Age: 7, 2 and twin 1-year olds

Enrolled in: Child Health Plus

Jennifer Cole is a wife and mother of four.  In the fall of 2010, she received a notice from the Department of Social Services (DSS) telling her that her family no longer qualified for Medicaid.

Jennifer was in a panic.  Her oldest son has autism and thankfully his coverage remained in place due to a special Medicaid waiver.  But, Jennifer herself has chronic asthma and her youngest son has epilepsy and must take daily medication to prevent seizures.

“I didn’t know at that point what I could do because, if you don’t qualify for something, that’s it – you don’t qualify for it and you have to figure out something else to do.  I was very torn up inside…I just can’t even describe how it felt being told that your son who has special needs… is being denied services because you are a little bit over income.”

Jennifer was able to enroll her other children into Child Health Plus (CHP), New York State’s version of the federal Child Health Insurance Program (CHIP), but both she and her husband were denied for Family Health Plus (FHP) because her oldest son was covered under the Medicaid waiver and so not counted in the family size.  This put them over the income limit.  She worried about her own health needs.

“Heaven forbid I had a terrible asthma attack and couldn’t catch my breath and had to take an ambulance to the hospital.  I would have to take out a loan to pay that, which I probably wouldn’t be able to pay until the end of my days.”

After getting the run-around from DSS, Jennifer contacted the Legal Assistance Center of Western New York, a CHA agency.  Sherry Corona, a CHA advocate, was able to fix the problem and get the Jennifer and her husband approved for FHP without having to do a fair hearing.

“It was really great news for me: My kids were going to have insurance.  I was going to have insurance.  My husband was going to have insurance.  And everything was going to be good…I just can’t put a price on it, and I can’t say thank you enough.”