Best hmo for jersey care

amother

Sun, Jul 23 2023, 3:11 am

Between Amerigroup and United Health for children
I'm new here so don't have specific doctors in mind.
I will probably start with precious health and will need Ot/Pt.
are there good specialists / dentists in surrounding areas (willing to travel ) that would accept jersey care. I tried calling an eye dr in Lakewood and there was a 5 month wait.
Will I have options to travel for just as good but easier to get into dr's?

amother

Obsidian

Sun, Jul 23 2023, 7:26 am

Someone I know who works with medical referrals hates amerigroup. She said she has had too many stories where children needed critical important care that needed exceptions and they are difficult to work with and refuse. She does not have that with UHC and some other hmos.
Re therapy there are almost no providers locally that take jerseycare aside for children's specialized hospital

amother

Violet

Sun, Jul 23 2023, 7:32 am

Most drs and therapies in town don’t take United healthcare .
( pretty sure precious health does not … but double check that)
Look into Aetna better health.
Amerigroup is terrible with prior authorizations .

amother

Rainbow

Sun, Jul 23 2023, 8:38 am

Precious Health does take United Healthcare, and it's also the best HMO for dental. For therapy, we went to Children's Specialized and you could also go to any hospital -based clinic. There's a shortage of eye doctors in Lakewood so no matter which HMO you have, there will be a very long wait. I'm looking into options outside Lakewood.

amother

Ballota

Sun, Jul 23 2023, 8:44 am

I have United healthcare and it’s what our pediatrician as well as our dentist takes. OT/PT makes no difference because only children’s specialized will accept jerseycare, and they accept every hmo out there.

amother

Mocha

Sun, Jul 23 2023, 8:46 am

I switched to United healthcare from horizon bec of precious health and just two things to note- you need a referral for everything which I didn’t need with horizon and the dentist claims it’s worse than horizon. Horizon pays more and is a better quality insurance

amother

Lightcyan

Sun, Jul 23 2023, 9:38 am

I have amerigroup.
Im very happy with them. They cover root canals and my childs braces. You do not need any referrals to dermatologist..
For therapy I use kessler in jackson,
Eye dr, I use freehold.

amother

Sun, Jul 23 2023, 2:27 pm

amother Obsidian wrote:

anyone have experience with moving from brooklyn and keeping insurance there?
I don't have babies so I can schedule advance appointments for well visits and use urgent care in lakewood for sick visits
Is this a bad idea?
or does rhr Lakewood system sound more complicated than it is.
I have no problem traveling to Freehold or anywhere else if decent Dr's accept jersey care

amother

Ballota

Sun, Jul 23 2023, 2:54 pm

amother OP wrote:

You can't have NY medicaid if you don't live in NY. Very very illegal.

amother

Olive

Sun, Jul 23 2023, 3:06 pm

amother OP wrote:

You can't keep ny medicaid if you don't live there. Jersey care covers a lot, I had better coverage than I do now on private. And I had no issues finding doctors if you are willing to travel 20-30 minutes.

amother

Purple

Sun, Jul 23 2023, 7:37 pm

Amerigroup is really not good if Chas Vesholom you have a true medical emergency. I’m talking from personal experience. There is no way to transfer to Chop, or get into any Dr there; and they stopped covering Du Pont now too.

amother

Tiffanyblue

Sun, Jul 23 2023, 8:27 pm

amother Lightcyan wrote:

I have amerigroup.
Im very happy with them. They cover root canals and my childs braces. You do not need any referrals to dermatologist..
For therapy I use kessler in jackson,
Eye dr, I use freehold.

Who is Kessler in jackson?Jackson?
I think there is one speech and o.t place in lakewood that takes all insurance besides uhc.

amother

Lightcyan

Sun, Jul 23 2023, 8:34 pm

amother Purple wrote:

Are there any hmo that still covers nemours?

If the child gets admitted through the e.r. then chop is covered. I had that unfortunately)

amother

Ballota

Sun, Jul 23 2023, 8:34 pm

amother Tiffanyblue wrote:

Who is Kessler in jackson?Jackson?
I think there is one speech and o.t place in lakewood that takes all insurance besides uhc.

Adults or kids?

amother

Sunflower

Sun, Jul 23 2023, 9:01 pm

It really matters what drs you use.
But also, just so you know, United healthcare has a new policy that they won’t cover any specialist appointments without a referral (even one that upon going to for years) so be very careful with that

amother

SandyBrown

Sun, Jul 23 2023, 9:18 pm

amother Purple wrote:

This is true of all the HMOs, not just Amerigroup

amother

SandyBrown

Sun, Jul 23 2023, 9:20 pm

amother Lightcyan wrote:

Are there any hmo that still covers nemours?

If the child gets admitted through the e.r. then chop is covered. I had that unfortunately)

This is true of any ER on any of the HMOs. Emergencies anywhere in the country are covered. Technically (not sure if it ever happens) if you are admitted for a long stay from the ER the insurance can demand you transfer to a place that is in their network once the initial emergency has passed.

amother

Purple

Sun, Jul 23 2023, 9:45 pm

amother SandyBrown wrote:

It’s worse with Amerigroup. My child was sick in Monmouth hospital who unfortunately couldn’t help him. Chai Lifeline got involved and many other Askanim too they all said with any other HMO they would’ve been able to get him into CHOP. BH Amerigroup did allow transferring to Columbia in Manhattan which we ended up doing but we lost 2 days in the process and my child was really critically sick at the time.