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Old 01-07-2016, 09:33 PM   #21
Thinks s/he gets paid by the post
John Galt III's Avatar
Join Date: Oct 2008
Posts: 1,033
Originally Posted by jim584672 View Post
According to the member handbook about bills...

"If You Get a Bill

UnitedHealthcare provides a full range of health care services at no cost to you. You never have to pay your PCP or any other UnitedHealthcare participating provider anything. You should not be charged for any approved services offered through UnitedHealthcare when you get them from a UnitedHealthcare Community Plan provider. If you are asked to pay for services by a UnitedHealthcare Community Plan provider, remind the office that you are covered by UnitedHealthcare and present your UnitedHealthcare Community Plan member ID card. You can also call Member Services at 1-800-493-4647 for help.

You may be asked to pay for services that are not covered by Medicaid or UnitedHealthcare. You cannot be charged for any such service unless you understood and agreed before the care was given that you would pay for it."

The max OOP is $200 a year.
Thanks! I am impressed with how clear, concise and reassuring that passage was. So different from the usual ambiguities and undecipherable jargon I find from most insurance companies.

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Update from original poster
Old 01-10-2016, 05:40 PM   #22
Confused about dryer sheets
Join Date: Apr 2015
Posts: 8
Update from original poster

Since I was the one who started this thread 9 months ago, I figured I would give an update! In August, 2015, I pulled the trigger and FIREíd at age 39. On 9/1/15, I applied for Ohio Medicaid online, given that I will not have income over the 138% poverty limit. By 10/15/15, I hadnít head from them, so I called, and found out that for some reason my application was not looked at yet! I found out later that applications are supposed be reviewed within 15 days. My conjecture is that none of the case workers wanted to pull that application because it was such a weird circumstance. After I made that phone call (and had to leave a message for someone else), I was phoned by a case manager and was approved within 3 days. I did have to provide information that I was no longer employed, as well as verification of my dividend and interest income. They did call my former employer to confirm as well, even though I had a letter stating I no longer worked there. The case manager was definitely perplexed to the situation and asked me ďWhat are you going to live off?Ē when I told her I was no longer working, and I answered honestly that Iíd live off savings along with dividend income.

The approval date for Medicaid was back dated to 9/1/15 and within a few weeks I received information about 7 managed care plans in Ohio I could choose from. I compared all of them and did find that some were better than others, specifically in the provider listing as well as the vision and dental care benefits. Some did not offer any vision and dental, and others offered full coverage at no cost. I chose United Health Care, which seems to be a high ranking health plan in many nationwide surveys. They had all of the local hospitals on their plan, and a large number of local doctors.

They assigned a primary care doctor (since I never had one since Iím healthy), but when I called to set up an appointment, I found out the doctor they assigned only accepts elderly patients. I called about 4 other doctors listed in the provider document until I found one that was accepting new patients. So for those who are choosy about their doctors, this may be an issue. I didnít have a preference since I donít know any particular doctors. My visit to the doctor was good. I didnít feel I have received any different care by being on this plan. He referred me to a podiatrist, who I did visit, and again, I received very good care from this doctor as well. To Bamamanís comment about the doctors often speaking English as a second language, this was not the case in my situation. My primary doctor also ordered blood work and another diagnostic test, and I had no issue finding a provider for these, and no different treatment by the providers, as well as no referrals necessary. I also had no copays for any of this. I have a dental appointment scheduled for next month with the same dental office I had used previously, as they were also a provider on United.

Another perk of United is that they have a rewards program, where you can earn gift cards or other free stuff by doing the things they want you to do (like visiting a primary care doctor, getting lab work, flu shots, dental checkups, and vision checkups). Itís a very generous benefit, and is the reason I even set up the primary care doctor appointment to begin with.

So far, so good, 4 months into it. No complaints being on Medicaid at all, other than the initial delay in processing the application.

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Old 01-16-2016, 12:08 PM   #23
Full time employment: Posting here.
Join Date: Feb 2014
Posts: 892
For some reason since Jan 1st UHC thinks I have an additional policy and they are refusing to cover prescriptions. Don't know where they got that idea from. So back and forth, phone calls, pharmacies, new scripts from the doc, and they issue a ticket for investigation. Picked one up today, hopefully they straightened things out for good.

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medicaid, ohio

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