MEDICAID/ PRIVATE INSURANCE

[Guest guest]

Hi there I need need some sound advice to make sure that my son is not being short changed with medical insurance.He is now 19 yrs old (Autistic) and is on my work insurance. He was approved for SSI in Dec 2009 and following that Medicaid. At no time was I asked about having private insurance. He had a grand mal seizure recently - it was recommended that he saw a neurologist . The doctor's office confirmed that it was approved by the insurance and I should receive a letter with an appointment. However no letter came and so I called the insurance and was told that my son's medical with Medicaid was not activated and they had my work insurance as his coverage. Is there

anything that I can do?I wanted to take my son off my work insurance but was told it would be better to keep him on so I have more options. Is it better to keep him on to take him off. (My plan has changed and I would be left with a percentage of the bill each time he uses it for specialists.......)Can Medicaid refuse to cover Medical? To date I have not received anything in writing to confirm their actions.... I would be most grateful if I could speak to someone who understands the whole benefits thing... its driving me crazy Thank

[Guest guest]

When my son got SSI they automatically gave him medicaid. I phoned them and told them I was using my own insurance and did not want the medicaid. According to Medicaid you have to contact a doctor to initiate your enrolment. If you don't do that you don't get medicaid. So I opted not to and they put on his records that he was using private insurance. However, when that ends my son will have the option to pick it up again. If your son has SSI he should automatically get medicaid. This has NOTHING to do with whether you can afford it or not. Your son is not under your income he's on his own - that's why he should be getting SSI. That information they gave you seems incorrect. If you want your son to have medicaid he's entitled to it.

, I am wondering if it is a new thing for medicaid to be provided if you have coverage? My son is covered on my husbands insurance (from work) and I was told that since we could afford to provide it he couldn't be covered by medicaid even if I wanted it instead of the insurance provided by my husband's employer. He is 26. Thanks for any info you can give me. I appreciate it. Glenda>> - your medical insurance will probably benefit your son much more > than Medicaid. And with the Obama administration he can remain under you > until he's 26. Do you have a PPO plan? There's only one plan with medicaid > that would probably give you more medical coverage and that's the medi-pass > but it's still not as good as your private insurance. The issue always with > medicaid is to find medical doctors who will accept medicaid otherwise you > are stuck with going to the medical professions medicaid will provide you > with. You need to check back with your insurance about this letter of > approval. Even if it is late, the neurologist office should accept that because > it appears that the only coverage you have now is your insurance company. > Just find out what you need to do to get the visit covered. If you want more > info contact me at 561 482-2855 > > > > > > > > Hi there > > > I need need some sound advice to make sure that my son is not being short > changed with medical insurance.> > > He is now 19 yrs old (Autistic) and is on my work insurance. He was > approved for SSI in Dec 2009 and following that Medicaid. At no time was I asked > about having private insurance. He had a grand mal seizure recently - it > was recommended that he saw a neurologist . The doctor's office confirmed > that it was approved by the insurance and I should receive a letter with an > appointment. However no letter came and so I called the insurance and was > told that my son's medical with Medicaid was not activated and they had my > work insurance as his coverage. Is there anything that I can do?> > > I wanted to take my son off my work insurance but was told it would be > better to keep him on so I have more options. Is it better to keep him on to > take him off. (My plan has changed and I would be left with a percentage > of the bill each time he uses it for specialists. (My pl> > > Can Medicaid refuse to cover Medical? To date I have not received > anything in writing to confirm their actions.... I would be most grateful if I > could speak to someone who understands the whole benefits thing... its > driving me crazy > > > Thank > > > >

[Guest guest]

I came across an SSI Fact Sheet which may have answers to some of your questions.

http://www.dcf.state.fl.us/programs/access/docs/ssifactsheet.pdf---

Subject: Re: MEDICAID/ PRIVATE INSURANCETo: sList Date: Tuesday, July 13, 2010, 8:43 PM

, I am wondering if it is a new thing for medicaid to be provided if you have coverage? My son is covered on my husbands insurance (from work) and I was told that since we could afford to provide it he couldn't be covered by medicaid even if I wanted it instead of the insurance provided by my husband's employer. He is 26. Thanks for any info you can give me. I appreciate it. Glenda>> - your medical insurance will probably benefit your son much more > than Medicaid. And with the Obama administration he can remain under you > until he's 26. Do you have a PPO plan? There's only one plan with medicaid > that would probably give you more medical coverage and that's the medi-pass

> but it's still not as good as your private insurance. The issue always with > medicaid is to find medical doctors who will accept medicaid otherwise you > are stuck with going to the medical professions medicaid will provide you > with. You need to check back with your insurance about this letter of > approval. Even if it is late, the neurologist office should accept that because > it appears that the only coverage you have now is your insurance company. > Just find out what you need to do to get the visit covered. If you want more > info contact me at 561 482-2855 > > > > > > > > Hi there > > > I need need some sound advice to make sure that my son is not being short > changed with medical insurance.>

> > He is now 19 yrs old (Autistic) and is on my work insurance. He was > approved for SSI in Dec 2009 and following that Medicaid. At no time was I asked > about having private insurance. He had a grand mal seizure recently - it > was recommended that he saw a neurologist . The doctor's office confirmed > that it was approved by the insurance and I should receive a letter with an > appointment. However no letter came and so I called the insurance and was > told that my son's medical with Medicaid was not activated and they had my > work insurance as his coverage. Is there anything that I can do?> > > I wanted to take my son off my work insurance but was told it would be > better to keep him on so I have more options. Is it better to keep him on to > take him off. (My plan has changed and I would be left with a percentage > of the bill each time he

uses it for specialists. (My pl> > > Can Medicaid refuse to cover Medical? To date I have not received > anything in writing to confirm their actions.... I would be most grateful if I > could speak to someone who understands the whole benefits thing... its > driving me crazy > > > Thank > > > >

[Guest guest]

Randy and all,

Thanks so much for posting that link, I had no idea there were so many different Medicaid programs.

To : There is no private insurance that will cover as much as Medicaid. No matter whether it's straight Medicaid or administered through an HMO like CMS, there are no premiums to pay, no co-pays, no deductible. In other words, Medicaid pays everything and you pay nothing. This is true not only for medical care but also for pharmacy, hospitalization, dental, optical, and therapies. The down side is that you must deal with a Medicaid provider. If your children are young that's easy, because most pediatricians take Medicaid, as does the Dan Marino Center, the Nova Special Needs Dental Clinic, etc.. When the kids get older, it's more problematic to find a practitioner.

To: sList Sent: Tue, July 13, 2010 10:46:00 PMSubject: Re: Re: MEDICAID/ PRIVATE INSURANCE

I came across an SSI Fact Sheet which may have answers to some of your questions.

http://www.dcf. state.fl. us/programs/ access/docs/ ssifactsheet. pdf

From: hidden_garnet <hidden_garnet@ yahoo.com>Subject: Re: MEDICAID/ PRIVATE INSURANCETo: sList@ yahoogroups. comDate: Tuesday, July 13, 2010, 8:43 PM

, I am wondering if it is a new thing for medicaid to be provided if you have coverage? My son is covered on my husbands insurance (from work) and I was told that since we could afford to provide it he couldn't be covered by medicaid even if I wanted it instead of the insurance provided by my husband's employer. He is 26. Thanks for any info you can give me. I appreciate it. Glenda>> - your medical insurance will probably benefit your son much more > than Medicaid. And with the Obama administration he can remain under you > until he's 26. Do you have a PPO plan? There's only one plan with medicaid > that would probably give you more medical coverage and that's the medi-pass > but it's still not as good as your

private insurance. The issue always with > medicaid is to find medical doctors who will accept medicaid otherwise you > are stuck with going to the medical professions medicaid will provide you > with. You need to check back with your insurance about this letter of > approval. Even if it is late, the neurologist office should accept that because > it appears that the only coverage you have now is your insurance company. > Just find out what you need to do to get the visit covered. If you want more > info contact me at 561 482-2855 > > > In a message dated 7/13/2010 4:19:23 P.M. Eastern Daylight Time, > aundre100@.. . writes:> > > > > Hi there > > > I need need some sound advice to make sure that my son is not being short > changed with medical insurance.> > > He is now 19 yrs old

(Autistic) and is on my work insurance. He was > approved for SSI in Dec 2009 and following that Medicaid. At no time was I asked > about having private insurance. He had a grand mal seizure recently - it > was recommended that he saw a neurologist . The doctor's office confirmed > that it was approved by the insurance and I should receive a letter with an > appointment. However no letter came and so I called the insurance and was > told that my son's medical with Medicaid was not activated and they had my > work insurance as his coverage. Is there anything that I can do?> > > I wanted to take my son off my work insurance but was told it would be > better to keep him on so I have more options. Is it better to keep him on to > take him off. (My plan has changed and I would be left with a percentage > of the bill each time he uses it for specialists. (My pl>

> > Can Medicaid refuse to cover Medical? To date I have not received > anything in writing to confirm their actions.... I would be most grateful if I > could speak to someone who understands the whole benefits thing... its > driving me crazy > > > Thank > > > >

[Guest guest]

Keep in mind that Medicaid is always the payer of last resort. If you have private insurance keep it! It will give you better benefits, but when you need to pay a co-pay or prescription sometimes you can use your medicaid to pay for the co-pay - thus reducing your out of pocket expenses. So I suggest that you always give both as your insurance just remember that your private is your primary insurance and your medicaid your secondary.

To: sList From: hidden_garnet@...Date: Wed, 14 Jul 2010 00:43:39 +0000Subject: Re: MEDICAID/ PRIVATE INSURANCE

, I am wondering if it is a new thing for medicaid to be provided if you have coverage? My son is covered on my husbands insurance (from work) and I was told that since we could afford to provide it he couldn't be covered by medicaid even if I wanted it instead of the insurance provided by my husband's employer. He is 26. Thanks for any info you can give me. I appreciate it. Glenda>> - your medical insurance will probably benefit your son much more > than Medicaid. And with the Obama administration he can remain under you > until he's 26. Do you have a PPO plan? There's only one plan with medicaid > that would probably give you more medical coverage and that's the medi-pass > but it's still not as good as your private insurance. The issue always with > medicaid is to find medical doctors who will accept medicaid otherwise you > are stuck with going to the medical professions medicaid will provide you > with. You need to check back with your insurance about this letter of > approval. Even if it is late, the neurologist office should accept that because > it appears that the only coverage you have now is your insurance company. > Just find out what you need to do to get the visit covered. If you want more > info contact me at 561 482-2855 > > > > > > > > Hi there > > > I need need some sound advice to make sure that my son is not being short > changed with medical insurance.> > > He is now 19 yrs old (Autistic) and is on my work insurance. He was > approved for SSI in Dec 2009 and following that Medicaid. At no time was I asked > about having private insurance. He had a grand mal seizure recently - it > was recommended that he saw a neurologist . The doctor's office confirmed > that it was approved by the insurance and I should receive a letter with an > appointment. However no letter came and so I called the insurance and was > told that my son's medical with Medicaid was not activated and they had my > work insurance as his coverage. Is there anything that I can do?> > > I wanted to take my son off my work insurance but was told it would be > better to keep him on so I have more options. Is it better to keep him on to > take him off. (My plan has changed and I would be left with a percentage > of the bill each time he uses it for specialists. (My pl> > > Can Medicaid refuse to cover Medical? To date I have not received > anything in writing to confirm their actions.... I would be most grateful if I > could speak to someone who understands the whole benefits thing... its > driving me crazy > > > Thank > > > >

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