I have always been in pretty good health, so I was surprised one day when my doctor told me my blood pressure was a bit high. She told me to begin watching my salt intake, start exercising, and to try to relax. Well, I intended to follow her advice when I left her office, but the next day I was back to my same habits. I kept using the salt shaker and didn't begin an exercise routine like I had planned. When I went for my next check-up, she told me that my blood pressure was even higher and approaching a dangerous level. I had to begin a blood pressure medication to manage it. I wanted to create a blog to share my story and remind people to listen to their doctors' advice. If a few lifestyle changes can improve your health, then you should make them.
Medicaid is a state and federally-funded public insurance program that provides free health care to low-income seniors, low-income individuals with disabilities, and low-income families who can't afford to pay for their own health insurance or medical care. Although you must meet the income requirements to qualify, being eligible for medical assistance is only the first hurdle.
The next challenge is to find a doctor who accepts Medicaid patients at a lower reimbursement rate than what other health insurance programs pay. In many cases, doctors who participate in the Medicaid program belong to a managed care network.
Medicaid Managed Care Plans
Many states offer Medicaid managed care plans that allow recipients who meet the eligibility requirements to receive health care benefits through private health insurance companies. States pay participating managed care plans a fixed fee for each individual or family enrolled in the plan.
Participating Doctors
While a managed care plan provides health care coverage from a network of doctors, clinics, and hospitals, you must choose a doctor as your primary care provider (PCP). Your PCP will provide preventive and primary care and referrals to any specialists you may need to see. For Medicaid to pay for your health care services, you must see only those doctors who belong to that network.
While the fee a doctor is paid for a visit varies by region, reimbursement rates lower than what other insurances pay deter many physicians from participating in a Medicaid program. However, it may be easier to find a doctor who accepts Medicaid payments if you live in an area where there are a significant number of low-income Medicaid beneficiaries and not many other health care options available.
Availability of Medicaid Manged Care Plans
The purpose of a Medicaid managed care plan is to reduce the cost of providing health care services to those enrolled in the plan. Therefore, depending on the state and county in which you live, if you receive Medicaid benefits, you may be required to join a Medicaid managed care plan. In some areas, the choice is yours to make, which allows you to join a managed care plan if one is available.
Co-Pays
Some medical services, such as clinic visits, prescription drugs, and non-emergency care at a hospital emergency room, that are paid for by Medicaid require a small co-pay. Generally, if you are enrolled in a Medicaid managed care plan, no co-pay will be applied if you receive services from a private practicing physician. There also are no deductibles.
For more information, contact companies like Lakewood Family Health Clinic.
Share26 April 2017
