Difference in Medicaid plans!

Submitted by RI-Transplant t3_xz7l3k in RhodeIsland

Just got a letter saying I can change Medicaid plans this month. What is the difference between them? I have the options of Neighborhood Health Plan, Tufts Health plan, and United Healthcare Community plan. Is it all the same? Is it a hassle to change? Would my specialist doctors stay the same, I’m getting a knee replacement in November from an excellent doctor so I don’t want to mess that up. I’m on Neighborhood right now.

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Simple-Swimming14 t1_irkqotl wrote

If you're getting surgery in a month I would not change anything in your plan because chances are you're going to need all of your referrals redone. So stick with what you have, make no changes. if you want to modify it do it next year after doing more thorough research. My only other advice is to always make sure your favorite doctor takes the insurance you're about to switch to..

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RI-Transplant OP t1_irl1hxh wrote

I definitely don’t want to lose my knee guy, Dr. Marchand, he’s one of the best and I’m so lucky to have him. Thanks for the advice.

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ases8089 t1_irkq8ug wrote

i got the same -def not Tufts - personally if what you have is working for you then i would stay. i always feel like any change you make triggers something else.

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RI-Transplant OP t1_irkzzrs wrote

I thought it was strange, they put my husband on Tufts and me on Neighborhood on the same application. I go to Thundermist and have a N.P, he goes to an actual doctor in a regular office. I’ve never had any kind of insurance before so I have no clue.

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ases8089 t1_irm9pft wrote

i would see if you can talk to someone- does thundermist have social workers? i would think so but ive never been there. medicaid is secondary for me so i dont pay it much attention but if its your primary then i would def take a look. you have until 12/7 to make changes

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noungning t1_irle19q wrote

Surgery sounds like it'd need prior authorizations from the insurance company. Changing it can mean a lot of new authorizations. Because they would have to prove to your new insurer that you truly need the surgery etc.

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goofyburrito94 t1_irl977v wrote

I work with health insurances for work, so can only give advice from that perspective. Out of the insurances you listed, personally I’d choose Tufts. I have found that they have a much smoother/easy to navigate phone tree, website, and it’s easy to communicate with their phone reps. I’ve also found that Tufts covers more supplies/equipment. Like if you have a surgery and need a wheelchair, wound supplies, a nurse to see you at home, etc, way more places will accept Tufts. Obviously these are super small things compared many other factors!

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maybebullshitmaybe t1_irlyuno wrote

Does it make a difference it's through medicaid tho versus say private/employer tufts or united?

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goofyburrito94 t1_irx0qa3 wrote

The plans will definitely be different and cover different things if it’s Medicaid vs employer, etc, but I personally still like tufts better and find that that all of their plans are easier to work with and cover more without having to jump through a million hoops.

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