Baltimore officials have dropped more than 1,600 spouses, children and others from city health care coverage after workers failed to fill out forms to prove they were eligible dependents.

The city purged the health care rolls after questions were raised about the eligibility of some dependents. The move will save Baltimore about $6.5 million a year, officials said.

But critics say some city workers were unfairly denied health insurance for their families and now can't afford to pay for doctor visits. Some workers say they never received notification that they needed to fill out the paperwork.

"They're playing with the health of children," said Councilwoman Mary Pat Clarke, who unsuccessfully appealed to the administration on behalf of one resident in her district. "It is an unfair cutoff, and it is inhumane."

In February, Mayor Stephanie Rawlings-Blake called for an audit of the city's health care system to weed out anyone taking advantage of the system and misusing taxpayer dollars.

More than 14,000 city employees were asked to prove their relation to spouses and children, through birth certificates and other documentation. City officials said they sent five letters and an email to workers, and that individual agencies held information sessions with employees.

But officials with unions who represent city workers said some never received the letters or had trouble locating all of the necessary documentation. Those who lost coverage are without city-provided health care until at least 2014.

Glenard S. Middleton of the local council of the American Federation of State, County and Municipal Employees said the city has not kept track when workers moved, meaning that some forms were sent to the wrong address.

"They're hurting a lot of people," Middleton said. "They didn't have the correct addresses. They didn't know how to reach out to people."

About 90 percent of the dependents of city employees — 22,825 in all — were verified as legitimate and continue to receive coverage, city officials said. But 2,181 were rejected, including 1,642 cases in which officials say the city worker did not respond on behalf of his or her dependents.

"If you did not comply as of July 1, your dependents were removed from the health care rolls," said Travis Tazelaar, a spokesman for Rawlings-Blake. "The city has a responsibility to ensure that all funds are spent on employees and legitimate, qualified dependents."

Tazelaar said the city pushed back the effective date of the health roll purge three times, giving employees months extra to complete the forms. He said city officials were willing to negotiate about 540 cases in which a worker mailed back a form, but not with those who turned in nothing.

"If you did submit something, anything at all, and you tried to comply with this, there's a high likelihood that we're working with you to figure this out," he said.

Employees who failed to mail in the forms can reapply in October and receive coverage for their dependents starting in January, Tazelaar said.

Clarke and union officials are calling on the city to work out a compromise to get those who say they never received forms in the mail re-enrolled. The city offers several insurance plans through a number of providers.

"There should have been a right of appeal. People are getting sick," Clarke said. "It's not too late to reverse this right now."

Beth Cooney, the wife of a city firefighter, said she learned recently that she and her three children had been dropped from city health coverage when she tried to pick up prescription medication for a torn muscle.

"We never got any notification whatsoever," said Cooney, 48, whose husband, Kevin, has worked for the Baltimore Fire Department for nearly 24 years. "We got nothing. Zero. The city's response is basically: 'Sorry for your luck.' I can't imagine what it would be like if any of my children had a life-threatening issue."

Cooney said one of her children takes a monthly medication, and all three have physicals scheduled before year's end. She and her children also have been dropped from vision and dental coverage.

"The fact that Baltimore City can get away with such behavior is reprehensible," she said. "What are we supposed to do?"