Florida Kidcare

My son name is dylan medina hernandez , DOB04/28/2017 , he has ASD , asthma and language impairment , he was referred to Cms. By parent to parent and he was clinically elegible but Florida kidcare doesn’t want to qualify him due he is in the full payment plan , but l never received like a denial letter from Florida kidcare , the reality is that my son without therapies going to lose the little progress that he has made , the three planes that are available for him doesn’t provide Aba therapy and the option was safety net , which is a grant and also a complicated process to receive the services , you know what hurt the most , know that your son needs the therapies and the law apply only for some people , l know this from fact l work for cms and l know that people with full payment plan are enrolled in cms , l would like to know why my son is been discriminated and the services that he needs are denied .

11/10/2021
Family Case # [protected]

My name is Madelaine Plutin and I am the mother of Jean Carlos Piriz. My son is currently enrolled with Florida Healthy Kids through CMS/WellCare. That is now Sunshine, I understand that the state is raising my premium based on my gross income. I believe that my actual net income is not being taken into consideration when this is being calculated. For this reason, I have decided to write to you because my Family was very affect due to COVID 19 and and still affected because the COVID complicated my Husband life with a paralysis in his legs preventing him from walking and other physiological needs, at this time which we are still going through difficult situations. As the sole earner in my household, I do not make enough money to pay the increase in premium. After taxes, rent, food, utilities, gas, mortgage, two cars, association and other basic expenses, I am struggling to make my monthly payments. Any additional expense will place a strain on my ability to provide for my family. Importantly, my child is benefiting significantly from the ABA therapies being afforded to him through the Florida Healthy Kids program. As such, if I am unable to pay for an increase in premium $210.00 Monthly, he will lose coverage for Speech, Occupational and the Behavior Therapies, that he so desperately needs. Please also note that the current therapies have had a huge positive impact on his behavior and his emotional development. I am incredibly grateful for these services and I sincerely feel that my son would suffer greatly if these therapies were discontinued as a result of my Family financial situation. With this letter, I wish to appeal to Florida Kid care corporation for a review of my case taking my net income into consideration as opposed to gross earnings. On behalf of my son, I would sincerely appreciate any help that can be provided. Thank you in advance for your assistance

Thank you,
Madelaine Plutin Piriz
[protected]

On November 2, 2021 I was informed by my childrens' doctors office that my three children do not have coverage. Upon calling kidcare I was told that someone made an error and put in my profile that I do not claim my kids on my taxes, even though I provided tax documents the first time I applied a year ago, and their premium was raised without my knowledge and I had just paid the previous
premium for two months in advance. I was told that the error had been corrected and that coverage would be activated within 24 to 48hrs. However, on November 3rd I received a phone call from a supervisor stating that I had to pay $10 extra on the already $30 credit and only one child would be emergency reinstated 24 to 48hrs after payment is posted on November 4th. I expressed how I needed all three children to be reinstated due to appointments already made. Today, November 4th, I called to see if the payment had posted and to see when my child would get her insurance back because she has a very important appointment on November 5th. I also called to see about getting the other two children reinstated. I was told that a supervisor would call in 24 to 48hrs to answer my questions and there is no guarantee when they will have insurance. I need help ASAP I have a sick child that needs medical attention and these people are taking their time on fixing an error they created. I need help ASAP.

So haven't been able to get on the website for 8 months it's says it's under maintenance but how long does maintenance take and when if ever will it be back up I've called numerous of times and they always have nothing to say about it only that there working on it.will it ever be up and running again if not just delete it and start another one we need to be able to access it

Account #[protected] for kidcare my son has had Florida Kid Care for over a year. When it was time to renew the website was down and we were directed to renew through MyFlaccess. I did on March 3, 2021 I then received a letter in the middle of March saying that his kid care has been terminated. I called and spoke to a supervisor who assured me all I need to do is fax or email income or pay stubs and his coverage will not be interrupted. My son is on WellCare CMS. I then called Wellcare CMS on March 31 to have them send me a new card. I was then told that his coverage has been terminated. I then called KidCare and was told that that they have notated and notified wellcare/CMS and that 24/48 hours Wellcare will show his coverage active. April 5th I called my sons therapy place and was told his insurance is still inactive. I then called Kidcare and was told that they resent everything to wellcare this was at 2pm and was told by the person I was speaking with to call Wellcare and ask to speak to a supervisor and tell them to refresh their system and that it should show. I did exactly what Kid Care told me to do and the Wellcare supervisor said that they could not understand why I was told to do that since it has nothing to do with their end it is all on Kid care. At 5:30 I called kidcare back and spoke to a supervisor by the name of Itza and she said that nothing was sent to florida kidcare a t 2pm. Before we got off the phone the supervisor had said she was resending the information over to wellcare/cms this was around 5:30 Monday. I called back Wellcare immediately and spoke to someone who said There is nothing that was sent over. She then placed me on hold and conferenced FL KIDCARE to see if she would be able to get an idea on a timeframe on which his insurance should be active. The stuff I was listening to between wellcare and kidcare was incredibly disturbing.. Kidcare represenitive is telling me over and over again that I shouldn't be speaking to wellcare that my son does not have coverage with Wellcare... I guess the training Kidcare is doing is not very thorough. CMS is a plan under tjhe insurance carrier Wellcare... Then I was told to avoid delays not make payment on time. I then stated again this is not due to late payment. The payment was made in the year 2020... He then apologized and he sees that it is not due to late payment. He then said he was going to get a supervisor and hopefully this can be fixed. When the supervisor got on the call it was the same supervisor from 30 min prior Itza. She then asked the Wellcare/CMS representative if she sees any confirmation number or anything the system from Kidcare? The representative from Wellcare/ CMS then replied by saying NO THERE IS NOTHING that shows. She also stated that they do not see confirmation numbers or things like that. Itza then asked if she can contact the enrollment dept to see if they see anything? Wellcare rep said "We do not have an enrollment dept... Kidcare does the enrollment..." I do not understand how the supervisor for kidcare did not know that KIDCARE does the enrollment... I honestly could not believe what I am listening to. I then was contacted Tuesday evening by my sons therapy place that they called and spoke to a supervisor from WELLCARE and was given a reference number and was told that there is no active policy, and that his insurance was terminated as of March 31, 2021. I then called Kidcare and asked to speak to a supervisor. The supervisor was got on the call was Itza and I was pretty upset she said when I am done she will answer my questions. I asked for her supervisor and she gave me an email.. I then asked her to let me know what answers she has for me that could possibly help my son and fix this complete mess. Itza said that she went to escalate this issue and was told that she can not escalate it that unfortunately there are several people having the same issue I am and that Wellcare should be able to see it active on Wednesday 4/7/2021. I do not know why that would make me feel better. That several families are having to deal with this. That is AWFUL. CMS is a plan for children that have intense therapies and greater needs. My son has been on a waiting list for ABA Therapy and for sensory and occupational therapy and was supposed to have an evaluation on Monday 04/05/21 that was canceled and so was his upcoming evaluation for occupational therapy. You can not even imagine the frustration, aggravation and complete feeling of helplessness since it is out of my control to fix any of this. It is really scary to see that NO One with kidcare has any idea what is going on or the products and carriers that they deal with. This is unacceptable and Fl kid care should be embarrassed and ashamed of the lack of knowledge and competence of their employes

I am having a huge issue with my Miami children's plan paying a bill for services that my daughter received while insured through Miami children's plan. I been told for over a year that my daughter Date of birth is Incorrect in the state system (Medicaid portal) After several calls and many representative later Florida kidcare fixed the DOB on their end however Miami children's is still denying a claim. Medicaid response has been that they can not change the DOB. Please help me this has been count less phone calls to Medicaid, Miami children, medi kids and Florida kid care all of which have not been able to change my daughter dob in the state system which is why Miami childrerns is claiming their reason for not paying but yet they took my money every month. Medi kids fixed her date of birth on their end but for what ever reason Miami children's claims that unless it's fixed on the Medicaid portal they can't pay the claim. This is fraud on all parts because I paid my monthly premium of 187 every month. I finally changed insurance 1/1/2021 because private insurance through my husband job became available and I no longer wanted to deal with this and now I get a bill from my doctor so I have no choice but to deal with it again. Yesterday on March 25, I was advised by Florida kid care representative by the name of sandy to mail the bill directly to Florida kid care so I did either way this is so horrible I spent over 20 hours trying fix the issue during the duration of my daughter coverage and still a problem since a bill is being denied.

I lost my job due to Covid. I called and the employee assured me my son would not lose coverage, my premium would be lowered to $15 and I would be referred to Medicare. 3 days later, they charged me the full $187 premium as a credit and cancelled my sons coverage. When I called, not only would they not return the $187 or put it towards the month to avoid a lapse in coverage, but the supervisor told me I was wrong and to wait for a call to advise me when I will have the funds returned. No one is helpful. No one cared. I was basically punished for losing my job due to Covid.

I was referred to Kidcare because supposedly I make too much money and I have to pay a premium of 230 monthly... Although it has to be paid a month in advance I have not received dental insurance cards, then I have to wait until the following month to use the services... This is the second time I requested it... After a 30 minute wait on the line. Mental health is a joke, only one provider in my area, after a few calls and the representative assuring that providers were active when they are not... What I meant that according to their page the have a several amount of providers when they are really not. Very disappointed

Hello, I was referred to florida kidcare by children and family, because I was supposed to earn enough income to qualify for this program . I HAVE BEEN CONSTANTLY agraveted by the many issues they have with my paychecks, they say my paychecks are not good because it does not show the frequency I get paid. It is a federal job though, besides I am disable and earn disability benefits, they also say the proof I show from social security are not good enough to reach a decision regarding how much I should pay. With all those excuses they have me paying the full premium amount $230 dollars monthly, I have no more proof of income to show and so it is a hard decision either to find each month the amount required or disconnect my son's iinsurance.Sadly, I know about other people paying less than me even married couples with two incomes. I am a single disabled mom working a part time job 30 hours at 10 dollars rate and I have to pay 230 monthly. Does it sounds right?

Hello. I called today the FL kid care department, because my children were referred by the dept of Children and families and their coverage was going to start effective on December. I sent all the required information over to them on time, and even paid. I never received any letter or advise telling me that I had to pay before Nov 30th to have coverage effective on December. I did paid on Sunday, Dec 1st. When I called today, I was told that the payment hasn't been process yet, and it would be processed hopefully by tomorrow, but I would not have Medical Coverage until January. FL Kid care was closed during the Thanksgiving weekend. Now my children are sick and I cannot afford to pay. The Supervisor who spoke with me, had a bad attitude, and said she couldn't do anything to help me out, that I just had to wait until January to get the coverage, and also, I had to send another payment by the 15th of this month. This is ridiculous. PLEASE, can somebody HELP ME ON THIS MATTER. My kids need medical coverage and I cannot afford to pay for it. It is not my fault that they were closed during the weekend because of the Holidays. Please assist me on this.

My children were not approved for healthy kids. Their information was sent to Medicaid. Then Medicaid approves the younger two children. They send the older two children's information back to healthy kids. I happen to check online(after checking almost daily) on the status. They approved my boys in a letter dated 9/27 as long I make the payment. I didn't get the letter until 10/1 so of course now they are not covered for October. The rep says a letter was sent to me on 9/25 and 9/27. Only one letter had been sent on 9/27 in the message center online. If a person is approved later in the month they are not giving anyone ample time or information to know that the application is approved to even get coverage for their children.

My child was approved for Kid-care on August 24, 2018. I was asked for the premium payment of $20.00 which i made the payment that same day. My daughter has ADHD and has depression and depends on her doctors visit to ensure she get her refills for her meds. They told be she would be insured as of September 1, 2018. I received a letter advising the name of the provider so i called to get information on her member number to set an appointment up for her dr. I called yesterday 9/4/2018 4 different times and was given 3 different answers. Then i was told that the provider is different than the one advised on the letter. Not only that but was told because i made a payment after the 14th there is a 7-10 day delay on processing the insurance... Wait WHAT WHY if i was approved for the insurance on the 24 how can i make a payment on the 14th. My daughter now needs to stay home from school because without her meds she will not function properly and will be very disrupted. Until they decide which provide and when the decide to processes. Not to mention all they ask when you call is for payment. How do you want me to pay again if i still have not been able to take my daughter to the dr.

This is the second month in a row my daughter has missed appointments because the customer service representatives aren't updated the information correctly in the system. So how they didn't update my account correctly and now it show my daughters coverage is inactive. She can't get her medication that she needs to help her daily which affects her ability to learn in school. She has a dentist appointment today due to a terrible toothache. The customer service representative refused to contact the doctors office to let them know she has coverage for the month of August. So now I have a child misses medication doses and suffering a toothache because of error by someone incapable of performing their job properly. I now have two cancellation bills that need to be paid due to the representatives error. I started a new job and the job was kind enough to give me this day to take my daughter to appointments within my 90 day probationary period with the exception of bringing a providers note to work on Monday. Which I can't present because she couldn't be seen. It's not fair we are being punished due to someone else's mistakes. So I have a child in pain and no note to present to my employer. So therefore the negligence of your staff most likely has me unemployed which means the next step is being evicted and hungry due to loss of employment. This is not acceptable at all and not fair... Is thit a really what Florida Kidcare is all about! The representatives still have their job and secure place to live... NOT FAIR ALL!

This past September my sister filled out the KidCare online application. After her application was processed a customer service rep contacted her and said she had to pay an upfront premium of $400 because she had too much income. She paid the $400 immediately using her credit card. A few days later she realized they had added an extra zero on to her income which is why the representative said she made too much money. Upon contacting them to correct the mistake and providing all necessary documentation and pay stubs for her 3 person household, she was told she did qualify under the income level. Even though it was a clerical error on their part and was verified and corrected, the representative told her they would not refund her $400 they made her pay when they had her wrong income. Who can she speak to regarding getting the $400 refunded since it was a mistake by the Florida KidCare staff? She desperately needs that money. She did NOT rightfully owe the money to begin with and now they will not give it back even though she makes well under the income level and the mistake has been corrected in the system?

My 14 year old son has been fortunate enough to have Children's Medical Services (extension of Florida Kidcare) for several years. He qualified for CMS because he was born with a single ventricle (half of a heart) and Celiac Disease. Since birth he has had 3 open heart surgeries, countless invasive medical procedures, been restricted to a strict gluten free diet, and suffered from severe learning disabilities.
This year I received notice that our payment would be raised from $20/m to $300/m because now they were taking his stepfather's income into account. This was a hard blow to us considering that we have 2 other young children(Not using KidCare). Yet the greatest blow was learning that not only were we having to pay such a significant increase (which I readily accepted), they now will not allow him into the CMS program anymore. CMS provided my son with a case manager to assist and navigate us through the many hardships we have faced. For example, I was unable to find a dentist that was willing to work on Jacob due to his heart condition. CMS linked us up to a dentist that excelled in special needs cases. Also, I have already had to cancel several of his doctors appts. because they do not accept the insurance that Florida Kidcare provided to us at the higher rate. These doctors have been following my son for years. They have worked together alongside his cardiologist. They know him inside and out.
I am beside myself and spent wasted hours upon hours sending in requested documents to CMS. They had me verify my income through tax records. That wasn't good enough so then they asked me to submit my last 2 paystubs. After a few weeks of not hearing from them I call only to have them request a written letter head note from my employer of how much I make. I never heard back so I called again and they requested that I fill out another application. After that they requested that I have my husband send in his paystubs (even after receiving all his tax info.) I finally put an end to it tonight in tears begging them to help me and stop with all the requests. This was about my son and his healthcare.
I finally got an answer.Basically, if I was in a lower tax bracket my son would receive better health care. My child is being punished because he has 2 hard working parents. My heart is broken for my son and for my country.

In my divorce agreement I am responsible for my children's health insurance. Florida Kidcare will not allow me affordable coverage because they live with there mother. In this day and age with a high divorce rate, and single parenting on the rise, I can' t understand why a parent living outside of the home can "DO THE RIGHT THING" and provide their kids with insurance.

I have had Kid Care for my son since he was 1 year old, next month he turns 5. Suddenly Medicare sends me notice of health coverage for my son, which automatically cancelled my Kid Care. 2 weeks later I get a notice from Medicaid that he was no longer eligible and his coverage would stop end of May. I have been fighting since then with Kid Care to get my son reinstated... I have taken all the steps required, filed a new application, sent in the supporting documents and all. I have been calling for over 3 weeks now trying to get my file looked at and they keep telling me that there is a glitch in their system that NOONE seem to be able to figure out, "they have escalated my case" I am not sure how many times, still cannot get a definite answer... This sucks! In the meantime my son is without coverage and I am calling every day to see if at least I could get him the coverage starting July... It is now June 25 and only have 5 days left or I will have to wait until August... Really, a big company like Florida Kid Care does not have competent IT people to find and resolve a "system glitch" in OVER 3 WEEKSSSS! This is very frustrating, I am scared of letting my son ride his bike or play sports, afraid that he will get hurt and I will have more hospital bills piling up on top of all the bills I already have!

Well unfortunately I'm here again.
This time I'm literally beside myself.
As I've done year after year in July of every year I renew my children's health insurance and one thing I've come to expect is consistently lost completed forms (even when sent certified mail) and staff that has no other advice for me then to resend my forms for the umpteenth time.
This time I'm here mainly because I attempted to add my new 18 month old son (who still is eligible for medicaid so technically not needing ins. for him at this point. just trying to add an additional family member.)
I've sent his birth certificate for U.S. citizenship status and a witnessed affidavit for his identity numerous times during and even before they requested them this renewal period. They were sent by fax, email and certified mail.
I figured this would have proven sufficient since my infant son is not in school yet and I am a stay at home mom so there is no child care documents available.
However this hasn't been the case, Now they are requesting me to obtain a U.S. Passport or Certificate of U.S. Citizenship (DHS form N-560 or N-561 ) for my U.S. born child whom has not and will not be traveling outside the U.S. in the much foreseeable future. I've even spoken to the U.S. Consulate's office in Tampa and they are in agreement with me that a birth certificate and Kidcare's affidavit form should be sufficient for the completion of this year's renewal process.

My three older children are being cancelled because of this and I cannot think of anything else to do but to just let it happen. I'm wondering how many other families are dealing with this problem and are told to obtain a passport at a price of hundreds of dollars per child . Isn't Kidcare in the the business of helping low income families obtain and keep insurance and peace of mind. Instead it seems it is one of the Kidcare corporation's goals to make parents feel like we constantly have to be on our toes to maintain one of the most basic needs for our children.
I haven't resorted to begging them yet but at this point I guess it could make things worse
Thank you for your time.
A.M.

As I do every year in July I renew my children's insurance. It's always a BIG hassle with tons of lost paperwork by Kidcare's great staff. Also btw, I always send all correspondence certified, return receipt requested due to this problem.
In August of this year (2010) I get a notice that my renewal is done and my payment would be the usual 15.00 a month starting 9/1/10.
Okay, so now I figure everything's fine for the upcoming year. On 9/1/10 I make my payment of 15.00 as usual. Then on 9/20/10 I received a change of payment notice from kidcare stating my payment will now be 20.00 instead. But this is when the real problem started, because they made my new payment retroactive for September(due in full on 9/1/10) which now made my payment late because of a 5.00 deficit. Upon reciept of this, I immediately sent 5.00 online hoping they would honestly understand the reason why it was late. The next day I received a cancellation notice from them so I immediately called them and disputed this and the woman, Erin said it was their mistake and my insurance was not being cancelled. Being fine with this I then relaxed and it didn't become a problem until today at the Doctor with my sick son. Not only did she lie to me, nobody has any proof that I even called. This caused my children's insurance to be canceled for 6 months now and it is absolutely making me sick! So today I'm fighting them by sending the proof of payment change dated 9/15/10 from kidcare to the Florida insurance comissioner and yet another certified letter to Florida kidcare.

Also, I want to give everyone a word to the wise when dealing with kidcare, unless you are calling customer service simply out of boredom wanting to chat, save yourselves alot of headache and simply send all important letters, grievances, etc over returned receipt certified mail only. This is the ONLY way to get any assistance, believe me! The people you talk to will say ANYTHING you want just to get you off the phone doing absolutely nothing for you except wasting your time. Anything done on the phone will turn into a nightmare that isn't worth your child's health.
Thank you for listening,
A.M.