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Our State will implement the privatization of Medicaid effective 1/1/16. I have spoken to the NH administrator where my MIL resides but unfortunately little information has thus far been distributed to the nursing homes. Just yesterday (Friday) we received a packet and notice from Medicaid that MIL needs to select a Managed Care Organization. However, I have not been able to find out how the MCO will coordinate with Medicare, Med-gap and Medicare Part D plans. Nor did this information explain how this change will effect MIL's nursing home benefit.

Has anyone else been through a similar transition? I intend to place a call to my MIL's Medicaid caseworker first thing Monday morning but that might mean being on hold with customer service for quite some time.

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Sevensmom---You guessed right and it is going to be a bumpy ride. In spite of vociferous public outcry, our governor is going to shove this down our throats effective 1/1/16. Hang on!
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Privatization has made an ugly, confusing mess of health care for MediCaid recipients, in WA.
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Are you from Iowa, Tessitura? I'm doing this both for my mom, on the Elderly Waiver, and my son, on the ID waiver. I've been e-mailing everyone I can think of to get this process slowed down or stopped by the federal government. I looked on-line and none of my son's providers (doctors, hospital, case management, HCBS provider, etc.) have signed under any of the 4 choices. My mom lives in rural Iowa, but has a neurologist here in Des Moines. None of her health care providers are listed either and it took me about 45 minutes to figure out how to check which providers are signed up under which MCO.

I'm very concerned about how my mom and son will be affected, since the state of Iowa just tried to "dis-enroll" (nice word for kicking her out) my mom from the Elderly Waiver program. They tried to say her level of care needs did not meet the qualifications for the waiver, but she has been enrolled for 2 years and has Alzheimer's! Fortunately, after a month of stress, getting paperwork from her doctor and neurologist, and trying to contact state legislators and anyone I could think of, they decided 2 days before her hearing that she did indeed qualify for the Elderly Waiver. However, I have a friend whose daughter with Down Syndrome just lost funding for vocational training.

Just had to vent...as a person who works outside of the home full time and having both a son and a parent in this mess, I'm very stressed and frustrated by the whole process.
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I work for a managed long term care company. These plans should not effect primary care physicians or specialists already being seen by the member. What they can effect are dentists, podiatrist, hearing and vision docs but there are also exceptions to those. Each company will have a list of what vendors they participate with. The programs tend to be geared more towards providing services to those still living out in the community. I don't believe you should see much of a change in things with your MIL already being in a NH. Hope this helps a little.
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I had to make multiple phone calls but here are the answers I received: The new plan to privatize Medicaid will effect mostly those low income persons who qualify for 100 percent subsidy for health care. For the elderly the changes will be, for the most part, not all that obvious.

The tier of health care payments will continue to be: Medicare first, medi-gap (if enrolled) second, and the MCO program will be the "clean-up" payer for any unpaid deductible/co-pays, hospital bills or prescription deductibles/co-pays that Medicare part D does not pay. The Department of Health and Human Service will continue to qualify persons for and administer long-term care for the elderly.

The biggest challenge will be to make sure that your Dr. and area hospital is enrolled in and accepts payments from the selected MCO plan. If anyone else has comments or advice, I would welcome it.

Staying on top of this is a challenge for one elder but I am trying to do this for two elders who reside in two different states. Each state has different rules.
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