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Old 07-20-2015, 05:12 PM
 
Location: Asheville, NC
215 posts, read 408,513 times
Reputation: 66

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Hi,
My children have Medicaid in North Carolina where we live. Last month we were in California and had to take 2 of the children to the Emergency Room. The hospital said they take Medicaid. I've now discovered North Carolina Medicaid doesn't cover out of state. So we've been hit with doctor and hospital bills. We've spoken to the doctor's billing office and they've reduced it by 50%. Still speaking with the hospital who have sent the highest bills and also incorrectly sent them via a collections agency, who said they shouldn't have be asked to deal with this yet because it's only been a few weeks and the hospital hadn't even billed us yet!
Any suggestions on how else we can deal with this?
What if we visit another state again and have to receive medical treatment, do we have to get some kind of travel insurance?
Many thanks
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Old 07-20-2015, 11:27 PM
 
7,555 posts, read 8,122,721 times
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First question, what did your state medicaid agency say when you asked about submitting an out-of-state claim?
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Old 07-21-2015, 06:52 AM
 
3,610 posts, read 2,196,399 times
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Second question, what were the ER visits for? If they were not true emergencies, you are probably out of luck getting any of it covered.
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Old 07-21-2015, 08:53 AM
 
Location: Asheville, NC
215 posts, read 408,513 times
Reputation: 66
Hi,
I called our state medicaid who said they don't cover ER visits if out of state, unless you are about to die from a car accident.
The visit was for a severe allergic reaction to poison oak, my son's face swelled up so bad his eyes closed up he was unrecognizable. My other son who is only 3 years old also had the same issue, but not quite so severe. We were trying to find an Urgent Care type place and were directed to this hospital because they said they take Medicaid. Stupidly I didn't have their Medicaid cards on me. But they did need to see a doctor for sure. They've classed it as a level 3 emergency on the doctors bill.
If we visit other states in the future, do we have to get some other kind of insurance for them each time!?
We are originally from the UK, this is our first experience of medical bills
Thanks!
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Old 07-21-2015, 11:57 AM
 
2,421 posts, read 3,263,180 times
Reputation: 3435
Welcome to the USA. If your insurance tells you they don't cover out of state emergency care unless it is something equivalent to a bad car crash, I would definitely purchase travel insurance if you are going to leave the state.

Insurance companies refusing claims is ever increasing now. There is no longer any piece of mind, should you or your children get sick, break an arm or anything the hospital deems not life threatening that you will be covered. Very unfortunate, but true. In some cases, almost half of a second paycheck is necessary just to pay medical expences here in the US.
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Old 07-21-2015, 05:35 PM
Status: "Autumn Delights..." (set 16 days ago)
 
873 posts, read 135,567 times
Reputation: 1670
You should at least file an appeal IN WRITING and SEND by CERTIFIED MAIL. Explain exactly what happened and how the young small children were swelling up. Allergic reactions can be life-threatening. You have the right to file an appeal of the decision.
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Old 07-21-2015, 06:53 PM
 
Location: Wisconsin
19,547 posts, read 37,254,648 times
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Quote:
Originally Posted by HollyhockGarden View Post
You should at least file an appeal IN WRITING and SEND by CERTIFIED MAIL. Explain exactly what happened and how the young small children were swelling up. Allergic reactions can be life-threatening. You have the right to file an appeal of the decision.
Indeed. Anaphylactic issues can be very dangerous. However, OP is in North Carolina, one of the most regressive states in the country - and getting worse - on social safety net issues.

OP, if you do appeal, let us know what happens. North Carolina, in particular, is a state I watch - ever since it deprived its citizens of federal unemployment benefits (a complete cutoff) - and reduced the amount and length of its state unemployment benefit 30%. If one isn't well-to-do, NC isn't the state for you - especially if you need help with the basics - like medical insurance and food.

Last edited by Ariadne22; 07-21-2015 at 07:01 PM..
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Old 07-22-2015, 09:09 AM
 
Location: Asheville, NC
215 posts, read 408,513 times
Reputation: 66
Very interesting, thank you. Re. sending in an appeal, I spoke to the Medicaid office in Buncombe County where we live in Asheville, NC. So, do I send the appeal in to them? They didn't even ask what the ER visit was for, just said they don't cover out of state ER visits, then the lady said 'well only if a really serious car crash, if you get what I mean...". I admit that sounded kind of strange.
And yes, my son's was having a really severe reaction and everything we read on the internet said take to ER! I can even send photos in with an appeal.

Thanks!
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Old 07-22-2015, 09:16 AM
 
Location: Asheville, NC
215 posts, read 408,513 times
Reputation: 66
Quote:
Originally Posted by Ariadne22 View Post
Indeed. Anaphylactic issues can be very dangerous. However, OP is in North Carolina, one of the most regressive states in the country - and getting worse - on social safety net issues.

OP, if you do appeal, let us know what happens. North Carolina, in particular, is a state I watch - ever since it deprived its citizens of federal unemployment benefits (a complete cutoff) - and reduced the amount and length of its state unemployment benefit 30%. If one isn't well-to-do, NC isn't the state for you - especially if you need help with the basics - like medical insurance and food.
Out of interest how does California compare to NC with regards to what you mention above?

We have Medicaid for the children and Blue Cross Blue Shield for husband and I (we are both self employed). At one point we were too poor to receive the reduced rate insurance because NC had chosen not to offer extended Medicaid, so we couldn't get that either. Actually earning a bit more means we now do have a better rate on our BCBS but I need to check if it covers out of state! It's a mind bender for sure!
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Old 07-22-2015, 01:40 PM
 
Location: Wisconsin
19,547 posts, read 37,254,648 times
Reputation: 12282
Quote:
Originally Posted by jukes View Post
Out of interest how does California compare to NC with regards to what you mention above?
CA is a dream state compared to NC and some other GOP ruled southern states like AL, GA, LA, FL - all of which are on the opposite end of the spectrum in political philosophy which is what determines the accessibility and benefits of their social programs.
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