Medicaid Approved WooHoo!!

[Bamfan1442]

I got my approval letter for Medicaid today! I can finally go see a doctor, but now I must wait for my ID card to come in the mail so I can look for a doc in the network. But then I have to call for an appointment and have no working phone until my BF is off on Monday and Tuesday--sighhhh........

[rjoneslaw]

@Bamfan1442 congrads!!!!! Here is a trick I learned the website for in network doctors is out of date. If you know a dr you would like to go to ask them if they take your card. Once you find a dr call and let the insurance know for the PCP. As for other doctors do the same thing just ask and if they say yes start seeing them. You PCP can help you get approval to see out of network doctors.

[Bygonelines in reply to rjoneslaw]

I have found that the better question to ask is "Are you participating with my insurance plan". In my area if you ask the doc "Do you take my insurance" and they say yes. It doesn't mean that they are participating. It just means that they will bill your insurance. This can be a huge difference in what you owe for your visit. Participating = In Network = Doctor writes off the difference between what they charge and what the insurance allows. Non-Participating = Out of Network = Doctor Does NOT write-off the difference between what they are charging and what the insurance allows.

I know it sounds like a nit-picky difference but it can make a HUGE difference in what you have to pay.

Another thing, when you ask if the doctor is participating give the insurance name and the plan name. For instance Regence Blue Cross Blue Shield Value Care instead of Regence Blue Cross Blue Shield. The reason is the doctor may not be participating with all plans for that insurance.

Navigating insurance can be a tricky thing. When I worked for BCBS I spoke with a woman who asked if the doctor took her insurance. They said yes but were out of network. Her surgery ended up costing her $49,000 more than she was expecting.

It was awful and it took me a couple of months to get the provider and hospital to take a lesser amount. It still ended up costing her $10,000 when she was expecting to only owe her $500 copay.

[Bamfan1442 in reply to Bygonelines]

Thank you for this info @Bygonelines! I haven't received my insurance card or info packet yet but when I do I'll be sure to mention this when I look for a Dr!

[WAshingtongirl]

That is great news, Bamfan1442 !

[greaterexp]

Bamfan1442 , hurrah for you! You're on your way! I hope you find a great doctor!

[Karen-x]

That is terrific! Moving forward is good. You will get there.

[jackgaume]

Bamfan that is good news. Keep working on your other forms for SSDI and SSI disability. you are on te right track

[Bamfan1442]

I have another question related to this topic that I hope someone one can answer! I just found an M.S. Clinic near me here in West Michigan and it's certified!!

mercyhealthneuro.com/progra...

Can I get a Primary Care Physician there or is that considered a "specialist" which I need a referral for? If any of you go to one of these types of clinics then I would really appreciate your input here! Thank you in advance

[Bamfan1442 in reply to Bamfan1442]

Oh, sorry p.s.: I haven't been diagnosed yet so I would probably need to see a Dr. here for testing if they take my insurance.

[Bamfan1442]

OK now I feel like a moron I should have investigated the site more before I posted this but I was too excited by finding it and caught up in the moment! Looking in the "For Patients" tab I saw where you need a referral from your PCP to set up an appointment. Sorry for all this nonsense! Now, in addition to finishing my SSDI forms, I need to take on the daunting task of choosing a plan and finding a doctor for my Medicaid Benefits so I can get a card. I have until May 22nd to choose. But there's sooo much research to do first-where to start? I suppose I should try to find out which of the plans, if any, are accepted by the clinic first? Uughh this is complicated!

[WAshingtongirl]

Do a little at a time Bamfan1442 . Write out a list of what you need to do and prioritize it. (Maybe you can do that today.) Cross each task off as you make calls and get your answers. That might help with the stress and anxiety, and make it all feel a little less overwhelming. 💕