Medicaid for expectant mothers

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Culturedpearls

Mon, Feb 10 2014, 10:28 pm

Can someone explain how this works?
In NY.
Thanks

amother

Mon, Feb 10 2014, 10:57 pm

I know in NJ there is emergency Medicaid given to pregnant women regardless, but maybe try to go to a Jewish social service office that can help you?

Smile1234

Tue, Feb 11 2014, 6:06 am

There's a place called Nachas Healthnet - they do the process for you. They are a division of Yeled V'yalda I believe.
(718) 436-7373

Pregnant women in NY are entitled to medicaid. Call nachas and ask them what you need, they'll schedule an appointment for you to bring in all your paperwork and they submit the application for you.

Beshaa tova!

Culturedpearls

Tue, Feb 11 2014, 6:26 am

Thanks it's not for me. I'm not even in US.
I'm trying to get info for someone & I have no idea how the USA (messed up?) health system works.
All expectant women can get medicaid?
Once qualified do they search for an OB who takes medicaid? Does medicaid cover hospital stay?
What if you are high risk? Want a specific OB?
Just trying to understand the system & it's limitations.

Smile1234

Tue, Feb 11 2014, 6:58 am

Medicaid has different health plans. Once she gets accepted to medicaid she can pick a health plan that the doctor she wants accepts.
Last year I know all expectant women were eligible for medicaid. I have no idea if things changed with Obamacare.

There's someone who used to work for Nachas and now does the same thing they do, but on her own and charges a small fee. She is extremely sweet and answers questions over the phone for no fee. You can pm me for her name and number.

Culturedpearls

Tue, Feb 11 2014, 7:42 am

Smile1234 wrote:

Does that mean any OB in any hospital will be covered under Medicaid? Or will there be out of pocket expenses? Medicaid will cover the cost of any health plan?
It just doesn't make sense that you can pick any doctor or the most prestigious hospital , regardless of cost & be covered under medicaid. Totally confused.

Smile1234

Tue, Feb 11 2014, 7:52 am

I don't know the details about that because I had my own private health insurance, and the medicaid was primarily for the baby.
I do know that anything that my private health insurance didnt cover in the hospital, medicaid did and we didnt end up paying anything out of pocket.
Kdai to call the doctors and hospitals that she wants to use and find out how it works.

groovy1224

Tue, Feb 11 2014, 7:57 am

Culturedpearls wrote:

Well, that's not really true. Not every doctor accepts medicaid. And not every hospital. So if she has a doctor she would like to use, she should find out if he/she accepts medicaid; and if so, what plans under medicaid. (Medicaid has different plans- it's kind of like having a concentration in you major at college. You can have a computer science major, but with diff concentrations. At the end of the day it's the same major, but just tailored a little differently depending on what you want/need. Medicaid is the same way. They have different plans; and you can pick any of them once you have been accepted. One isn't better or worse than the other, just a specific doctor may prefer taking one instead of another, for whatever reason.) A private hospital, or a super fancy private practice upper east side doctor probably will not accept medicaid, you're right about that.
Or, once she is accepted, her plan can give her a list of practitioners covered under her plan.
No, there will be no out of pocket expenses. All her prenatal and hospital care will be covered. I don't think it's any different with a high risk pregnancy, though she may have to have some things pre approved first.

Culturedpearls

Tue, Feb 11 2014, 8:09 am

Thanks ladies. I presume private hospitals won't be covered.
What about Maimonides? Can't find any info on their site.

Smile1234

Tue, Feb 11 2014, 8:12 am

Should be covered. I gave birth there. You can try calling them.

Fabulous

Tue, Feb 11 2014, 10:28 am

AFAIK not all pregnant women can get medicaid, but most. Depending on income but just much higher.

A lot of Brooklyn doctors take different medicaid plans, most Manhattan ones won't. Also only a few high risk doctors will take it.

All hospitals must take it AFAIK but you can only go if the doctor you are seeing participates in that hospital.

The hospital least likely to give you trouble with medicaid is Maimonides because they are so used to it. Half of the OB patients that go there likely have some form of medicaid.

Hatzlacha and bishaa tova!

nylon

Tue, Feb 11 2014, 4:55 pm

It's dependent on income, still. Here are the limits:

https://www.health.ny.gov/comm.....e.htm

it is much more complicated than public or private. Almost all hospitals participate in straight Medicaid (there are strings attached to federal money that mean they have to), but they do not have to participate in Medicaid managed care, and many physicians will not see Medicaid patients, at least in their private practices (they may also work through clinics).

Maimonides is a private hospital, BTW.

vintagebknyc

Tue, Feb 11 2014, 8:49 pm

nylon wrote:

healthy NY has not existed since last year, so that data has to be incorrect

MaBelleVie

Tue, Feb 11 2014, 8:57 pm

She has to be a NYS resident and qualify based on income guidelines. Not all doctors accept medicaid. Most or all hospitals do.

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