Guest guest Posted August 8, 2011 Report Share Posted August 8, 2011 Hi all: Here is the response I received from at Aetna. Ellen Ellen Garber Bronfeld egskb@... Another story... Hi and : Here is another story/question... Yesterday, I received the packet from IlliniCare. It is effective starting 8/1/2011. DHS had preselected them and the PCP. I called the PCP office on 8/3 and the receptionist said they don't accept Aetna or IlliniCare. Go figures. I'm reading the IlliniCare guide and two things stuck out: 1) you can continue to see a current doctor (who is not in the IlliniCare plan) for 90 days provided they are Medicaid certified (and possibly afterwards) 2) if you see an out of network provider, then the cost is out of pocket. I thought if you were on Medicaid, you couldn't pay a doctor out of pocket. My daughter gets behavioral health at Loyola. I know if you pay at time of service, they will discount it 40%. I'd rather still pay them, then switch psychiatric care. It would cost us an additional $221 a month to add our daughter to our insurance. If she sees the psychiatrist monthly (sometimes she goes every 2 months), the visit minus the 40% discount is $75. This question is one that I broached on Friday... Can someone, out of network, prescribe, refer, etc...if a family choses to private pay? Since this person is with Illini and I don't have a contact, , could you either get me a contact person or forward this on with my contact information? I would also like to know how Aetna will handle this situation. I am in a similar situation as I plan on using Noah's prescribing psychiatrist, his dentist and his internist...all of whom have been in Noah's life a very long time...changing would be detrimental to his care, in my opinion...All I care about is that prescriptions would be honored...It is obvious to me from the choices of physicians and dentists that Noah's health care would be diminished not improved by switching docs...I realize that is not the case for those who have not had long standing relationships with health care providers... Sure wish we had a flexible, cost sharing system, or something that allowed for choice... Guess that is for the perfect world in my dreams... Thanks. Ellen Garber Bronfeld egskb@... This e-mail may contain confidential or privileged information. If you think you have received this e-mail in error, please advise the sender by reply e-mail and then delete this e-mail immediately. Thank you. Aetna Quote Link to comment Share on other sites More sharing options...
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