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Managed Care Update

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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.

Anyone else have questions about the packets?

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