CHIP

by Guest » Fri Jan 24, 2014 07:34 am
Guest

My son had to be admitted in a hospital on urgent basis for appendix removal. We were out of state during that time. The hospital administration accepted our insurance and told us not to worry. After that their business wing came after us, sent all the bills to us and said they won't accept the policy. When I reached out to our members' advocate services, they pretty much assured us and said they would pay the bills and everything was approved. But they won't even accept this!! Ridiculous. I just wonder why are they refusing to get paid!! As per our state agreement, CHIP members never get contacted directly to deal with billing issues. If there is something contradictory, we have no clue about it. So what should I do now to get out of this mess? Is this legal what they are doing?

Total Comments: 2

Posted: Tue Feb 04, 2014 12:19 pm Post Subject: My son's Medicaid.

First things first, did you ever took the trouble of informing the concerned hospital that your son was on Medicaid? Second, you’re permitted to take advantage of Medicaid in your own state only.

However, in case of an emergency, any state can accommodate you with respect to your son’s Medicaid. That said, did you clarify about this prior to your son’s surgery?

As per your post, you said that your son had Medicaid. Therefore, what is it? Its quite evident now that Medicaid wouldn’t consider your son’s case as an emergency, and hence, they won’t provide any coverage to him.

Posted: Fri Feb 07, 2014 07:57 pm Post Subject:

Second, you’re permitted to take advantage of Medicaid in your own state only.

This is 100% incorrect in the case of a medical emergency. All insurance, public or private, must pay the expenses of emergency treatment "out-of-network" in the same manner as if in-network, meaning same deductibles, copays, and/or coinsurance.

Its quite evident now that Medicaid wouldn’t consider your son’s case as an emergency, and hence, they won’t provide any coverage to him.

I don't know how you can make such a statement. We don't have those details. As I read the original post, the appendix went "hot" suddenly. That's a medical emergency.

This is a matter for the individual's state Medicaid agency to handle. Please do not listen to the garbage posted by Insurance Sucker, or you, too, will become one.

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