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Forum -> Inquiries & Offers -> Lakewood, Toms River & Jackson related Inquiries
If your family has Medicaid which hmo and why?
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amother
OP


 

Post Thu, Sep 29 2022, 9:00 am
We have United healthcare because they approved a few of my kids for braces a few years ago and I didn’t want to lose that coverage. My next 2 kids were recently declined for braces and my older kids are not wearing them anymore so there is no reason to stay on United healthcare. I would much rather have an hmo that CHOP accepts- also dr shanik even though I’ve been taking my kids to chemed the last few years…
So please tell me which hmo you have and why you chose it.
Thanks
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amother
Carnation


 

Post Thu, Sep 29 2022, 9:02 am
I switched every few years depending on which was best for the doctors we were using at the time
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rkay




 
 
    
 

Post Thu, Sep 29 2022, 9:49 am
I don't believe CHOP accepts any HMO anymore. Jerseycare only covers doctors and hospitals within NJ.
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amother
OP


 

Post Thu, Sep 29 2022, 9:50 am
Anyone know which hmo is more likely to cover braces?
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amother
Brickred


 

Post Thu, Sep 29 2022, 10:24 am
rkay wrote:
I don't believe CHOP accepts any HMO anymore. Jerseycare only covers doctors and hospitals within NJ.


Jersey care covers all Drs in Delaware too.
(Possibly bec. There is an office in nj so they can bill through that office..)
They have a great children's hospital there..
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amother
Ballota


 

Post Thu, Sep 29 2022, 10:27 am
following
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amother
Leaf


 

Post Thu, Sep 29 2022, 4:56 pm
Wellcare. Their continuity of care policy allows Chop for specialties seen through the ER. So if my DC started seeing a pulmonologist when admitted through the ER, they will continue to cover CHOPs pulmonologists for this child. Same if they started seeing the doctor while on private insurance.
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amother
Tomato


 

Post Thu, Sep 29 2022, 5:14 pm
I’m actually on amerigroup bec of Dr Shanik and we couldn’t transfer to CHOP a when my child was very sick in Monmouth Hopspital but we were able to transfer to Columbia Presbyterian in Manhattan and Amerigroup covered the hospital stay and all his treatments. I know that Chai Lifeline doesn’t like it bec it doesn’t work for Chop but I don’t know which is better.
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amother
Jetblack


 

Post Thu, Sep 29 2022, 5:28 pm
I have Amerigroup. It helps with braces afaik.
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amother
OP


 

Post Thu, Sep 29 2022, 6:03 pm
Thank you to everyone who responded.
Does anyone have any info on horizon?
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amother
OP


 

Post Thu, Sep 29 2022, 6:04 pm
amother Tomato wrote:
I’m actually on amerigroup bec of Dr Shanik and we couldn’t transfer to CHOP a when my child was very sick in Monmouth Hopspital but we were able to transfer to Columbia Presbyterian in Manhattan and Amerigroup covered the hospital stay and all his treatments. I know that Chai Lifeline doesn’t like it bec it doesn’t work for Chop but I don’t know which is better.


Dr shaniks office is recommending amerigroup?
Which hmo does chop want people to go with?
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amother
OP


 

Post Thu, Sep 29 2022, 6:07 pm
amother Leaf wrote:
Wellcare. Their continuity of care policy allows Chop for specialties seen through the ER. So if my DC started seeing a pulmonologist when admitted through the ER, they will continue to cover CHOPs pulmonologists for this child. Same if they started seeing the doctor while on private insurance.


I’m wondering if there is a continuity of care policy like that with other hmo’s? I’m sure there would be a hefty bill if a child gets admitted to chop under WellCare even if they cover the pulmonologist.
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amother
Leaf


 

Post Thu, Sep 29 2022, 6:26 pm
amother OP wrote:
I’m wondering if there is a continuity of care policy like that with other hmo’s? I’m sure there would be a hefty bill if a child gets admitted to chop under WellCare even if they cover the pulmonologist.


Wellcare has the best continuity of care policy of any hmo. If the child is admitted through the ER they will cover the stay in full.
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amother
Scarlet


 

Post Thu, Sep 29 2022, 7:29 pm
amother OP wrote:
Dr shaniks office is recommending amerigroup?
Which hmo does chop want people to go with?


CHOP doesn't "want" you to go with any, they aren't officially covered by any Jersey Care HMOs anymore. That being said, I have heard that United Healthcare sometimes pre-approves depending on the case. Any HMO is supposed to cover an ER visit anywhere in the USA, so any of the HMOs should cover an ER visit in CHOP. Wellcare seems to be decent with allowing you to follow up with the CHOP doctors who you saw on an ER stay. But none of them officially cover CHOP doctors on a regular basis.

My kids are on Amerigroup. They did approve my daughter for braces but her case was pretty bad. No idea if a less severe case would have gotten approved. When I need a specialist, Dr Shanik has sent me to Nemours Children's Hospital in Delaware.
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amother
Honeydew


 

Post Thu, Sep 29 2022, 8:00 pm
United healthcare because as far as I know they are the only plan with dental options other than Chemed.
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amother
OP


 

Post Thu, Sep 29 2022, 8:23 pm
amother Honeydew wrote:
United healthcare because as far as I know they are the only plan with dental options other than Chemed.


Really?? That’s very important!
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amother
Ballota


 

Post Fri, Sep 30 2022, 12:29 am
amother OP wrote:
Really?? That’s very important!
: my kids' dentists accept wellcare ( as well.as othet hmo's)
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amother
Scarlet


 

Post Fri, Sep 30 2022, 12:31 am
amother OP wrote:
Really?? That’s very important!


Dentistry for Children takes Amerigroup
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amother
Canary


 

Post Fri, Sep 30 2022, 12:35 am
Uhc is bh covering my kids braces although I was warned they don't easily approve.
They also covered continued care at chop specialist.
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amother
Caramel


 

Post Fri, Sep 30 2022, 12:37 am
Many many dentists accept other hmos aside for uhc.
Also poster mentioned about amerigroup covering in Columbia. I had similar with one of my children. We were preapproved for a surgery in my sinai because the dr had an office in nj where we initially went for consult. I recently heard that they no longer do that but I can’t be sure
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