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Need recs for new Medicaid insurance



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amother
OP


 

Post Sat, Jul 13 2019, 11:40 pm
NYU, the hospital and doctors we’ve been using for my son who has Down syndrome, is no longer accepting United Healthcare Community Plan. Does anyone have a recommendation based on the following available insurances?

Empire BlueCross BlueShield HealthPlus

HealthFirst

Fidelis

EmblemHealth

MetroPlus

Thank you in advance!
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Sunny Days




 
 
    
 

Post Sun, Jul 14 2019, 12:21 am
Since when? Totally didn’t hear about this!
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pesek zman




 
 
    
 

Post Sun, Jul 14 2019, 6:42 am
Columbia widely accepts fidelis and healthfirst and both are known to be good (at least from the provider side)
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amother
OP


 

Post Sun, Jul 14 2019, 8:53 am
gamzehyaavor wrote:
Since when? Totally didn’t hear about this!


Could it be only the children’s hospital? We got a letter about it
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nanny24/7




 
 
    
 

Post Sun, Jul 14 2019, 8:53 am
AFAIK Columbia also takes Empire BCBS unless they changed anything since I was there a few months ago.
Your best bet is to speak to NYU and ask them which plans they recommend based on the doctors you use.
FYI if you call to switch before the 15th of the month the switch can be effective by the following month but if you switch after the 15th it would only be effective the month following the next month.
So for example if you call up to switch July 17 the change will be effective September 1st.
Also do you use any specialists?
Basically ask all the doctors you need what they take.
Hatzlacha!!
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nanny24/7




 
 
    
 

Post Sun, Jul 14 2019, 8:57 am
gamzehyaavor wrote:
Since when? Totally didn’t hear about this!

AFAIK all NYU and their affiliates are stopping to take United Healthcare Community Plan as of September 1st.
They said they would send letters but as I said in my post above if the letters come after August 15, or close enough that people only end up calling to switch after August 15 then that would be too late to switch in time for September.
That's why I kept calling NYU monthly to ask about this since I figured they would stop taking it soon.
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Sunny Days




 
 
    
 

Post Sun, Jul 14 2019, 10:15 am
nanny24/7 wrote:
AFAIK all NYU and their affiliates are stopping to take United Healthcare Community Plan as of September 1st.
They said they would send letters but as I said in my post above if the letters come after August 15, or close enough that people only end up calling to switch after August 15 then that would be too late to switch in time for September.
That's why I kept calling NYU monthly to ask about this since I figured they would stop taking it soon.

My child sees about 10 providers affiliated or in NYU. Did not get a single call or letter about this.
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Sunny Days




 
 
    
 

Post Sun, Jul 14 2019, 10:21 am
nanny24/7 wrote:
AFAIK Columbia also takes Empire BCBS unless they changed anything since I was there a few months ago.
Your best bet is to speak to NYU and ask them which plans they recommend based on the doctors you use.
FYI if you call to switch before the 15th of the month the switch can be effective by the following month but if you switch after the 15th it would only be effective the month following the next month.
So for example if you call up to switch July 17 the change will be effective September 1st.
Also do you use any specialists?
Basically ask all the doctors you need what they take.
Hatzlacha!!

The Fink outpatient and hassenfeld cancer clinic both accept healthfirst. We were actually looking into switching so I asked them about it. But we won’t be able to switch this month anymore. Hope we won’t run into issues...
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nanny24/7




 
 
    
 

Post Sun, Jul 14 2019, 12:39 pm
gamzehyaavor wrote:
My child sees about 10 providers affiliated or in NYU. Did not get a single call or letter about this.

Neither did I get any calls or a letter. But I use NYU for my kids as well as for myself (OB/GYN). I called last week to make an appointment for myself in August and the Secretary was kind enough to warn me about the change happening September 1st. Just a few weeks ago I specifically asked when I was at the doctor with the kids (also NYU) if they will stop taking it and they said don't worry for now we are still taking it. If any changes you will get a letter.
So last week I called the NYU office that I go to with the kids to check and they confirmed they will no longer take it as of September 1st. So this most be a very recent development.
I wouldn't worry about having any issues. If you switch now the change should be effective for September 1st which is when the change is happening.
I am switching all of us to Empire BCBS because that it what works for us after I checked with all our doctors but that doesn't mean that plan is necessarily the best. Everyone should do what works for them and their doctors.
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nanny24/7




 
 
    
 

Post Fri, Jul 19 2019, 12:10 pm
I just got this email from NYU My Chart which is the online portal.

UnitedHealthCare Community Plan
Dear Patient/Guarantor,

We are reaching out to you because our records indicate that you currently have UnitedHealthcare Community Plan insurance coverage - or that you are the guarantor of a child with that coverage -- and that you or your child have received or are scheduled to receive healthcare services with one of our physicians. Please note that effective September 1, 2019, all NYU Langone Health physicians and hospitals will be out of network with UnitedHealthcare Community Plan.

While you may receive a letter from UnitedHealthcare Community Plan stating that you/your child will need to change your current physician(s) and preferred hospital, this is not the case for most patients. By selecting one of the other plans with which NYU Langone Health participates, your/your child's current care will not be disrupted and you can continue to access NYU Langone Health physicians and hospitals.

NYU Langone Health is pleased to accept the following plans, which provide the same benefits as UnitedHealthcare Community Plan:

- Empire BlueCross BlueShield HealthPlus
- Healthfirst
- Fidelis Care
- EmblemHealth (HIP)

To change coverage for Medicaid and Child Health Plus beneficiaries, please contact New York Medicaid Choice:
1-800-505-5678
Monday - Friday: 8:30 am to 8 pm
Saturday: 10 am to 6 pm

To change coverage for Essential plans, please contact the New York State of Health Official Health Plan Marketplace:

By Phone:
1-855-355-5777
Monday - Friday 8 am to 8 pm
Saturday 9 am to 1 pm

Online:
nystateofhealth.ny.gov

Physician participation may vary by plan. For more information, please call our physician referral service at 646-929-7800 or visit nyulangone.org/doctors .

Thank you,
NYU Langone Health
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amother
Brunette


 

Post Fri, Jul 19 2019, 12:58 pm
I recently scheduled an appointment with one of the specialists at NYU and they stated that they do not accept Fidelis. Maybe it was just for that particular specialty?

ETA, I see above post states that it varies by specialty. OP, maybe confirm which plan all of the doctors you use accept...
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Sunny Days




 
 
    
 

Post Fri, Jul 19 2019, 1:04 pm
amother [ Brunette ] wrote:
I recently scheduled an appointment with one of the specialists at NYU and they stated that they do not accept Fidelis. Maybe it was just for that particular specialty?

ETA, I see above post states that it varies by specialty. OP, maybe confirm which plan all of the doctors you use accept...

Another thing to take into consideration is if you get any other services or supplies, make sure your current providers except the new insurance and that insurance will cover.
Based on my research now we will run into an issue with formula...

So psa to those switching to healthfirst and getting DME & medical supplies I heard that they require a pa* for everything and are not as generous with supplies as UHC.
*take into consideration that will take longer to get supplies
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