Care Select to Traditional Medicaid?

good. luck. I just got off the phone with careselect.. trying to decipher some issues myself. I was having a hard time with one.. I have no clue what the other is..the website isnt great. but I do recall seeing 2 different plans under care select... .

I tried calling and talking to them but that just confused me more.. What i got out of them is that Care Select & Traditional Medicaid pay the exact same.. The only difference is with Care Select you must pick a primary care physician and with Traditional you can go to anyone who accepts medicaid. That makes absolutely no sense to me... Then why do we have two seperate things?? ugh.. Apparently CareSelect is only going to be for foster kids & adopted kids with real medical issues. AD#1 is healthy so she gets switched to traditional.. AD#2's file says Severe Emotional Disturbance so she can either stay on CareSelect or move to Traditional.. I'm even more confused than when I started.. lol.

I used to work in Medicaid and Naca is right - high risk kids will stayin CS (care select, sorry!) and others will not. Care select has the same benefits (everything covered under one should be in traditional - traditional often has less restrictions a lot of times actually) but doesn't have case and disease managers. If you are healthy you don't need a CM or DM so those kids will get moved to traditional. You won't have MDwise or Advantage now - you will just deal directly with the state. You won't likely have to have PMP's anymore either as traditional doesn't (currently at least) have them.Hope that helps. I was there several years so i should be able to help give general advice on how things were (at least up until last month when I left).

So who should one contact about moving out of state and transferring? The last time I asked when it was MDWise/CS, they said I needed to talk to the case manager. I told them they were adopted, we don't have a case manager. She was clueless. Love all the changes! :D

from my understanding if your children were adopted they do have a case worker still but, within the medicaid office, not a foster child case worker. my daughter was adopted back in 2007 and she has a medicaid case worker. if you called your county office they would be able to tell you who her medicaid case worker is. good luck

Yeah I tried that...they said it wasn't anyone there, it would be someone from DCS side of things. As always the left hand doesn't know what the right hand is doing.

well....i called the number listed on the paper received in the mail. they have my older son listed as staying with care select, but after reading all of this and hearing what the rep had to say, i asked if i was still able to switch to traditional medicaid if i wanted to and she said yes, so i did. i explained i liked not having to get a referral every time i needed a doctor or being required to have a primary care physician. for me, the other services care select provided was not something i thought we needed. hope i did the right thing. but i guess i can switch back if need be? i dunno. this feels more flexible. as soon as i am able to do it with my other son i plan to.

Lakin - you do need to call the old DCS caseworker. Indiana medicaid can ONLY pay IHCP (indiana health care providers) so, if you move to, say, TX, there wouldn't be anyone there that takes Indiana Medicaid (it is not a federal program). So - you need to track down the case worker at DCS or the overall manager for your county DCS office and have them help you work out an interstate compact type of situation where the new state will honor the medicaid (if you rec'd Title IV it is federally backed so you will get it - it may just take time like everything in DCS land). Does that make sense/help at all??

Thanks for the info Nicole!! So if it were you, would you transfer over to traditional vs staying with CS for those of us that have that option? Personally we have never once talked to any of the CM or DM to date so it's not like they are a help to us anyway. I have one kid that has to switch (not given the option) and 3 that have the option to stay at CS or switch over.

If you're not going to use the CM/DM i would, personally, switch. It would save the State a lot of money too :) The pro to you is no PMP/referral issues. Coverage/benefits are the State plan (what feds require) just like CS and you don't have to mess with an MCO (mdwise/advantage) for billing issues. Con is you don't have an MCO for billing issues ha. It is harder to get someone to help you if you have an issue but, in general, those who have major issues are pretty minimal. And, if you are one that often has issues, I would stay with CS (or if your child has a lot of disease issues that could use care coordination/case mgt, etc i.e. hemophilia, aids, etc) DIsclaimer that I no longer work in Medicaid and the above thoughts are all my personal thoughts and do not represent the State nor any Medicaid vendor opinions. Don't hold me liable for any information given. Ok, just had to cover my butt! :)