[Davidsmom17]

Hi all,
I am waiting for the call for a fost-adopt baby girl and trying to figure out the health insurance while I wait. I was told the baby will come with a medicaid card and also I would have to select a managed care plan for her.
My pediatrician takes one of these plans but the office manager told me today that if the plan is paid through medicade then that is no good. The office has no medicade number and does not accept medicaid. Is this true, or can the office just bill the HMO directly without a medicade number?
In other words, will I need to find a Dr. who accepts medicade or just the managed care plan?
Thanks for any advice!
Laurie

[leenab]

it does get confusing. Because some doctors will take the plan in name, but not if it's through medicade. I know it doesn't make sense at all.

Also it takes a while to get the HMO plan into effect. So it's good to have a doctor who will also take straight medicade (some do).

If you know of other foster or adoptive parents you may want to ask them who they use.

I know it's easier to find a doctor in northern nj who takes medicaid and HMOs than it is in the south. Your family resource worker may also be able to help you with this.

Most doctors directly affiliated with a hospital (as in their office is at a hospital) take medicade.

You may also want to have a doctor who knows about drug exposed/neglected/abused/etc children and what to watch out for, etc. It's a good idea to interview doctors before selecting one.

Hope this helps

[vernellinnj]

My pediatrician also does not take Medicaid. The Group does accept an HMO so it has not been a problem for me. Good luck.

And Leenab is correct, it took forever for my FS to be enrolled in his HMO. Had I not followed up daily and taken down the name of every person I spoke with, he probably still would not be enrolled. Be vigilant - it will pay off.

[RandomReality]

The number I have for Medicaid is 1-800-356-1561 and the two numbers I have for Americhoice, a Medicaid HMO are 1-800-941-4647 and 1-800-701-0710.

If the little girl is placed with you, she will arrive with a Medicaid card and number. If, for some reason, the workers forgot the card then nag the living daylights out of them till you get the card. AND the foster parent letter. And make copies of both. See if your doctor takes Americhoice - that is the HMO we use.

All the other mommies are right - it takes WEEKS to get the child onto the HMO and you have to call and bug. Also, your CW has to physically put you into the system as the person in charge of the child's medical care. THEN you can enroll in the HMO.

My pediatrician's office was VERY snobby about Medicaid at first even though I had cleared it with the office ahead of time and the doctor gave his ok. The woman behind the counter at the doctor's office kept repeating: "Oh he has MEDICAID, oh I am not sure what we do for MEDICAID, because the MEDICAID forms are different." I wanted to smack her in the head. It was like she was taking pleasure in broadcasting that Baby Boy is on Medicaid. But I think she was just a stupid woman. Have not had any trouble since.

If you can't find a pediatrician at first who takes Medicaid or the HMO, look for a low-cost clinic in your county and they will know all about it. It may feel weird to go there but your foster child will qualify. They also qualify for WIC - I got vouchers for formula from WIC.

[Tammi5143]

For anyone out there who gets a new placement, and needs help getting the child(ren) enrolled in an HMO, please PM me - I can put you in touch w/ a person who can help. She is wonderful and has helped me w/ everything - I will definitely not lose her number.

Just as an FYI for those that currently have an HMO but want to change their HMO, you can do this directly over the phone, w/out all of the paperwork.
The phone # for the enrollment change is 1-800-701-0710
(I had to go through this when moving from Middlesex County to Warren County and it turned out that HealthNet cannot operate in Warren County so I had to switch to University Health Plan -- ugh! Headache, but I am getting there!