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My mom is now on medicaid, she is 86 now, and is also on Medicare and has supplement ins. too. Also, does she have to see certain doctors or can she stay with the ones she has had for many years?? Not sure how this works and the paperwork I got is confusing. Thank you

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I can't speak on how your mom's case will work out, but, I can say that in my state, patients with Medicare and Medicaid, file the charges first on the Medicare and what they don't pay, Medicaid does. And if they are a Medicaid accepting facility, then they are not supposed to charge the patient anything out of pocket. They have to accept the Medicaid rate and that involves no money from the patient. My cousin has never been charged any money for any medical care or treatment in that situation. You do have to confirm that the doctor, hospital, provider, etc. accepts Medicare and Medicaid. I've read that in some places it's difficult to find that, but, in NC, almost all the healthcare providers do accept it, like UNC, Duke, etc. Even most private providers accept it here in NC.

If the long time doctors do not accept Medicare or Medicaid, I suppose she would have to pay out of pocket. That's tough. I'd try to find new ones that will accept, as that is a huge savings to not use.


HOWEVER, medication is different. They will file on Medicare, then Medicaid, but, there always seems to be some money due from the patient per month. The Supplemental medication normally pays almost all of this though. And don't forget to apply for Extra Help with paying the Supplemental medication policy. That should cover that completely, if she qualifies.

If anyone knows how to get Medicaid to pay for the out-of-pocket Medication costs, I'd love to know how.
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Sunny - I think a good Plan F will cover those outside of coverage Rx's.

JD - I'd suggest you clearly find out what moms supplemental is and how it works or doesn't work for those with Medicaid. Usually a medicare supplemental (tied to her region or a health system, like Kaiser or Oschner) or a secondary insurance (like BCBS), will stop paying once they are on Medicaid as Medicaid becomes either their primary or secondary insurance. Then after you find that out, contact each of mom's MDs to see if they participate in Medicare & Medicaid.

If they do, then lucky mom.
If they don't, mom will have to find new docs or private pay whatever Medicare doesn't. My mom did this with the retina specialist she had seen for years. Usually physicians affixed with a big health science center will take the M&M's, but MDs in independent or smaller group practices won't as the reinbursement is too low.
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As an aside -- the level of complication is deranged! For seniors, no less. A good chunk of Medicare and Medicaid's target audience have trouble using a push-button phone and the remote control. But they're supposed to understand this borderline Ponzi scheme?! Aye yi yi.
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