Author Topic: Any reason to NOT take Medicaid?  (Read 1907 times)

IslandFiGirl

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Any reason to NOT take Medicaid?
« on: February 07, 2020, 10:11:47 AM »
Tinkering with the Marketplace website, it seems I cannot figure out the right income level to qualify for subsidies.  The amount I enter is more than what I think I'll count as income this year (final paycheck and RMD from and inherited IRA) and even then the site keeps telling me I qualify for Medicaid based on my income.  I feel a little uncomfortable with applying for and potentially accepting Medicaid if it is offered to me because I HAVE money, but the full price marketplace plans are astronomical.  Besides the feeling that I'd be receiving welfare if I got on Medicaid, is there any other reason I shouldn't select that option?  Like maybe at the end of the year I made way more than expected, so I'd have to pay that money back?  This turned out to be way more confusing than I had anticipated!

Queen Frugal

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Re: Any reason to NOT take Medicaid?
« Reply #1 on: February 07, 2020, 12:23:53 PM »
Different states have different rules, but you must make a minimum level of income to qualify for coverage under the affordable care act. I believe the minimum is 100% of the federal poverty level.

We don't have expanded Medicaid where I live - which it sounds like you probably do.  My only concern would be with Medicaid is that not all doctors take it. Your only alternative would probably be private health insurance if you don't qualify for a marketplace policy. If it was me, and I am healthy, I would take Medicaid over paying a ton of money for private health insurance.

For better advise in your state, you might try your state insurance department.

terran

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Re: Any reason to NOT take Medicaid?
« Reply #2 on: February 07, 2020, 01:27:49 PM »
My understanding is that different areas have different medicaid acceptance rates. You might try calling your regular doctor(s) and asking if they will accept medicaid.

If you do want to get your income high enough to qualify for subsidies you could convert traditional IRA/401(k) balances to Roth. That will generate income and you don't have to (shouldn't) spend it. This wouldn't be a bad thing to do anyway while you're in a low tax bracket.

yachi

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Re: Any reason to NOT take Medicaid?
« Reply #3 on: February 07, 2020, 03:15:32 PM »
I feel a little uncomfortable with applying for and potentially accepting Medicaid if it is offered to me because I HAVE money, but the full price marketplace plans are astronomical.  Besides the feeling that I'd be receiving welfare if I got on Medicaid,

I'm not yet at a withdrawal phase, but in planning I've felt like this.  The reality is you are playing by the rules set up by the US government.  The US government decided you get Medicaid with XX income.  They also, intentionally decided not to subject it to asset tests.* 
The British government decided to set up their rules differently and provide health care at no cost to those needing it.
The Canadian government also decided to set up their rules differently and provide health care at no cost to those needing it.
You are no more abusing the US system of health care by accepting medicaid, than a resident of Canada would be abusing their system by going to the doctor.


*Note that in my state at least, those over 65 are subject to an asset test for Medicaid, this prevents them from having medicaid pay for end of life care while sitting on large retirement accounts.

Paul der Krake

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Re: Any reason to NOT take Medicaid?
« Reply #4 on: February 07, 2020, 03:17:29 PM »
No coverage at all outside the United States and coverage can be lost if you remain there for longer than a short vacation.

MonkeyJenga

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Re: Any reason to NOT take Medicaid?
« Reply #5 on: February 07, 2020, 03:24:02 PM »
Why is Medicaid welfare but not ACA subsidies?

IslandFiGirl

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Re: Any reason to NOT take Medicaid?
« Reply #6 on: February 07, 2020, 03:31:12 PM »
Why is Medicaid welfare but not ACA subsidies?

That's a good point.  I guess if you think about it, it's really all the same.

DaMa

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Re: Any reason to NOT take Medicaid?
« Reply #7 on: February 07, 2020, 04:02:02 PM »
If you have a preference on doctor, than absolutely yes.  If no, then probably not.

My primary did not accept Medicaid patients.  She also didn't accept all of the ACA plans.  I looked into moving to another doctor, and she also didn't take all the ACA plans, and didn't take Medicaid.  This is from my notes:

Dr. A  Preferred HMO, select HMO, premiere PPO, not Metro Detroit
Dr. P  Preferred HMO, premiere PPO, Metro Detroit

It's ridiculously complicated.  Also, be sure to call your doctor's office directly and confirm, because sometimes the websites don't reflect the most current information.

I wouldn't hesitate to take Medicaid on moral grounds.  Your tax dollars pay for these benefits.  Congress has had almost 10 years to close this loophole.

spartana

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Re: Any reason to NOT take Medicaid?
« Reply #8 on: February 07, 2020, 11:03:34 PM »
Why is Medicaid welfare but not ACA subsidies?
Exactly! Medicaid premiums paid for by the Feds are generally much lower than the premium the feds (taxpayers) pay to private insurers because those premiums are negotiated at lower amounts.  If you are receiving larger subsidies and cost-sharing when using an ACA plan, it is likely costing the tax payers more to insure you then it would if you were on Medicaid.

For example: My sister was on a ACA Enhanced Silver Plan with Kaiser. The monthly premium was $900/month but because she was low income she only paid about $150/month and $75 deductible/year and the Feds (taxpayers) paid the difference of $750/month to Kaiser plus whatever amount her costs were for healthcare treatment after her $75/ year deductible was met. Now she is on the same Kaiser plan but it is thru Medicaid. While she doesn't pay anything, the government negotiates lower premiums and costs with insurers for Medicaid so it is highly likely Medicaid is paid much less by the taxpayer when she is on Medicaid compared to when she is on a highly subsidized ACA plan.
« Last Edit: February 07, 2020, 11:09:55 PM by spartana »

Paul der Krake

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Re: Any reason to NOT take Medicaid?
« Reply #9 on: February 07, 2020, 11:17:40 PM »
It's ridiculously complicated.  Also, be sure to call your doctor's office directly and confirm, because sometimes the websites don't reflect the most current information.
Insurer and clinical groups are always comically out of date. They basically tell you that this person, at some point, was licensed to practice medicine. As an authoritative source, they're worthless. Only use them to get some names to get started, don't even bother with using the search filters.

Regarding acceptance, I have empirically found that large hospital groups tend to take it, smaller practices do not. I called a couple dermatologists last week and the first question they ask is always:
"Who is your insurance carrier?"
immediately followed by:
"It's not the Medicaid plan is it?"

Not a problem if you're on a Kaiser Medicaid plan, but a major PITA otherwise.


blingwrx

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Re: Any reason to NOT take Medicaid?
« Reply #10 on: February 08, 2020, 12:09:12 AM »
For Medicaid you do not need to pay the money back if you make more through out the year. Once you qualify youíre eligible for 1 year. Then they will ask you to renew a month before a year is up and if your income doesnít qualify it will just expire when the year is up and then you can just apply for a Regular ACA plan and pay the thousands in premiums.

Medicaid has been fine for me when I had it as most my doctors accept it, but as others have mentioned you should browse around and see which doctors will take it in your area. If youíre relatively healthy and only use it occasionally for check ups and what not then I donít see the big deal in seeing a different doctor and just save the thousands a year in premiums Copays and deductibles.

Youíre not doing anything wrong itís not illegal if youíre putting down your legitimate income at the time you apply. Itís not your fault the govt doesnít donít do any asset checks. Do huge corporations like amazon complain when they donít pay any taxes, no they do not, they did everything legally and are happy to find any loopholes to save money. You pay your taxes youíre entitled to any benefits you can qualify for as long as you do it legally.

EscapeVelocity2020

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Re: Any reason to NOT take Medicaid?
« Reply #11 on: February 08, 2020, 12:50:34 AM »
RootOfGood's children are on Medicaid (CHIP) and he's early retired with over 2M net worth.  The working public find it to be disagreeable, but he seems to be OK with it.  I'd probably feel more guilty.  Personally, I like to make my own way especially since I know that I can and feel really blessed, but I don't hold any grudges against those that need or figure out a way to get low income assistance. 

Dollar Slice

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Re: Any reason to NOT take Medicaid?
« Reply #12 on: February 08, 2020, 01:14:30 AM »
One thing to note is that if you are now or in the future on some newer/more unusual/expensive medications, the drug manufacturer may have a coupon or discount program that is good ONLY if you are on commercial insurance (i.e., employer or COBRA or ACA, but not Medicaid or Medicare). I avoided going on Medicaid for a few months because I would have had to pay something like $700/month just for one medicine that I currently get for free via the manufacturer. This is an edge case, but it is definitely worth knowing if you are in that small fraction of people.

eostache

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Re: Any reason to NOT take Medicaid?
« Reply #13 on: February 08, 2020, 08:43:30 AM »
Why is Medicaid welfare but not ACA subsidies?

Yes. Someone (I think it was a doctor friend) once told me that it is cheap for the gov't to cover Medicaid premiums, I think she said it was about $50/mo at that time. I'm on a silver ACA plan right now at $0 premium for myself. The monthly cost of over $500/mo is totally covered by subsidies.

I'm collecting unemployment at the moment. In a couple of months when UI runs out and my income goes to $0 (unless I find a job) I will drop down to Medicaid. I've been on Medicaid before and I was happy with it. I only used a small amount of services: allergist, a couple visits to urgent care, dental cleanings. Copays of $0-$2, no paperwork.

I'm in western Colorado and there seems to be pretty good services for Medicaid care here.

The US needs Medicaid for all.

DaMa

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Re: Any reason to NOT take Medicaid?
« Reply #14 on: February 08, 2020, 08:54:38 AM »
One thing to note is that if you are now or in the future on some newer/more unusual/expensive medications, the drug manufacturer may have a coupon or discount program that is good ONLY if you are on commercial insurance (i.e., employer or COBRA or ACA, but not Medicaid or Medicare). I avoided going on Medicaid for a few months because I would have had to pay something like $700/month just for one medicine that I currently get for free via the manufacturer. This is an edge case, but it is definitely worth knowing if you are in that small fraction of people.

The insurance companies are fighting these programs hard, so don't be surprised if they go away.

spartana

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Re: Any reason to NOT take Medicaid?
« Reply #15 on: February 08, 2020, 09:30:29 AM »
One thing to note is that if you are now or in the future on some newer/more unusual/expensive medications, the drug manufacturer may have a coupon or discount program that is good ONLY if you are on commercial insurance (i.e., employer or COBRA or ACA, but not Medicaid or Medicare). I avoided going on Medicaid for a few months because I would have had to pay something like $700/month just for one medicine that I currently get for free via the manufacturer. This is an edge case, but it is definitely worth knowing if you are in that small fraction of people.

The insurance companies are fighting these programs hard, so don't be surprised if they go away.
The VA does the same thing to keep other costs down. They only have something like 450 formulary drugs (most generic and commonly used) compared to private insurers who will pay for many many more.  So if you need something unusual and costly you'd have to fund it yourself or let them try lower cost drugs first before prescripting expensive ones.. .
« Last Edit: February 08, 2020, 09:39:14 AM by spartana »

Paul der Krake

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Re: Any reason to NOT take Medicaid?
« Reply #16 on: February 08, 2020, 10:05:05 AM »
Why is Medicaid welfare but not ACA subsidies?

Yes. Someone (I think it was a doctor friend) once told me that it is cheap for the gov't to cover Medicaid premiums, I think she said it was about $50/mo at that time. I'm on a silver ACA plan right now at $0 premium for myself. The monthly cost of over $500/mo is totally covered by subsidies.
Nowhere near $50/month, more like $500:
https://www.kff.org/medicaid/state-indicator/medicaid-spending-per-enrollee/

spartana

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Re: Any reason to NOT take Medicaid?
« Reply #17 on: February 08, 2020, 10:17:45 AM »
Why is Medicaid welfare but not ACA subsidies?

Yes. Someone (I think it was a doctor friend) once told me that it is cheap for the gov't to cover Medicaid premiums, I think she said it was about $50/mo at that time. I'm on a silver ACA plan right now at $0 premium for myself. The monthly cost of over $500/mo is totally covered by subsidies.
Nowhere near $50/month, more like $500:
https://www.kff.org/medicaid/state-indicator/medicaid-spending-per-enrollee/
Interesting. It said a full Medicaid benefit was $4193/year in Calif (approx $395/month) but not sure I read it right as it said for an adult it wss $1800/year. Big difference but in either case lower than the $900/month paid to a private insurer plan my sister had when using the ACA (she qualified for big subsidies though).

Paul der Krake

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Re: Any reason to NOT take Medicaid?
« Reply #18 on: February 08, 2020, 10:33:27 AM »
Why is Medicaid welfare but not ACA subsidies?

Yes. Someone (I think it was a doctor friend) once told me that it is cheap for the gov't to cover Medicaid premiums, I think she said it was about $50/mo at that time. I'm on a silver ACA plan right now at $0 premium for myself. The monthly cost of over $500/mo is totally covered by subsidies.
Nowhere near $50/month, more like $500:
https://www.kff.org/medicaid/state-indicator/medicaid-spending-per-enrollee/
Interesting. It said a full Medicaid benefit was $4193/year in Calif (approx $395/month) but not sure I read it right as it said for an adult it wss $1800/year. Big difference but in either case lower than the $900/month paid to a private insurer plan my sister had when using the ACA (she qualified for big subsidies though).
Column "all full or partial enrollees" means everyone enrolled in Medicaid, the one that really matters. The other columns are subgroups.

Column "aged" is seniors 65 and above.
Column "disabled" is, well, enrollees who are disabled.
Columns "adults" and "children" are people who don't fall into the "aged" or "disabled" category.

So yeah, if you exclude all the really sick people from the healthy pools in the reporting, things look incredibly cheap.

jim555

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Re: Any reason to NOT take Medicaid?
« Reply #19 on: February 08, 2020, 12:44:26 PM »
To the OPs question.  Medicaid usually is run by Managed Care Plans in your area.  Look these up and see their doctor networks and pick the best one for you.  If you are older than 54 your state MAY claw back any payments made against your estate upon death.  Check your state for this.  I know NY does NOT do estate recovery for the expansion group.  If you have increased income report in within 30 days.  As long as you accurately report changes you will be fine. 

ACA subsidies can cost way more per patient than Medicaid, yet people loose their minds when they hear Medicaid.  I think in NY it is around the low $400s a month per person capitation rate for the expansion group.


jim555

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Re: Any reason to NOT take Medicaid?
« Reply #20 on: February 08, 2020, 12:49:01 PM »
For Medicaid you do not need to pay the money back if you make more through out the year. Once you qualify youíre eligible for 1 year.
I know in NY they redetermine every year so you can keep it until your annual date even if your income goes up.  I don't think other states do it like this though.

spartana

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Re: Any reason to NOT take Medicaid?
« Reply #21 on: February 08, 2020, 12:51:52 PM »
To the OPs question.  Medicaid usually is run by Managed Care Plans in your area.  Look these up and see their doctor networks and pick the best one for you.  If you are older than 54 your state MAY claw back any payments made against your estate upon death.  Check your state for this.  I know NY does NOT do estate recovery for the expansion group.  If you have increased income report in within 30 days.  As long as you accurately report changes you will be fine. 

ACA subsidies can cost way more per patient than Medicaid, yet people loose their minds when they hear Medicaid.  I think in NY it is around the low $400s a month per person capitation rate for the expansion group.
I forgot about the claw back thing. That could be a potential issue for some who want to leave their estate to someone besides their spouse after they die (no claw back until after spouse dies) but may remove some of the.moral or ethical feeling about using Medicaid for others. At least for the over 55 crowd here in.Calif which has that.

Cassie

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Re: Any reason to NOT take Medicaid?
« Reply #22 on: February 08, 2020, 01:26:22 PM »
I am glad that Medicaid program has a claw back feature. Itís unfair for people to use it and leave their money to others. A friend of mine used Medicaid after all her money, paid off home was gone. Itís a safety net for the poor.  What root of good does is legal but I feel that itís not living with integrity. 

jim555

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Re: Any reason to NOT take Medicaid?
« Reply #23 on: February 08, 2020, 02:15:26 PM »
Claw back for Medicaid and not for ACA subsidies seems totally unfair to the poor.  It leaves their families in a constant state of poverty that is hard to escape from.

I don't want a claw back at all for anyone.

scrunchythief

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Re: Any reason to NOT take Medicaid?
« Reply #24 on: February 08, 2020, 03:09:12 PM »
We were on it for about a year or so, even with about 100k in assests.  I didn't feel bad about using it at all, probably in part because I strongly believe we should have a single payer system.

If you see specialists, receive psychological care or are strongly attached to your doctor, I would check to see if they accept it.  A lot of providers in the psych field in my area don't accept Medicaid due to the extra work it takes to be able to accept it.  I had a fabulous psychiatrist who I am so indebted to because she went through the process so that she could accept it for me.

Cassie

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Re: Any reason to NOT take Medicaid?
« Reply #25 on: February 08, 2020, 03:42:56 PM »
Jim, they initiated clawback for nursing home care because people were leaving their money to their kids and going on Medicaid.  Itís unsustainable.

spartana

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Re: Any reason to NOT take Medicaid?
« Reply #26 on: February 08, 2020, 03:52:15 PM »
Claw back for Medicaid and not for ACA subsidies seems totally unfair to the poor.  It leaves their families in a constant state of poverty that is hard to escape from.

I don't want a claw back at all for anyone.
Do they actually do claw backs for Medicaid premiums and healthcare expenses or is it just for nursing home care? If it is just for nursing home care (which is covered after you spend down your assets and income) then the claw back is probably warranted. But I agree that if its to repay the government for premiums and medical care costs then.the same should apply for ACA subsidies. Of course it seems much easier to have a universal healthcare plan that everyone can help fund and access.

Paul der Krake

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Re: Any reason to NOT take Medicaid?
« Reply #27 on: February 08, 2020, 03:58:47 PM »
It's just for long-term care Medicaid, basically nursing homes.

It'd be impossible to even compute how much to clawback from "vanilla Medicaid" if they wanted to. Over a lifetime it's dozens and dozens of millions of people who cycle in and out of it the program. Good luck tallying everything up and coming up with a bill for every person.

jim555

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Re: Any reason to NOT take Medicaid?
« Reply #28 on: February 08, 2020, 04:31:36 PM »
I wasn't referring to elderly Medicaid, that always has had a claw back (since 1993).  The expansion group technically could have a claw back too.  The law says recover anything 55 or more.  When they passed the expansion they didn't change the law about claw backs.  So some states will try to claw back on the expansion group because technically that is what the law says.  The states can try to recover everything if they want to, or just nursing home cases (they have to on those).

https://www.macpac.gov/wp-content/uploads/2015/11/Medicaid%E2%80%99s-New-Adult-Group-and-Estate-Recovery.pdf

If I was in a state I wasn't sure about I would create some income and get to 138 + 1% to avoid the possibility for a recovery case.
« Last Edit: February 08, 2020, 04:52:10 PM by jim555 »

jim555

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Re: Any reason to NOT take Medicaid?
« Reply #29 on: February 08, 2020, 05:06:45 PM »
It's just for long-term care Medicaid, basically nursing homes.

It'd be impossible to even compute how much to clawback from "vanilla Medicaid" if they wanted to. Over a lifetime it's dozens and dozens of millions of people who cycle in and out of it the program. Good luck tallying everything up and coming up with a bill for every person.
It isn't impossible.  They pay Managed Care Companies $XX per month per person.  They know you are on plan X for X months.  The cost can be calculated pretty easily.

jim555

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Re: Any reason to NOT take Medicaid?
« Reply #30 on: February 08, 2020, 05:43:34 PM »
Claw back for Medicaid and not for ACA subsidies seems totally unfair to the poor.  It leaves their families in a constant state of poverty that is hard to escape from.

I don't want a claw back at all for anyone.
Do they actually do claw backs for Medicaid premiums and healthcare expenses or is it just for nursing home care? If it is just for nursing home care (which is covered after you spend down your assets and income) then the claw back is probably warranted. But I agree that if its to repay the government for premiums and medical care costs then.the same should apply for ACA subsidies. Of course it seems much easier to have a universal healthcare plan that everyone can help fund and access.
With Elderly Medicaid they make you spend down to like $2,000 before Medicaid kicks in.  They have special provisions for owning a house.  After the surviving spouse dies they can move to recover from the house sale. 

American GenX

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Re: Any reason to NOT take Medicaid?
« Reply #31 on: February 08, 2020, 06:26:30 PM »
Why is Medicaid welfare but not ACA subsidies?

How about child tax credits?  Or dependent exemption?  Or any other deduction/credit on your taxes outside of the standard deduction?

American GenX

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Re: Any reason to NOT take Medicaid?
« Reply #32 on: February 08, 2020, 06:32:50 PM »
This has been discussed on this forum before.  One example:

https://forum.mrmoneymustache.com/welcome-to-the-forum/why-keep-income-above-medicaid-limits/

In most states, the Medicaid expansion costs can be recovered through the asset recovery.

Even if you don't actually use any health care facility or see a doctor, you may still be racking up a huge bill through the managed care services used by Medicaid.

States also have the option to recover costs of all other Medicaid services for people who are 55 or older and have a separate option to extend the recovery beyond probate estates, which is known as "expanded estate recovery".

https://en.wikipedia.org/wiki/Medicaid_Estate_Recovery_Program

Congress also gave states the option to go further ó to target the estates of all Medicaid recipients for any benefits they received after age 55

https://www.washingtonpost.com/national/health-science/little-known-aspect-of-medicaid-now-causing-people-to-avoid-coverage/2014/01/23/deda52e2-794e-11e3-8963-b4b654bcc9b2_story.html

Medicaidís Dark Secret
For many participants, the program that provides health care to millions of low-income Americans isnít free. Itís a loan. And the government expects to be repaid.

https://www.theatlantic.com/magazine/archive/2019/10/when-medicaid-takes-everything-you-own/596671/

« Last Edit: February 08, 2020, 06:45:26 PM by American GenX »

Paul der Krake

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Re: Any reason to NOT take Medicaid?
« Reply #33 on: February 08, 2020, 07:41:16 PM »
It's just for long-term care Medicaid, basically nursing homes.

It'd be impossible to even compute how much to clawback from "vanilla Medicaid" if they wanted to. Over a lifetime it's dozens and dozens of millions of people who cycle in and out of it the program. Good luck tallying everything up and coming up with a bill for every person.
It isn't impossible.  They pay Managed Care Companies $XX per month per person.  They know you are on plan X for X months.  The cost can be calculated pretty easily.
Except managed care is just one aspect, and it's a joint program administered by 50 states + DC + territories, and many of those are incapable of keeping data organized and safe for 10 years let alone 80.

Reminder: we don't even know for sure how many people live in the country on any given day!

Then throw in all the complications with people changing names, disappearing, reappearing, getting benefits retroactively granted/reversed, add in accounting for all sorts of legal judgements. Then account for people who are claiming your estimate is wrong, you need to cross-reference all that data somehow.

Yeah, you're not getting a number aaaanytime soon.

Monerexia

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Re: Any reason to NOT take Medicaid?
« Reply #34 on: February 08, 2020, 07:52:51 PM »
If you're not sensitive to class issues then you'll be fine, most likely. Waiting rooms will be like riding the bus in the ghetto. Also medicaid facilities will have a combination of students, new practitioners working on full licensure and overworked burned out lifers with few other options--the ones with experience and options go elsewhere for too many reasons to list.

jim555

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Re: Any reason to NOT take Medicaid?
« Reply #35 on: February 08, 2020, 07:58:32 PM »
If you're not sensitive to class issues then you'll be fine, most likely. Waiting rooms will be like riding the bus in the ghetto. Also medicaid facilities will have a combination of students, new practitioners working on full licensure and overworked burned out lifers with few other options--the ones with experience and options go elsewhere for too many reasons to list.
I have been on a Medicaid Managed Care plan for the last 5 years and nothing you are saying has been the case for me.  The same doctors I had at work are in the MMC plan and I have been to several specialists.  The only difference I can see is I am not getting the bill. It is better coverage than I had at work.

Monerexia

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Re: Any reason to NOT take Medicaid?
« Reply #36 on: February 08, 2020, 08:15:04 PM »
If you're not sensitive to class issues then you'll be fine, most likely. Waiting rooms will be like riding the bus in the ghetto. Also medicaid facilities will have a combination of students, new practitioners working on full licensure and overworked burned out lifers with few other options--the ones with experience and options go elsewhere for too many reasons to list.
I have been on a Medicaid Managed Care plan for the last 5 years and nothing you are saying has been the case for me.  The same doctors I had at work are in the MMC plan and I have been to several specialists.  The only difference I can see is I am not getting the bill. It is better coverage than I had at work.

Yes ymmv--perhaps there are large differences on the state level. I have had the same problem I outlined above with some years with private plans from the marketplace--all foreign educated doctors and sketchy facilities. Glad it's worked for you.

jim555

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Re: Any reason to NOT take Medicaid?
« Reply #37 on: February 08, 2020, 08:17:08 PM »
If you're not sensitive to class issues then you'll be fine, most likely. Waiting rooms will be like riding the bus in the ghetto. Also medicaid facilities will have a combination of students, new practitioners working on full licensure and overworked burned out lifers with few other options--the ones with experience and options go elsewhere for too many reasons to list.
I have been on a Medicaid Managed Care plan for the last 5 years and nothing you are saying has been the case for me.  The same doctors I had at work are in the MMC plan and I have been to several specialists.  The only difference I can see is I am not getting the bill. It is better coverage than I had at work.

Yes ymmv--perhaps there are large differences on the state level. I have had the same problem I outlined above with some years with private plans from the marketplace--all foreign educated doctors and sketchy facilities. Glad it's worked for you.
New York is one of the most generous states when it comes to Medicaid.

blingwrx

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Re: Any reason to NOT take Medicaid?
« Reply #38 on: February 08, 2020, 08:56:13 PM »
If you're not sensitive to class issues then you'll be fine, most likely. Waiting rooms will be like riding the bus in the ghetto. Also medicaid facilities will have a combination of students, new practitioners working on full licensure and overworked burned out lifers with few other options--the ones with experience and options go elsewhere for too many reasons to list.
I have been on a Medicaid Managed Care plan for the last 5 years and nothing you are saying has been the case for me.  The same doctors I had at work are in the MMC plan and I have been to several specialists.  The only difference I can see is I am not getting the bill. It is better coverage than I had at work.

I agree here but Iím also in NY but YMMV for other states. My platinum insurance from work and Medicaid got me to the same doctors and specialist. A few cases some didnít take but overall still good doctors to choose from for Medicaid. They also donít treat you differently if you have Medicaid. You wait in the same line as people with platinum employee insurance except you have no copays or deductibles to pay.

jim555

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Re: Any reason to NOT take Medicaid?
« Reply #39 on: February 08, 2020, 09:02:59 PM »
I agree here but Iím also in NY but YMMV for other states. My platinum insurance from work and Medicaid got me to the same doctors and specialist. A few cases some didnít take but overall still good doctors to choose from for Medicaid. They also donít treat you differently if you have Medicaid. You wait in the same line as people with platinum employee insurance except you have no copays or deductibles to pay.
This year I am moving up to the Essential Plan due to higher income, same doctors but more co-pays.  Instead of $200 max OOP, it is $2,000 max OOP.

spartana

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Re: Any reason to NOT take Medicaid?
« Reply #40 on: February 09, 2020, 09:42:24 AM »
If you're not sensitive to class issues then you'll be fine, most likely. Waiting rooms will be like riding the bus in the ghetto. Also medicaid facilities will have a combination of students, new practitioners working on full licensure and overworked burned out lifers with few other options--the ones with experience and options go elsewhere for too many reasons to list.
I have been on a Medicaid Managed Care plan for the last 5 years and nothing you are saying has been the case for me.  The same doctors I had at work are in the MMC plan and I have been to several specialists.  The only difference I can see is I am not getting the bill. It is better coverage than I had at work.

I agree here but I’m also in NY but YMMV for other states. My platinum insurance from work and Medicaid got me to the same doctors and specialist. A few cases some didn’t take but overall still good doctors to choose from for Medicaid. They also don’t treat you differently if you have Medicaid. You wait in the same line as people with platinum employee insurance except you have no copays or deductibles to pay.
My sister is in Calif and nothing changed for her either. Kaiser plan thru work to to same Kaiser plan (and doctor) while using the ACA to same Kaiser plan and doctor when she went on Medicaid.
« Last Edit: February 09, 2020, 09:52:07 AM by spartana »

iris lily

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Re: Any reason to NOT take Medicaid?
« Reply #41 on: February 09, 2020, 09:49:23 AM »
Why is Medicaid welfare but not ACA subsidies?

Itís the slippery slope. If you are more comfortable with black and white thinking then yes, they are all welfare.

Paul der Krake

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Re: Any reason to NOT take Medicaid?
« Reply #42 on: February 09, 2020, 10:18:22 AM »
Something else I thought about: consider the stability of your local Medicaid managed care plan market.

Here there have been credible rumors that Kaiser might pull out of the state entirely. If that does happen, it's likely that their Medicaid plan will be the first to go, then everyone else. The only other game in town is the local BCBS, and as I noted in another post above, few doctors take their Medicaid plan. Tens of thousands of patients will all of sudden competing to find those that do.