DS is currently being evaluated... ADHD seems to be a sure thing because he's responding to the meds but there is something else going on... SPD or possibly something else. He will not be getting an official diagnosis till he turns 6 years old. The psychologist is throwing possibilities out there now and the psychiatrist is keeping his mouth shut until all testing is complete.
I have him on my insurance and Medicaid is secondary. DS's psychologist will bill both but DS's psychiatrist will only bill primary which is my insurance. DS's office visits have cleaned out my health fund which our family uses to cover office visits till we meet our deductible. DS's subsidy check is not enough to cover all the weekly doctor visits he has.
Can I file to Medicaid on my own for the doctor visits that are not filed? Or would it be best to drop him from my insurance and let Medicaid cover the whole thing? Will the state allow me to drop him from my insurance? The only reason I initially put him on my insurance is because it didn't cost me any extra and I have better dental coverage. I hate the Medicaid drug coverage... Yes it's not costing me anything but I get nervous being forced to wait until he's taken his last pill before he can get a refill. I started using my prescription coverage and pay the co-pay.
I need to come up with some strategies since this is going to be a long term medical issue with him.
Can you drop him from your insurance? I had a similar problem. P went to the ER. They billed my insurance. I got bills for the remainder. I sent the Medicaid info but they didn't submit that portion to Medicaid.
I wasn't sure if I could drop him since the state knows I have medical coverage. The state usually sends out a letter every year to verify medical coverage and I didn't get one this year... turns out they are doing the checks themselves instead of relying on the adoptive parents to do it. I would hate to drop him and Medicaid doesn't automatically become primary. Enrollment time is coming up and it would be the perfect time to drop him.
Call Medicaid to verify the following just in case.
I called Medicaid yesterday for my DD because I am dropping her on my Insurance at the end of this month. Medicaid said to call them in early October to let them know they are now the primary insurance.
Our son has medical spec needs and we were told that if he gets close to maxing out our family plan then we should remove him from our insurance and only use the medicaid. We were told that we did not have to keep him on our insurance if it caused financial burden. Our adoption assistance worker specifically said that it was up to us whether or not we keep him on our insurance.
Interesting. I wonder if Medicaid is like SS where you can get 10 different answers to the same problem...
Both of our son's have special needs (one has alot, the other minor). We have private and medicaid for insurance. Many of the providers will not take medicaid so I keep them on our insurance. Just check to see if medicaid covers their medications. One son is on two medications that medicaid does not cover. They are newer meds....and they cost a lot.
Good luck,
I know one of his meds is covered by Medicaid and not sure about the other. Both of his doctors and his primary care accept Medicaid. I'm nervous about dropping my insurance because a lot of doctors do not accept medicaid. He's good to go right now but if we need to see additional doctors at some point it may become a problem. When we were fostering it was crazy how many doctors stopped accepting medicaid. DFCS had to start giving foster parents lists of doctors who took it to keep us from going on a wild goose chase. My son's PCP no longer accepts new patients on Medicaid.
I'll dig up the phone number for Medicaid and see what they say. The last time I tried calling the number on his card it was no longer in service. Can you believe that? They should have sent out new cards if the phone numbers were no longer valid.