Which insurance plan? (9/16 update)

amother

Ecru

Wed, Sep 28 2016, 6:16 pm

We have medicaid level HMO. We were on HIP until now but they changed to Health Care Partners, I don't even know what that means because everything still says HIP on it, but my doctors say it's a massive pain in the neck on their end, it covers less stuff, you need a referral for every single thing, they don't always approve referrals, and it takes a couple of days to process and find out. I'm ready to push through a switch.

All threads I see are old. Please post what are good medicaid-level insurance plans and why you like them.

amother

Taupe

Wed, Sep 28 2016, 6:26 pm

Assuming you're in NY (because, you know, it's the center of my universe), I'm happy with United Health Care.

I would suggest contacting the doctors your kids see (PCP, dentist, any specialists) and getting a list of medicaid HMOs they accept and working from there.

I'm pretty sure all these plans require referral for scans and specialists (barring a few exceptions).

amother

Ecru

Wed, Sep 28 2016, 6:37 pm

New York, yes thanks Smile

All the doctors we currently use accept all the health plans with the exception of a couple that nobody ever heard of except us because DH chose his plan randomly so now we know that nobody accepts it Rolling Eyes

(he switched by now... to HIP, so I expect he'll have this problem too at some point)

The doctor who told me what a pain HIP had become said some plans don't require referrals at all (struck me as odd but ok?) but he didn't know which because he doesn't deal with that end of things in detail. But in any case I always used to require referrals and had no issue with that. Now the problem is threefold: You need a new referral for every little thing - used to be if the pediatrician gives the referral for the allergist and the allergist decides to run bloodwork and tells you to come back two days later, that's all included in the referral. And referrals to specialists used to automatically include a few follow-up visits. Now they don't, and because you need the exact date on the referral you need to keep calling back and forth to get it done right, they can't just give it to you at the beginning. Then, they also started denying some referrals. Used to be if the doctor said it's medically indicated, the referral was just a formality. No more. Finally, they take a few days to process the referral and let you know if it was approved. So there's no more "oops I forgot the referral for later today let me call the doctor's office" or "I just got to the specialist and they said they never received the referral that the doctor said was sent, can they send a new one?" or "The doctor said we should do the radiology as soon as possible, is there any way you can squeeze us in tomorrow?" Nope nope and nope.