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  #1  
Old 10-01-2008, 08:08 AM
QueenEsther QueenEsther is offline
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medicaid question

I'm still in PRIDE classes, but our trainer told us to start looking for a pediatrician that takes Medicaid. I really don't know anything about Medicaid -- how does it work? Once we find a pediatrician who takes medicaid, do we have copays? What about prescriptions?

I'm just doing my worrying in advance. Thanks for any guidance.
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  #2  
Old 10-01-2008, 09:32 AM
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msgypsylee msgypsylee is offline
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Most peds take some type of medicaid. NJ medicaid uses HMO's to service the kids. I would suggest you find a pediatrician you like and find out if/what type of Medicaid they take. My pediatrician use to have NJ horizion but switched mid year to another plan. I was able to switch my kids to the new HMO so they could stay with their regular pediatrician. If the kids are already in the system, and have one type of medicaid HMO, but you want to swtich it to what your Ped takes, you can do that.

There are no copays. You need references if you are referred to a specialist. All covered prescriptions are free.
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  #3  
Old 10-01-2008, 01:19 PM
QueenEsther QueenEsther is offline
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Wow, thanks! That's good to know. I know they'll give me paperwork to read when the time comes, but I'd rather know in advance so I can be prepared. Thanks!!
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September 2008: Began PRIDE training
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February 2009: Z is placed in our home
June 2010: Z's birth mother signs identified surrender
November 2010: Z is adopted!!!
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Old 10-01-2008, 05:20 PM
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irelady10 irelady10 is offline
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I have not had the same experience of most peds accepting medicaid...my fs's ped. stopped accepting his hmo and switched to another, but this other hmo is not accepting any new patients in our county...i had a pretty good struggle finding a new ped. for him.

if you google nj medicaid, you shoud find a sight with the 5 different medicaid hmo's that foster kids are eligible for; then, you can click on each hmo and search for pediatricians in your area...it takes some time, and it is a good idea to get a dr. lined up before you get a placement, because things get really busy (happily so!) then. oh, it takes a month for the hmo to kick in, so you need to find a clinic or dr. who takes straight medicaid in the meantime- many hopsitals have a clinic you can use.

good luckl!
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  #5  
Old 10-02-2008, 04:45 PM
QueenEsther QueenEsther is offline
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Great, thanks! I'll do some googling and figure this out!
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September 2008: Began PRIDE training
December 2008: Licensed!
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June 2010: Z's birth mother signs identified surrender
November 2010: Z is adopted!!!
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Old 11-30-2008, 10:48 PM
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mamala mamala is offline
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QueenEsther... I know you're in Somerset Co. but not sure where. Straight Medicaid docs are at the clinic on Rock Ave. in Plainfield and Somerset Family Practice in Somerset Med Ctr/hospital.

If you call the Medicaid enrollment the 2nd or 3rd day the child is placed to enroll them in an HMO, you'll wait less time. It can take up to 3 days for Medicaid to get the child into the system.

If you get a placement before the 15th of the month (and call before the 15th) then you might be able to get them covered by the HMO by the 1st of the following month. But in the second half of the month, you have to wait to the first of the FOLLOWING month. So the baby I brought home on the 19th (and called in on the 19th) won't have Medicaid HMO coverage until Jan. 1st.

There is nothing to pay out of pocket. If you have a medical emergency in the first 3 days, I suggest going to a hospital ER because they know how to work around Medicaid if they don't show up in the system.

If you have to pay anything out of pocket, it better be an emergency or you'll need to call the cw (or cw supervisor, or keep going up the ranks until you get a body on the phone) to approve the cost for reimbursement and write their name down. But this really shouldn't happen. Medicaid has always covered everything.

If you have a child placed with you that has any kind of serious health issue (but not medically fragile) then the HMOs will assign an HMO caseworker to follow-up with you each month. We had this when one of our former fcs had a hospitalization for food allergy when she was almost 1 month old. It was good because I could tell the woman what the concerns were and what specialist we intended to see and she made sure it was approved.
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