‘I was ready to pack up and move to another state’: parents share frustration with Medicaid claims

LAS VEGAS, Nev. (FOX5) -Two local moms are sharing their frustration with trying to provide care for special needs children.

Their kids were born with a rare condition and need adaptive equipment that can cost thousands of dollars. Elena, 5, was born with a rare condition called chromosome deletion. She’s not able to talk, walk, or sit up on her own and has the mental ability of an 18-month-old.

“She was premature, I had her at five and half months, so she was in the NICU for 83 days,” Her mom, Noemi Becerra said.

Becerra left her job to care for Elena and her two siblings. She says it’s been a struggle to get healthcare needs covered through Medicaid.

“It has never been stable, have to reapply, doesn’t qualify for certain things, it has just always been a battle, it has been hard,” Becerra said.

Services are often denied. In 2022, Nevada Medicaid denied 29% of claims overall, according to the Nevada Department of Health and Human Services.

“Any special needs kids with autism, or anything like my daughter has, they should automatically get the help, automatically be able to get any kind of equipment that they need,” she said.

Elena is now in need of a new wheelchair.

“The wheelchair, to this day, we haven’t been able to have anybody come and adjust it for her,” she added.

It’s a frustration shared by many local families including the Sigmunds.

“I was ready to pack up and move to another state, very, very, quickly, because the resources that people can get much easier,” Aubrey Sigmund said.

Her 5-year-old son, Kade, was born with Ohtahara Syndrome. He wasn’t supposed to live past six months.

“It’s a very rare seizure disorder, so he would have, our typical was 100-300 seizures a day,” Sigmund said.

She left her job as a nurse to care for her family of five, and also struggled with getting equipment for her son.

“It is always a months-long process. It took us an entire year to get our first set of equipment when he was around two-years-old,” she said.

Sigmund says she applied for a new adaptive wheelchair in December of 2022, only to be denied six months later.

“Nobody wants to be stuck sitting in their bed and never be able to leave and that was going to be my son’s case,” she added.

Her son then unexpectedly passed away.

We contacted Nevada Medicaid, who declined to go on camera, but did provide a statement:

“All official prior authorization denials include the reason for the denial, how to request a Fair Hearing from Nevada Medicaid and the phone numbers to reach us.”

Families can also contact the Nevada Office for Consumer Health Assistance. It’s a free service for Nevadans who are needing help navigating health insurance claims.

The office, which helps about 1,000 people every year, tried to resolve claim issues within 90 days.

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