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Forum
-> Children's Health
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amother
Brunette
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 Mon, Nov 28 2016, 1:30 pm
Hi, this question is for anyone who ever went to a doctor working in Boston childrens Hospital. What insurance did you use? We have to go and our insurance denied to pay out of network. Does medicaid pay if it's the secondary insurance? Please help me! Thank you!
P. S. It's for a heart defect
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pesek zman
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Mon, Nov 28 2016, 1:35 pm
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Medicaid is state to state. Meaning NY Medicaid isnt accepted in Massachussets. In order to be seen by an MD in Boston you need prior auth from Medicaid. The MD office in Boston should be able to help you with this
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amother
Brunette
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Mon, Nov 28 2016, 5:38 pm
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Let me rephrase my question. Is there any way to be approved for straight medicaid?
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anonymrs
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Mon, Nov 28 2016, 6:16 pm
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OP, can you pm me? I'm trying to do the same. Thanks!
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pesek zman
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Mon, Nov 28 2016, 6:18 pm
| amother wrote: | | Let me rephrase my question. Is there any way to be approved for straight medicaid? |
Question still isn't clear
Even straight Medicaid would need special authorization for out of state treatment
I'm a hospital social worker so I know what I'm talking about
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amother
Brunette
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Mon, Nov 28 2016, 6:27 pm
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I know that I will need authorization with the straight medicaid. But first I need to figure out how to get the medicaid. Will they pick up the charges if my primary insurance is declined (since it doesn't have out of state coverage)
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pesek zman
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Mon, Nov 28 2016, 6:37 pm
| amother wrote: | | I know that I will need authorization with the straight medicaid. But first I need to figure out how to get the medicaid. Will they pick up the charges if my primary insurance is declined (since it doesn't have out of state coverage) |
Complicated but the Medicaid (secondary insurance) would need to authorize the out of state treatment but they very well may not do so if there is comparable treatment in NY. You will need a compelling reason to go out of state. You will need treatment that cannot be provided in NY.
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Amarante
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Mon, Nov 28 2016, 6:43 pm
Medicaid is based on finances so I don't understand how you would get Medicaid unless you are already covered by Medicaid.
As others have posted, Medicaid is based on state requirements and I would also imagine that reimbursement is through the state.
I don't know Medicaid but I would imagine it would be difficult to prove that comparable medical treatment is not available in New York which is a center of cutting edge medicine
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