GETTING TO YES: WHAT TO DO WHEN YOUR CHILD’S MEDICAL ASSISTANCE INSURER DENIES OR REDUCES SERVICES

December 12, 2025

THE PROBLEM

Most children on Medical Assistance (also called Medicaid or just MA) are enrolled in Managed Care Organizations (“MCOs”) --one for medical care and another for behavioral services. (See our summaries of each system at www.imaginedifferent.org/medicaiddefense.) These MCOs get to determine the amount of services for which they will pay. Some of these MCOs appear to be preparing for the upcoming cuts to federal funding by reducing the amount of services they approve.

PHONE CALLS NOT ENOUGH

Most people’s inclination when finding out their child has had their services reduced or terminated is to call the MCO. However, if you rely on phone calls alone, you may lose important rights that can help you get your child’s services back. To learn more, click here.