Maya’s Medicaid Story

Posted in

Maya is an aspiring entrepreneur and mother of three. When we spoke with her, her youngest had just turned 4 months old. Over the years she’s worked many jobs: she was a certified nursing assistant, she worked in hospice care, and she’s done rehabilitation and home health. She found her passion as a bakery assistant though and now dreams of opening her own bakery. 

She also has her hands full with her kids. With an almost three-year-old, a one-year-old, and a new baby, being a mom is a full-time job on its own. 

As a new mother, Medicaid has allowed her and her children to access vital healthcare services, and it’s also provided many resources that have helped make her a better mother for her kids. The way Medicaid links with other programs, like WIC, has helped her provide for her growing family – especially during the challenging years of the Covid-19 pandemic. 

But she’s also faced challenges using Medicaid benefits. She’s learned firsthand that most dentists do not accept Medicaid, and many Medicaid managed care organizations (MCOs) only provide limited dental coverage—if they provide any at all. This has been particularly hard, because oral health is linked to many other health conditions. 

Dental services aren’t the only example. She’s also found that often medications are not covered by Medicaid. This has been especially tough for her son who has bad allergies. Unfortunately, the medication he needs to keep his allergies under control hasn’t been covered by their MCO – even though his doctor prescribed it and it’s the only thing that really helps. 

“My son has allergy issues. So, his allergy medicine is not covered. He can’t really do anything over the counter because it doesn’t clear his allergies up. He pretty much needs a high dosage of allergy medicine, and it’s not covered.” 

And that’s not all. Maya also knows firsthand from her time as a CNA the way some people and providers view people with Medicaid benefits. She fears that sometimes this stigma has led to a lower quality of care. “I kind of see negative remarks, face gestures… ‘well, they have Medicaid, so I’m going to kind of put them last in rotation’ as far as being seen.” 

Despite these challenges, Maya remains thankful for all the benefits that Medicaid provides for her and her children. But she worries about the future. In South Carolina, most adults are ineligible for Medicaid, so while she’s covered now, after her baby turns one, she’ll fall back into the coverage gap and lose her healthcare coverage.  

She hopes to have a job that will provide health insurance benefits by then, but that adds its own set of difficulties to overcome, including the costs of childcare and being able to breastfeed while she’s working.  

“A lot of moms have to stay out of work due to (lack of affordable) childcare, due to breastfeeding and things like that. So, if we’re out of work, and the child’s, you know, a certain age, that coverage is up.” 

Despite having concerns for her future, Maya maintains a positive outlook. She believes that all her hard work and dreams will pay off, and she’ll be able to get her business off the ground. Until then she’s grateful for Medicaid, and she hopes for the day when the quality of coverage it provides is even better. 

Medicaid provides essential healthcare coverage for over 1 million South Carolinians. Even with its many benefits, the South Carolina Medicaid program has room for improvement. One example from Maya’s story is the way dental benefits vary between MCO providers, and the limited benefits currently offered for adults. 

The good news is that Medicaid in South Carolina has gotten better over time. For example, Medicaid is only required to extend coverage for new mothers for 60 days after a baby is born. But in May of 2022 CMS approved the extension of this coverage to 1 year in South Carolina. This was a big step forward for the program and shows the benefits of advocacy to continue to improve the program. 

Maya’s story also illustrates the importance of expanding Medicaid in South Carolina. Expanded Medicaid could extend coverage to 345,000 South Carolinians, building health in our state—and building our economy, at the same time.

For more information on Medicaid Expansion efforts in SC, visit: 

Stories help to put a human face on healthcare policy issues. By sharing your story, you help speak for people who may be facing issues just like yours.