Can someone help with Medicaid info? (plan, doctor, coverage, benefits)

[Dt1101g2]

I signed up for Obamacare end of last year.

Recently, I got a letter from NJFamilyCare saying:

"Now that you are on Medicaid you are required to enroll in an HMO..."

My question is, what does that mean?

Am I covered, and what is covered and what do I have to pay? Is there a monthly premium? I haven't seen anything that breaks down the costs of co-payments and premiums for any of the HMOs.

I have read some stuff that makes it sound like it will be more expensive that what I pay for health insurance now (bare bones EPO).

[CravingMountains]

What they are saying is that you have to now enroll in a medicaid managed care plan. Basically, you will be trading in your medicaid coverage for an insurance policy. The government will pay the HMO on a monthly basis to administer your care in a more efficient and costly manner. Here is a link to a medicaid managed care company that I used to work for. There are dozens and dozens of similar companies though so make sure you pick one that operates in your state or residence and has a good doctor network nearby.

https://www.wellcare.com/

Remember the key word in your search needs to be medicaid managed care. Good luck!

[Dt1101g2]

Originally Posted by CravingMountains

What they are saying is that you have to now enroll in a medicaid managed care plan. Basically, you will be trading in your medicaid coverage for an insurance policy. The government will pay the HMO on a monthly basis to administer your care in a more efficient and costly manner. Here is a link to a medicaid managed care company that I used to work for. There are dozens and dozens of similar companies though so make sure you pick one that operates in your state or residence and has a good doctor network nearby.

https://www.wellcare.com/

Remember the key word in your search needs to be medicaid managed care. Good luck!

Thank you so much for your response.

What will my monthly premium be, say with that HMO, what would it have been?

Does it vary by applicant? That is the part that is confusing me.

Or will the HMO give me that info when I choose a plan.

[CravingMountains]

With Wellcare it would have been free on your part. You will have to call various companies though to see if premiums are attached to any of the plans. If there is a premium involved I expect your provider network and benefits to increase.

Also be aware that medicaid managed care plans often omit benefits for certain conditions to provide more benefits for another health area. Lets say you have arthritis, but have a healthy heart. You will want to pick a plan that provides good benefits for arthritis and that omits coverage for heart problems.

[reed303]

It looks like you need to start at this St of NJ website to see what Medicaid plans are available in NJ.
Department of Human Services | NJ FamilyCare Health Plans

Not all plans are available in all NJ counties. Find which ones cover your county, then look them up on the provided links, or call them directly for answers to your questions.

Good Luck

[Weichert]

Thats interesting. Is Medicaid run like a Medicare Advantage plan equivalent?

[reed303]

Originally Posted by Weichert

Thats interesting. Is Medicaid run like a Medicare Advantage plan equivalent?

In New Jersey it is. See Department of Human Services | NJ Medicaid & Managed Care