Re: Chrissy, Barbara: Medicaid

[Guest guest]

Tonia,

My son has had medicaid since he was 3yrs old since he is on SSI because he is autistic. I have never had any problems with drs and he sees alot of specialists and has had tons of medical problems with his GI tract and colitis and esophagitis never mind aspiration pneumonia everytime I turn around. We live in MA and have the best children's hospital..but he is only there when hospitalized he sees all private drs. He has speech thearpy, OT, PT and ABA and all is covered by medicaid. No one has ever said to me we don't accept medicaid except on speech pathologist which then gave me #'s for about 4 others that she would recommend. I just got medicaid for myself since my income is so low on SSDI..they are going to cover my premium B plan cost through medicaid and all prescriptions which is awesome. I know they cover remicade as long as a specialist states it is the only treatment that will help me...and my dr has already told me she wuld fight for

them to cover it. All my drs that I currently have take medicaid..so I will not have to look for a new dr...in fact it will be easier from now on I won't need referals for each specialist I see from my primary care dr anymore...I can see whom ever I choose to whenever a problem arises. So all of the northeast isn't that way when it comes to dealing with medicaid patients. I think being near Boston helps to have a better choice in drs and maybe living in rural areas might be different...but I have never heard of anyone having trouble with medicaid in MA. Hopefuly where it is a problem drs will realize that some people cannot afford ins premiums and that medicaid is a must for some and that by not accepting medicaid patients they are being inconsiderate of the needs of alot of people out there. Hope you had a great weekend..Hugs..GinnyTonia wrote:

It must really be different living on the East Coast having Medicaid.....because here in Iowa and in Eastern Nebraska, I have never had any problem in having a doctor, hospital, or pharmacy accept my medicaid. I even went clear to Chicago, Illinois and They accepted my Iowa medicaid!! I made 16 trips to Chicago, had 6 Lumbar Sympathetic Blocks, 3 Bier Blocks done, all paid by Iowa Medicaid, and was able to bring prescriptions back from Illinois to Iowa to have them filled here in Iowa......no problems.

My Regular Doctor is in Nebraska, my Pain Doctor is in Iowa.....and the hospital where I have a Block done every month is in Iowa. And Iowa Medicaid pays for every single appointment and block that I have done. It also pays for every single Psychiatrist appointment that I go to.

Danette, who lives in New Jersey told me today when she called me, that when she was on Medicaid that she had no Hospitalization with hers....that there was a thing called Charity Case that you applied for when you was in the hospital, and once you are approved, it will let you know how much of your Hospital expenses were approved to be paid, and how much you have to pay yourself. Here in Iowa, luckily, Medicaid pays for everything no matter what. It pays for Doctor's appointments, Tests, X-rays, Ambulance, Dental, Eye Care, Prescriptions, Psychiatrist, Specialists, Labs, everything possible.

And, if you are under the age of 21, you don't have to worry about any Co-pays.

If you are over 21, you have to pay between $1-$6 for prescriptions, $3 for Doctor Appointments, $2 for Eye Appointments and $2 for a pair of glasses, $5 Ambulance.

Depending on your income, some people has something called a spend down. Some has to pay so much of the medical bills before the State will finish paying the rest. Like if they have an Income of $900 for a family of 2, they would have to pay the first $300 of the Medical bills. After that $300, Iowa Medicaid will pay everything after that no matter how high it gets to be.

I don't know why Medicaid is so different from State to State. It would be much easier if it was all the same......preferrable like what I have here in Iowa, because just from what I was told what New Jersey's was like, I sure would hate that. NJ has to pay 60 percent of the prescription, no hospitalization, eye care, dental, nothing.....whereas Iowa has it all.

The only thing that Iowa has that is a pain in the butt is that they have 2 different kinds of cards. Once kind is a green card.....you can go and see any doctor without any referrals. The other is a red card....where you have to have a primary doctor who gives out referrals to see any other doctors like specialists.

Thats the pain in the Butt for me, because I have to get a referral every single month from my Primary Doctor just to be able to go see my pain doctor.

I hope that this helps explain a little about the difference in the Way the States do things differently...

Tonia