must reconsider their eligibility if the form comes back within 90 days after the termination, and that a new application is not required. Your termination date is September 30, so you are three weeks into that window. Send the form back, or call HHSC and say these words: coverage ended because the renewal was not returned, and I want it reconsidered. Have your recent pay stubs ready, because that is what they usually ask for.

Three more things. First, write down the name and date of whoever you speak to, and ask them directly whether coverage will be restored back to October 1. I cannot promise you that it will, because that is HHSC's decision on your case. Second, if the kids had any appointments or prescriptions since October 1, mention the unpaid bills when you call. Third, fix the email on the account today, before you do anything else.

I wrote all of this up this week, including the 12 months of continuous coverage children get once they are approved, in Medicaid renewal in Texas. And if you think the termination itself was wrong, the fair hearing window is 90 days from the effective date on the notice, which is in appealing a denial in Texas.

The email thing gets everybody. Mine was an address from a job I left in 2019.

Called this morning. On hold 50 minutes, then a very patient woman. I said the sentence. She said I could upload the form and the pay stubs and it would go in as a reconsideration, not a new application. Done by lunch. She could not tell me about the October dates, said the decision would say.

Health center saw my daughter yesterday for the prescription, $30 on the sliding scale. Fine.

Decision came into the account today. Both kids renewed, and the notice says coverage continues from October 1, so there is no gap. The pharmacy reran the October prescription for my son.

New email on the account, and a reminder on my phone for the first of every month that just says LOG IN. Thank you Delia, and thank you Cyn for the health center tip.