Essential plan medicaid

amother

Thu, Jan 04 2024, 12:25 pm

Anyone know which medicaid plan to choose? What is the difference between the different options- fidelis/blue cross/health first etc?

amother

Mistyrose

Thu, Jan 04 2024, 12:32 pm

It depends where you are located.

I'm in BP where Fidelis and First Choice are popular.

I suggest you call your doc or pediatrician, eye doctor, dentist and any other specialist you use to make sure they accept the plan you chose.

ETA, meant to say Health First.

MommyM

Thu, Jan 04 2024, 12:36 pm

I would start with finding out which plan your doctors accept and choose one of those. They are Medicaid plans under regular insurance companies so they can have different in-network doctors.
Sometimes there are benefits with one plan over others, but I have never compared. Majority of the things they cover are the same though.

amother

Khaki

Thu, Jan 04 2024, 2:10 pm

for me it boiled down to between fidelis and health first. For many years I had health first and it was overall great. Easily covered , Dexa scans , X rays , MRI etc. and even certain difficult medications got approved.

Cons though. Hardly coverage for PT , and certain dental procedures not covered like root canal (may we never need one)... and since time was dire I had to pay out of pocket...

Fidelis gave a generous amount of PT sessions ,and covered Root canal procedures but every time there was a radiology procedure (like X ray , dexa , MRI ) they needed prior authorization and that the doctor call them to approve.

In terms of mental health I think there are a few more therapists who accept fidelis but not healthfirst (although I heard that for therapy blue shield is the best)

amother

Thu, Jan 04 2024, 2:51 pm

amother Khaki wrote:

wow, thank you for that. so clear!

amother

Charcoal

Fri, May 03 2024, 6:49 am

Bumping this. Which insurance should I choose? I would prefer no referrals for specialists but that the hospitals in Manhattan accept. Also one that has decent dental coverage. Does City MD accept all?

amother

Crimson

Fri, May 03 2024, 7:42 am

I had empire til recently. Then I lost essential care so switched to fidelis cuz it was the cheapest plan. Then they changed the essential rules and I am back on so they automatically enrolled me in fidelis.... So.... Yeah I donno.... Haven't really used it much to know, but I believe my regular Dr takes both, as does my husband's psychiatrist. You gotta call your most important doctors to ask...

amother

Charcoal

Fri, May 03 2024, 11:01 am

amother Crimson wrote:

And they require prior authorization for special right?