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Essential plan medicaid



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amother
OP


 

Post 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?
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amother
Mistyrose


 

Post 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.
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MommyM




 
 
    
 

Post 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.
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amother
Khaki


 

Post 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)
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amother
OP


 

Post Thu, Jan 04 2024, 2:51 pm
amother Khaki wrote:
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)


wow, thank you for that. so clear!
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