In an interview with Variety, Medicaid accountant Remy Reyes said Medicaid Office employs three personnel and only Benito handles the review of applications.
She said the office used to have two eligibility workers but the other one retired last year.
Benito said their office deals with 14,700 clients.
“As eligibility worker I determine whether they meet the eligibility criteria based on income and resources. And if they do, I approve it and give it to the director for approval,” said Benito.
Benito and Reyes confirmed that this issue of manpower had already been communicated through the proper channels and they are still waiting for this to be addressed.
“The one who retired in 2010 hasn’t been replaced until now,” said Reyes.
Asked by Variety if they could cite one immediate concern that they would like addressed, Benito said “hiring of an eligibility worker.”
“At least two,” she added
On a regular basis, Benito said their office receives and processes between 50-60 applications.
She said she accepts applications in the morning and processes and reviews them in the afternoon when their office is closed.
The two Medicaid employees said they appreciate Rep. Teresita Santos’s bringing this issue out in the open.
Asked if there was an increase in applications after the implementation of the reduced work hours in the government, Benito said, “Oh yes!”
She said, “Last year, before austerity, we would average 30 [applications] at the most. Now, we are getting 50-60 applicants a day.”
Moreover, they also told Variety that with the increased number of applicants, they also start getting complaints.
“A lot of people come to us and start complaining. What can I do? I can only do so much? I am fighting an uphill battle here,” Benito said.
Asked on the breakdown of the Medicaid clients per ethnicity, Benito told Variety that it has yet to be finalized. “We should be able to get a breakdown very soon,” assured Benito.
She also told Variety one major reason for the declined applications is the applicants did not meet the required income and resources.
“To be eligible you have to meet the low-income bracket. Some have too much money in their account and have more than one car,” she said.
Based on the eligibility requirements, a single applicant must have a monthly income level of $674 to $1,011 or not more than $2,000 resources.
A household of two members must not exceed a monthly income of $1,517 or must not have more than $3,000 in resources.
Given their situation at the office, Reyes and Benito suggested for the new applicants to also provide complete and pertinent documents to support their application. These documents include birth certificate of children, passport or birth certificate of parents, marriage certificate (if married), Social Security card for applicants and dependents, bank statements, check stubs, among other documents.
Meanwhile, those who are eligible gets 100 percent coverage for hospital expenses: in-patient and outpatient services, laboratory and X-ray, nursing facility services, home health care, physician services, among other services.
Benito said Medicaid does not cover cosmetic procedures and over the counter medications.
With a lean staff at the Medicaid Office, Benito said they can only do so much.
So far, she said, they need at least two eligibility workers.
There was a time, Reyes said, that the two employees were sick. She said she had to just take and accept the applications.
Given the situation at the Medicaid Office, Benito is asking for the public’s understanding.
“Bear with us. We are trying our best. It is not that we don’t want to help. It’s just that our hands are tied,” Benito said.
