Should I switch to Health First?

amother

Sun, May 07 2023, 12:59 pm

I'm thinking of switching to Health First Medicaid. I'm in Brooklyn and need it for adults. If you have it, do you recommend it? If, not, why not? TIA!

kenz

Mon, May 08 2023, 12:44 pm

Switching from what? It makes a difference. Are you presently on a Medicaid-based plan?
I have Healthfirst and am reasonably satisfied with it. None of the NYS plans are accepted by everyone, and particularly not by “top” doctors. For routine care, checkups, urgent care visits, etc., it’s fine. No dentists take it though.

amother

Mon, May 08 2023, 12:54 pm

Thank you for responding! I'm switching from Empire. It seems like a lot of places don't accept it. Do you think Fidelis or another medicaid plan is better?

amother

Aubergine

Mon, May 08 2023, 2:52 pm

I have Fidelis in Brooklyn for my kids and found the ped, dentist and eye doc took it.

I've also seen specialist in NYC without a problem. (ENT, Urologist)

Your best bet is to call your existing providers and check if they take it.

amother

Mon, May 08 2023, 3:39 pm

I don't have existing providers, so I'm trying to get a feel for which plan is better and which plan has better doctors. If anyone can chime in or share your experience, I'd appreciate it.

amother

Mon, May 08 2023, 3:39 pm

amother Aubergine wrote:

Does Fidelis require referals?

amother

Cherry

Mon, May 08 2023, 4:48 pm

I would recommend fidelis over Healthfirst
I work at a drs office and I have health first and my dh has fidelis
You can get dental and eye with fidelis
Fidelis does require referrals but it’s not done online so a paper script is good enough

amother

Mon, May 08 2023, 5:09 pm

amother Cherry wrote:

Thank you. This is helpful. To clarify, do you need a referral for a dentist and an eye doctor? I need to find a dentist and an opthalmologist, so if you have one whom you recommend, I'd appreciate it.
Also, do you know if Fidelis approves things easily?
Thank you for your help.

amother

Cherry

Mon, May 08 2023, 5:14 pm

amother OP wrote:

To the dentist no, to the eye doctor it depends on what type of dr and what the visit is for
I like dr Raphael Rosenbaum for eyes
And I can’t remember the name of the dentist but I’ll come back here when I do lol

And in regards to approving things…
No insurance is easy
Sometime they’ll submit on the spot, and sometimes make you wait like a week or 2
I haven’t found them to be more difficult than anyone else tho

amother

Aubergine

Mon, May 08 2023, 5:40 pm

amother OP wrote:

Does Fidelis require referals?

Nope. Not for any of the visits we did, mentioned in my earlier post.

kenz

Tue, May 09 2023, 6:11 pm

I agree that you should check providers before deciding. Even if you don’t have anyone specific yet, you can look at who’s available. We have Empire for the kids and Healthfirst for adults and bH are satisfied (so far).

amother

Milk

Tue, May 09 2023, 6:27 pm

I beg to differ. My husband has Fidelis and we have a very hard time getting approval for everything. He has medical conditions so he uses one of the top Manhattan hospitals. His dr there says he never has such difficulty getting meds and procedures approved besides Fidelis.

Healthfirst doesn't require referrals whereas Fidelis does.

One reason drs and pharmacies like Fidelis is because they reimburse the drs more than other hmos. However, for the patients, it's sometimes hard to get services approved.

Good luck