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My mother has been on Medicare since was eligible (she's 73 now) and has in the past 9 months been on Medicaid. I'd like to think that it wouldn't matter, but I can remember my mother stating something to that effect when she worked as the dietary manager in the nursing home.

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I think what standards of care you get are interdependent on so many different issues. Some of the best levels of care are in teaching hospital settings and those always take Medicare & Medicaid. But teaching hospitals are almost always in large urban areas so if you live in a more remote rural area you are not going to easily get the same standard of care.
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Thank you so much!
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While it's true that the payment to doctors and nursing homes under Medicaid is less than if they billed privately, it should not affect the level of care. I have never heard anything to the contrary. As for Medicaid vs Medicare, it should be about the same.
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My Dad who is 90 1/2 has been in a nursing home for going on 3 years and is on Medicaid and Medicare and he is been well taken care of. I am lucky the NH is close by and go often so they know me I think that makes a difference and I thank everyone for taking care of him as I know it is not an easy job. Wishing you all the best.
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I'm not sure a private Dr. would even know that a patient was on Medicaid. For example, I'd be willing to bet that my PCP has no idea what insurance I have.
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I am on Medicare and Medicaid, and the quality of my care (I'm 60) has declined drastically since going on it. I am forced to go to a Medicaid clinic even though its my secondary insurance. I am diabetic and get 10 minutes with the doctor every three months. I now go without treatment and diagnoses all the time because there is no time to talk to him about everything that's wrong with me and thus tests do not often get done at all and no treatment. Everyone here in my area knows the truth of this, and they say they wish they could get rid of their Medicaid so that they could get an attentive doctor. So, "expert," you are wrong, I'm sorry to say!
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P.S. I'm talking about outpatient care only. And I live in a rural county.
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Here in NYC, there's plenty of ghetto-style, assembly-line care for people on Medicaid. I've seen it, and been through it. The problem is that many people don't realize that white card is their American Express to medical services anywhere in NYS, and initially accept and then get used to seeing the doctor at 3 instead of 9:30. That was never an option for me, so I was labeled the "Monster Patient" b/c I insisted on being treated with respect and being provided with quality services.
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That is an easy one-the answer is yes. This is coming from an R.N. in the field 40+ years. Wish I did not have that as an answer. Can just speak from my experience.
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As a nurse, I can tell you doctors typically do not know nor want to know the insurance side of a patient. So rest assured a doctor would be breaking the Hippocratic oath if he/she treated your mother differently. Best wishes!
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Try going to a Medicaid outpatient clinic. They treat you all like second or third class citizens.
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All the more reason to work and support efforts to better the health care system in this country, especially for the elderly. I have experienced similar things in regard to my 93 yr old father who lost his doctor of 30 years because that doctor went to Concierge care. My dad is on fixed income and couldn't afford to stay with his favorite family doctor.
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I was a practicing family physician for 16+ years (ended after a traumatic brain injury.) Unless the patient brought it up, I never knew what kind of insurance they had and it made no difference in the care I provided. I was lucky and worked with specialists that also took Medicaid patients so was able to refer all of my patients based on their needs, not their insurance.
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I agree. Around here Medicaid patients even get a lower quality mattress in nursing homes!
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My dad had no changes in care with or without Medicaid in Pittsburgh area. In Arkansas, Little Rock docs are fine with Medicaid, private practice in some towns especially Southwest will not accept it and tend to treat people badly if they have to see them for some reason. YMMV. I sure don't treat Medicaid folks differently, nor do most folks in pediatric practice. Medicaid is stricter about covered prescriptions and tends to pay for only the cheapest in any category, it is a lot of bother to have to fill out forms and write letters and make calls to get something when that is not adequate...repeat q 6 months too. Other than that Medicaid coverage is good coverage for the most part.
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Yes there is a difference. I was told straight out by my doctor. They don't send them as often to specialist and they have to work within set limits set up by Medicaid. The Blue Button lower right for home health care cater to Medicaid and apologize because your parent has Medicare supplement. Nursing homes want Medicaid residents because the government is paying.Think of it this way, Medicare supplement is chosen by retirees and can be HMO extra or PPO. Medicaid is HMO limited.
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After he developed dementia, my husband had a first-rate geriatrician as primary care physician and a world-famous expert on his form of dementia treating that. I doubt that either of them knew when my husband enrolled in Medicaid. It certainly made no difference in his care. (We are in a large urban area, in Minnesota.)

I think my husband got sub-standard care each time he was hospitalized, both before and after being on Medicaid, and that is because our hospitals -- even great ones -- do a piss-poor job of taking care of those with dementia. It is lamentable, but a completely separate issue from who is doing the paying.

My mother is on Medicaid and is now in a nursing home, and on hospice (paid for by Medicare). I doubt very much if her aides and nurses know how her bills are being paid. I'm impressed with the care she is getting.

My daughter works in an Assisted Living Facility as a PTA. I asked her once how many of their residents are on Medicaid. She said she assumed that most of them who have been there a long time have run out of money and are on Medicaid, but that she doesn't know that for sure or which they are. Obviously she is not giving anybody any worse treatment.

I'm sure it is possible that some places that accept Medicaid are not great places. I suppose that some places that have both private-pay and Medicaid patients do discriminate in the levels of care they provide. I don't doubt the experiences of other posters. But I'm happy to say that I have never seen any of that with my husband or with my mother.
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Look at the front of your chart that the doctor sees. It is coded to the insurance company. Doctors don't work for free and they know what can be charged. After all their doctors office is a business.
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My husband is a private (solo) practice pediatrician. Although he does not treat Medicaid patients any differently than those with other insurance or private pay, he does have to limit the number of Medicaid patients in his practice because of the extremely low reimbursement rates. Maybe reimbursement is better in some states than in others, but in our state, the reimbursement is often about 30% for outpatient care, which does not even cover the overhead costs of running the office. Without the higher reimbursement from the non-Medicaid patients, he would not be able to stay in business. Also, as vstefans and daughterdeb said, there are often treatment restrictions that cause extra work for him and his staff. Sometimes, services that had been covered in the past are suddenly not covered. For these reasons, the doctor and his staff need to know what insurance a patient has so that they can make appropriate treatment decisions. I can't speak for skilled care facilities, but it is possible that they must also deal with treatment restrictions, and likewise would not be able to operate without the higher payments from private pay residents.
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Ferris, you know nothing about the assemblyline outpatient Medicaid system, then. But I guess you are talking inpatient. It is important to make that distinction. No one in the hospital probably has the time to see what insurance a person has. But on an outpatient basis, its a whole other game!
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I had the same feeling when my mom, with dementia was hospitalized in March.
They did not give her the anti-anxiety meds she needs twice a day. She hallucinated for two days. Had some gosh awful stories I know weren't true.
They asked NUMEROUS times what meds she was on, but the stress was just too much I think. She was saying "I'm going to start breaking things if they don't let me go home." Fortunately, they had said she could go that day. That was my biggest complaint, the lack of meds.
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I really appreciate everyone's response. Thank you! This is my first time posting a question-although, I've come to this sight to read issues that others are having being a caregiver. For me, it's been a Godsend to know that I'm not losing my mind with some of the thoughts I've had and/or the incredible guilt, anger, and resentment sometimes (I work 2 jobs and care for my mother by mostly by myself-my brother will on occasion, come for an hour or two). So.....to everyone who was kind enough to give me some insight on my question with Medicaid and to those whose stories I've read and found comfort in....Thank You for your generous spirit and helpfulness!
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Well thank you LuvCosmos for enlightening me! I realize my statements were made in an ideal world, and we live in anything but...
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I do want to state, shopping for a new doctor if you feel the care is inadequate.
My doctor is set up where he has a "referral girl" who he instructs to get a specialist for me when needed. She looks at my chart and does it all, making the appt to getting approval to preregistering. My mothers doctor says you have this insurance and I can send you to so and so. Well the so and so did nothing about mother's heart which was 80% blocked, said there was nothing he could do. Yet when she had her heart attack 3 weeks ago, I was able to get my heart surgeon who immediately put in a stent. Yep changing her doctors.
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In 8 yrs of having my mom and then my dad in a nursing home I never saw any difference at all. Perhaps the only difference I did see was when a relative of a worker was a resident. I think they did get preferential treatment
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I can tell you from both my experience and my aunt's - who is in a nursing home. She has macular degeneration. My other aunt, who had great insurance, was given very expensive treatment for the disease that may or may not have helped ( though she thought it kept the disease from progressing) and my aunt on Medicaid did not get ANY treatment. I also know that her medicines have not been reviewed in years.

My opinion on the care that I get - it depends on the doctor. One specialist that I go to doesn't care what type of program I am in and gives me good care, but another specialist says that he cannot give me medicines that may work because Medicaid will not pay. Have heard horror stories about hospital care for elderly with Medicaid also. Really think it depends on the doctor - someone who is against government programs would not be a good doc to have!

The worst experience that I had was a clinic for people without health insurance. The doctors did not know as much about the illness as I did, and they acted like they were experimenting on you. And they acted like you should never ask questions.
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I'm curious Luvcosmos, are Medicaid clinics privately owned and operated, or are they government owned and operated. I've never had occasion to use one, so I don't know. I thought that Medicaid patients went to private practice docs like the rest of us.
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All I know is my grandmother was on Medicaid, and her nursing home room was smaller than my college dorm room, and one dinky window which looked out into a brick wall. Every time I visited she asked me if I were there to take her back home.......
BUT, another grandparent was self-pay, with Alzheimers. They had a gorgeous nursing home "suite". However, towards the end, when they required an immense amount of care (this was before they had "memory care", it was all just nursing home, 1980's), the administration switched them to a double room, very tiny, and STILL CHARGED them the full rate!!!! we were incensed at this, but they said the level of care required could only be accomplished in the double room. We are still mad at that.
In retrospect, For all the money the one grandparent saved the government, by not being on welfare (and they earned every penny they had) they should have had both my grandparents in really nice rooms.
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I think the biggest lesson to be taken from all this is that everyone EVERYONE needs a close-watching advocate.......
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Thanks again for more insightful answers to my question regarding Medicaid. I'm questioning whether or not I should have listened to the hospital personnel and put my mom on Medicaid. Maybe I should have just kept whittling away (there's no way we can afford any insurance supplement)...although, that would mean she wouldn't get things like her oxygen since they are not like the hospitals and accept payments. Wow-amazing. I can't imagine what some elderly do that don't have people to watch out for them.
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