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Jillian Crawford
Jillian Crawford asked in Business & FinanceInsurance · 9 years ago

Medicaid and needing treatment?

Does anyone happen to know anything about Medicaid? I really need to go in for an ultrasound to see why I have to much pain on the left ovary/incision asap, but I don't know if I make an appt to pay it out of pocket if they'll try sticking the medicaid bill on me too when medicaid should have covered it. They want me to pay for the surgery because medicaid didn't want to, but I need an ultrasound to see if any cysts or infections have grown. Would I be able to pay for the ultrasound out of pocket and end up getting stuck with the bill, or should I stlil be okay?

Someone please help me out here. I am in so much pain and I need to get this treated right away but I cannot afford to get 3k's worth of bills over my head if it was medicaid's bill in the first place. My school doesn't know and medicaid specialists won't talk to me.

Update:

I already talked to planned parenthood. they said they can't help me with anything related to this. I don't know how or why they can't, but they are unable to help. I am just curious about the financial aspect of this so I know if I'd get trapped with the surgery bill thanks to medicaid's mistake or not if I go in for something else. The doctors said this doesn't count as post-op for some reason either.

Update 2:

I was told I had medicaid until 7/30/12. The surgery was on 7/18/12 and medicaid claims the cut-off day was 7/16/12 on my 21st birthday when other peolpe claim that it's actually 7/30/12, which is why they're sticking the surgery bill on me.

3 Answers

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  • Casey Y
    Lv 7
    9 years ago

    "medicaid claims the cut-off day was 7/16/12 on my 21st birthday when other peolpe claim that it's actually 7/30/12"

    Are you more likely to believe medicaid, or some random person who doesn't know what they are talking about?

    I would not assume that Medicaid will pay even $1 going forward.

  • Anonymous
    Lv 7
    9 years ago

    Medicaid is a needs-based welfare benefit program, run on a state by state basis. Each state's program can vary.

    WHO is saying you need an ultrasound? If a DOCTOR says it's medically necessary, they'll arrange for it. If YOU are saying you need one - that's not good enough. A DOCTOR determines medical necessity, not you.

    Medicaid will NOT reimburse you. They only pay the provider, and only if the provider is ALREADY a medicaid provider.

    You go to your Medicaid primary care doctor's office, discuss it with them. They'll make the referrals, if they think it's necessary.

    Of course, if you no longer have Medicaid, they're not going to pay anything.

    As you've noticed, it's much harder for an adult to get welfare health benefits, than a child. I think you're going to need to see a doctor, treat, and then when you're feeling better, get two jobs and work 80 hours a week to pay the bills off. Bonus - at least one of them will probably have health insurance benefits for you.

  • Zarnev
    Lv 7
    9 years ago

    Welfare cuts off on your birthday, so if your 21st birthday was 7/16 that is the day your benefits stopped. Anything after that is your responsibility to pay.

    Source(s): Independent Ägent
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