Strange problem Molina ACA

[vic120]

I have Molina for my family, I am recent move to Ohio

I also have a special needs child, and I keep running into issues and have to go far for care for him
Because I am finding the providers are saying to my wife yes we take Molinia but not Medicaid Molina?

But I am not on Medicaid nor anything like that, and they respond its Medicaid because I got it on the marketplace and I would have to get it off exchange ????

I have never heard anything like that before not from my own experience nor my clients but NOW since moving here i am hearing it all the time at least half dozen times

And I have been super busy my wife has been having these conversations and she does not know what to say

WHY are they convinced I am on Medicaid when I don't even qualify for subsidy?

I don't even think I can purchase of exchange because of health condition< honestly though I don't know much about off exchange

 

[Jim Wright]

It's likely the person you're talking to not understanding what they are doing. Ambetter has that problem a lot too. They either equate it with Medicaid or they say " we don't take that" because they've never heard of it.

Re: off exchange, you absolutely can go off ex. There is no underwriting. And usually the silver plans are cheaper because they take out the CSR cost.

 

[Northeast Agent]

vic120 said:

I also have a special needs child, and I keep running into issues and have to go far for care for him.

Because I am finding the providers are saying to my wife yes we take Molinia but not Medicaid Molina?

Does your child have an IEP? They may be eligible for Medicaid (Medical Assistance/MA) alone, even if your income is too high to qualify for a subsidy.

I would contact the DHS in your state, or the county assistance office for clarification on this. Usually there are several MA plans to choose from.

 

[somarco]

providers are saying to my wife yes we take Molinia but not Medicaid Molina?

Office staff many times have no idea what they are talking about. I get this when someone produces their Medicare card AND Medigap ID.

"We don't take that plan. We are not in their network".

Doesn't happen much but once I had to call the office and ask someone to go on their webpage and tell me WHERE it says they do not take Medigap plans. In fact, their site clearly states they accept ALL Medigap plans

 

[vic120]

vic120 said:

I also have a special needs child, and I keep running into issues and have to go far for care for him.

Because I am finding the providers are saying to my wife yes we take Molinia but not Medicaid Molina?

Does your child have an IEP? They may be eligible for Medicaid (Medical Assistance/MA) alone, even if your income is too high to qualify for a subsidy.

I would contact the DHS in your state, or the county assistance office for clarification on this. Usually there are several MA plans to choose from.

I am so confused about this stuff ,I will read something that states, I can get him Medicaid because of disability

but when I try it they say it is still based on incolme and I cannot

I am told He cannot get anything till he is an adult then he can apply for SS disability but not till he is at least 17

 

[vic120]

Office staff many times have no idea what they are talking about. I get this when someone produces their Medicare card AND Medigap ID.

"We don't take that plan. We are not in their network".

Doesn't happen much but once I had to call the office and ask someone to go on their webpage and tell me WHERE it says they do not take Medigap plans. In fact, their site clearly states they accept ALL Medigap plans

I have his ABA being paid by school, because they cannot keep him, but they have to keep with school schedule

I tried to get them to take our insurance

they told my wife sorry but we do not take Medicaid, So I jumped into the email and explained it not Medicaid,

then the owner jumped on and said it is marketplace we do accept Molina just not Medicaid or marketplace

Now I run into the same thing, My son cannot just get a normal check up at the dentist, or get a cavity filled without being put under

Ins usually covers this as medical, Ive never had an issue in TN

But my wife is being given this same line everywhere we accept Molina but not medical or marketplace has to be off exchange

they want like 3K just to do check his teeth

found one place about 3 hours from me will take it but no appointment till January

I mean there are no problems finding reg doctors and hospitals though