Nc Medicaid Managed Care Mandatory
To learn more about NC Medicaid Managed Care, go to the NC Medicaid Managed Care Website. Most beneficiaries receiving Medicaid or NC Health Choice will be required to transition to NC Medicaid Managed Care. This means you must choose a health plan and a Primary Care Provider . If you must choose, NCDHHS – Division of Health Benefits will send you a letter that tells you how to transition to Managed Care. You will be required to transition to NC Medicaid Managed Care if you:
- Receive full benefits through the Family and Childrens or the Aged, Blind and Disabled Medicaid programs, or through the NC Health Choice or Medicaid for Pregnant Women program.
If you are transitioning to NC Medicaid Managed Care and want to keep the PCP you have now:
- Choose a health plan that your provider works with. If you have questions about the instructions in the letter you received ,
To find a doctor, go to Find a provider.
Find A Counselor Or Therapist:
The provider directory is updated daily. If you find an update missing, or an error, request a change at .
If you or your child needs mental health or substance abuse services or would like to change his/her therapist, call Health Plan of Nevadas behavioral health team at 1-800-873-2246. You can also call the mental health hotline at 702-364-1484 or toll-free at 1-800-873-2246.
What Is Family Medicine
A certification by the Board of Family Practice practitioners prevent, diagnose, and treat a wide variety of ailments in patients of all ages, placing special emphasis on the care of families on a continuing basis. They have received a broad range of training that includes surgery, psychiatry, internal medicine, obstetrics and gynecology, pediatrics, and geriatrics.
You May Like: Sports Medicine Doctors That Accept Medicaid
Traveling To Another State
If youre traveling to another state and fall ill, you may be out of luck Medicaid wont cover the cost of services in a state that isnt your home state. Generally, you can only use your Medicaid coverage out-of-state if you encounter a true life-threatening emergency that requires immediate care .
That said, sometimes, pre-approved treatment at an out-of-state facility is covered by Medicaid, but only when proper authorization is obtained. Similarly, Medicaid coverage may kick in if you receive treatment in an out-of-state facility that borders yours, and in which residents of your state routinely seek care. Again, you must make sure Medicaid will cover such care before pursuing it, or you risk getting stuck with the associated bills.
Maurie Backman has been writing professionally for well over a decade, and her coverage area runs the gamut from healthcare to personal finance to career advice. Much of her writing these days revolves around retirement and its various components and challenges, including healthcare, Medicare, Social Security, and money management.
Dont Miss: Braces Place That Take Medicaid
What Happens If I Cant Find A Primary Care Physician Near Me
In most cases, your Medicare Advantage plan will have several participating physicians within the plans service area. If you already have a doctor and he or she doesnt contract with your plan, you may need to switch to a doctor in your plans network.
If you cant find a primary care doctor near you, contact your plan for help. Also, keep in mind that plans may change their provider networks from time to time. A doctor who participated last year may choose not to participate this year.
Many Medicare Advantage HMO plans require a referral from your primary provider before they pay for tests or specialist care, even from providers within the plan network. If your plan requires a primary care referral and you dont get one, the plan may not pay, even if the specialist service would otherwise be covered.
To find a Medicare Advantage plan in your area, enter your zip code on this page.
Out-of-network/non-contracted providers are under no obligation to treat Preferred Provider Organization plan members, except in emergency situations. For a decision about whether the plan will cover out-of-network service, you or your provider are encouraged to ask for a pre-service organization determination before you receive the service. Please call the plans customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
New To Medicare?
Read Also: Does Medicaid Cover Incontinence Pads
All Primary Care Offices Are Currently Accepting Patients
THOMAS HEALTH PRIMARY CARE AT ASHTON1097 Fledderjohn Road | Charleston, WV 25314 | Appointments:Michelle Burdette, MD Richard Capito, MD John Lewis, DO Tina Ly, MD Donald Moore, MD Gregory McCartney, PA-C Mohammad Yousaf, PA-C
THOMAS HEALTH PRIMARY CARE ON CHESTNUT STREET506 Chestnut Street | South Charleston, WV 25309 | Appointments: | Office:Michael DeWitt, DO Christy Estep, DO Leo Gibson, DO Katrina Walker, FNP
THOMAS HEALTH PRIMARY CARE ON DIVISION STREET400 Division Street, Suite 6 | South Charleston, WV 25309 | Appointments: | Office:Paul Kuryla, MD Ashley Mellert, PA-C
THOMAS HEALTH PRIMARY CARE ON DONNALLY STREET500 Donnally Street, Suite 203 | Charleston, WV 25301 | Appointments: | Office:William Jeffrey, MD Lester Labus, MD Jennifer Ladd, DO Mark Richards, MD Angela Whitman, DO
THOMAS HEALTH PRIMARY CARE ON KENTUCKY STREET4820 Kentucky Street | South Charleston, WV 25309 | Appointments: | Office: Crystal Bastin, MD Rebecca Donohoe, FNP
THOMAS HEALTH PRIMARY CARE IN WINFIELD
No Insurance No Medicaid No Problem
At MainStreet Family Care, we strive to treat all of our patients like family. In order to meet this goal, we offer several payment options to accommodate all of our patients. If you dont have insurance, you can come in and self-pay. We can calculate a patient estimate for you, or you can pay a flat fee of $125.00 which covers all in-house labs, tests, COVID-19 rapid antigen testing, procedures, and x-rays. Patients are responsible for the full cost of any other outside services. The following is a list of specific services not included in self-pay:
- Vaccines & Immunizations
Recommended Reading: Ohio Medicaid Managed Care Providers
For Traditional Medicaid Members:
If you are new to Indiana Medicaid, use our provider search to determine whether your current provider participates in the Medicaid program. If your provider is listed, you should contact him or her ahead of time to see if he or she is accepting new patients. If you don’t have a provider, you can search by zip code to find a provider near you.
Some doctors no longer participate in the Medicaid program. If you cannot find your doctor, you can check the list of terminated Medicaid providers.
Benefits Of Having Your Own Family Doctor:
Medical History Family doctors get to know you and your medical history and your familys health history. Having a relationship with your primary health care provider gives them an advantage of monitoring changes in your health throughout the years, knowing what medications work most effectively for you, as well as your home life.
Additionally, they can easily recognize new and unusual symptoms, as well as significant changes that could indicate significant or obscure conditions.
Managed Health Care Family doctors not only provide yearly check-ups, but they can also manage your common complaints. From the flu, sinus infection, bladder infection, immunizations, life concerns, chronic conditions such as heart disease, arthritis, blood pressure, diabetes, thyroid issues, to minor surgical procedures. There are so many issues your family doctor can treat.
Referrals Family doctors are typically the first step in receiving a referral. Whatever the reason your family doctor will know the best-qualified specialist to recommend based on your medical history.
Our primary services include:
Recommended Reading: Pregnancy Medicaid Texas Phone Number
How Can I Book An Appointment Online With A Medicaid Family Physician
Zocdoc is a free online service that helps patients find Medicaid Family Physicians and book appointments instantly. You can search for Medicaid Family Physicians by symptom or visit reason. Then, choose your location. Based on that information, youll see a list of providers who meet your search criteria, along with their available appointment slots.
Va Approved Urgent Care Facility
MainStreet Family Care is one of Alabamas first VA authorized civilian urgent care clinics. As a result, eligible Veterans can now receive same-day treatment for minor illnesses and injuries with NO CO-PAY! Find out more information here. We are an authorized civilian urgent care facility and we look forward to serving you.
Don’t Miss: How Do I Know If My Medicaid Is Still Active
For Healthy Indiana Plan Hoosier Healthwise Or Hoosier Care Connect Members:
Please remember that if you are enrolled in the Healthy Indiana Plan , Hoosier Healthwise, or Hoosier Care Connect, you will need to choose a Primary Medical Provider within your health plan.
If you are looking for a specialist and are in a managed health plan, you may need a referral from your PMP before Medicaid will pay for certain services. Please check with your PMP or your health plan before seeking additional services.
If you have questions, you should contact your health plan directly. You can find the phone numbers for each health plan on the Contact Us page.
Use the links on the right hand side of the screen to locate providers based upon your health plan.
Centers For Medicare And Medicaid Services Physician Compare
Medicaid is a structural federal and state partnership, subject to federal standards. States administer the Medicaid programs and have flexibility in determining covered services, health care delivery models, and methods for paying physicians and hospitals. Visiting your local state health department website should be the first step. Physician Compare by the CMS allows you to search a practices name, medical specialty, medical condition, or organ system. You can access a list of physicians that accept Medicare. Most practices also accept Medicaid, making it an excellent directory for finding a doctor who accepts Medicaid.
Also Check: Physical Therapy Offices That Accepts Medicaid
How Can I Make A Same
On average, patients who use Zocdoc can search for a Family Physician who takes Medicaid insurance, book an appointment, and see the Family Physician within 24 hours. Same-day appointments are often available, you can search for real-time availability of Family Physicians who accept Medicaid insurance and make an appointment online.
Schedule An Appointment With Our Family Medicine Doctor In Uniondale That Accepts Medicaid
At the Charles Evans Center, our team is committed to providing the traditionally underserved members of the community with the medical attention and care they deserve. If youre being affected by a brain or nervous system problem, the help of our experienced neurologist may be needed to gain a better understanding of what is taking place. To receive the necessary diagnosis and care, make sure to contact our team today.
Read Also: Does Fidelis Medicaid Cover Bariatric Surgery
Are Video Visits With A Family Physician Online Covered By Medicaid
Most insurers provide coverage for video visits at the same cost as in-person visits. You can search on Zocdoc specifically for Family Physicians who accept Medicaid for video visits by selecting your carrier and plan from the drop-down menu at the top of the page. We recommend you check with your insurance carrier directly to confirm your coverage and out of pocket costs for video visits.
Transferring Medicaid Benefits To Another State
Technically, theres no formal program or option that allows you to transfer your Medicaid coverage from one state to another. Therefore, if youre relocating, youll need to reapply for Medicaid in the new states.
The good news is that youre allowed to apply for Medicaid in your new state immediately after relocating, and doing so can help you avoid a lapse in benefits. It generally takes anywhere from 15 to 90 days to receive a letter of approval once you apply for Medicaid, and you can usually submit your application online.
One thing you should know about Medicaid is that you cant be covered by it in two different states at the same time. Therefore, to transfer your coverage so to speak youll need to first terminate your original Medicaid coverage and then apply in your new state once youve relocated.
Most states offer retroactive Medicaid coverage, which allows you to receive coverage for up to three months prior to the date of your applications approval. However, you may be forced to pay for healthcare services out of pocket until that retroactive coverage kicks in and renders you eligible for reimbursement. To this end, make sure to retain copies of all medical receipts for services received during your coverage gap.
Read Also: Humana Medicaid Florida Over The Counter
Also Check: Medicaid How Much Money Can You Make
Will I Have To Find A Primary Care Doctor Near Me
Not all types of Medicare coverage require a primary care doctor. If you enroll in Original Medicare , you generally dont need to choose a primary care doctor but you still may wish to. You can see any doctor who takes Medicare patients, although your out-of-pocket costs will be lower if you use a doctor who accepts Medicare assignment. Medicare assignment is an agreement that the doctor will accept the Medicare-approved amount as payment in full, and wont charge you anything besides the deductible or coinsurance, if applicable.
Medicare generally covers doctor visits in most medical settings, such as in the doctors office, in the hospital or outpatient department, in a nursing facility, or at an approved health clinic.
If you enroll in a Medicare Advantage plan, you may need to select a primary care physician. Medicare Advantage Health Maintenance Organization plans and many Special Needs Plans require each person to have a primary care doctor. Medicare Advantage Preferred Provider Organizations and Private Fee-For-Service plans typically do not require members to choose a primary care physician.
Medicare Advantage is another way to receive your Original Medicare benefits through a private insurance company. Medicare Advantage plans must cover everything that Original Medicare covers, except of hospice care, which is still covered by Medicare Part A.
How Do I Find Primary Care Doctors Near Me
Your Medicare Advantage plan typically sends you a list of doctors that participate with the plan. The list usually includes not only primary care doctors, but also specialists, hospitals, pharmacies, and outpatient facilities contracted with the plan. Of course, if you have a medical emergency, you should get care from the closest appropriate provider, regardless of network.
If you enroll in a Preferred Provider Organization, or PPO, you may still get a list of doctors in your plan network. While you typically dont have to choose a primary care doctor or get your routine care from providers within the plans network, you might pay less out of pocket when you see network providers.
Recommended Reading: Dentist In Winston Salem That Accept Medicaid
Learn More About Family Medicine Specialists And How To Choose The Right One For You
A family medicine doctor specializes in the comprehensive prevention, diagnosis, treatment, and ongoing care for a wide range of conditions. Family medicine is a broad specialty that focuses on your general, overall health rather than one type of disease or condition. Family medicine specialists often serve as a primary care doctor, providing preventive and therapeutic care services for the entire family through all stages of life.
Family medicine doctors treat a wide variety of conditions and often consult with other members of the patients medical team. A family doctor typically:
- Evaluates a patients medical history and teaches the patient about wellness and disease prevention
- Diagnoses and treats acute diseases and conditions including infections and injuries
- Screens, treats and monitors a range of chronic physical conditions, such as high blood pressure, diabetes, thyroid disease, heart disease, and depression
- Orders and interprets laboratory and imaging tests and prescribes medications
- Performs minor surgical procedures and assists with major procedures
- Provides cancer screenings, such as skin and thyroid exams
- Performs reproductive health screenings including pelvic exams, Pap smears, breast exams, and sexually transmitted disease screenings
- Provides care, in some cases, for women during pregnancy, labor and delivery, and after delivery
- Provides family planning and contraceptive counseling including birth control prescriptions
Need a Telehealth visit? Connect now.
What Is A Family Doctor
Family doctors are primary care providers who offer comprehensive medical care for people of all ages, often providing care for members of an entire family. As a family doctor, these physicians generally develop close relationships with patients over an extended period of time, allowing for personalized care. The American Board of Family Medicine offers board certification for family physicians who voluntarily meet additional standards beyond basic licensing .
Family physicians are tasked with caring for not only the physical health of patients and families, but also the mental and emotional health and how it relates to the family dynamic as a unit. Family medicine also emphasizes preventive care, which helps keep patients, and works to prevent diseases before they occur through regular exercise, a healthy diet and healthy life choices.
With regard to preventive measures, family doctors perform regular examinations or checkups, immunizations, and other pertinent screening tests, based upon the specific patients health. Family physicians are trained to identify and treat a very wide range of illnesses and injuries, but may also refer patients to a specialist when they deem it necessary. That said, family doctors may also treat and manage chronic conditions without the assistance of a specialist.
Don’t Miss: Obgyn In Houston That Accept Medicaid
Best Primary Care Doctors In Nyc Who Accept Medicaid
Our clients who enroll in the Consumer Directed Personal Assistance Program know that they need to be on medicaid in order to qualify for the program.
In order to help you make a more informed decision regarding your health, we put together this guide of the 10 Best Primary Care Doctors in NYC Who Accept Medicaid
Are Video Visits With A Primary Care Doctor Online Covered By Medicaid
Most insurers provide coverage for video visits at the same cost as in-person visits. You can search on Zocdoc specifically for Doctors who accept Medicaid for video visits by selecting your carrier and plan from the drop-down menu at the top of the page. We recommend you check with your insurance carrier directly to confirm your coverage and out of pocket costs for video visits.
Don’t Miss: How Long Does It Take To Get Approved For Medicaid
