Question--Nurses and Medicaid recipients

sulilina · January 2012

Basically, right now I have BCBS federal employee insurance through my mother but I turn 26 in february and they will be dropping me March 20. So they have left me with the option of paying for the plan out of pocket which is $600/mo (I would be paying for April and May). Everything is 100% covered with her insurance. I don't pay for anything, not even ER visits... only my prenatal vitamin copay. So, FI and I were going to just pay for it and then drop it once I give birth. I have one more year of school which is all rotations in the hospital and then I will be working and have benefits. FI has no benefits.

SO, needless to say, the baby will not have any insurance when he is born and this has been driving me crazy since I got pregnant.. probably my biggest stressor. After thanksgiving, I decided to apply for FL Medicaid to see if I would qualify that way the baby is automatically streamlined with medicaid, has a card and I won't have to deal with reapplying when he's born while I'm juggling finals and this new lifestyle.

Well, today I got a piece of mail from Medicaid and I qualified as well as the baby. We are super SUPER excited as this will save us $1200 and a TON OF STRESS and wondering whether the baby would or wouldn't qualify! But, then I got to thinking that I don't want to be treated differently come labor and delivery time. I don't know if medicaid has some crazy formulary that hospitals have to follow and things I may or may not have available to me (certain drugs, certain procedures, sonograms, etc) because I am a medicaid patient. So now I am wondering if I should just chalk up the $1200 to keep BCBS until birth. FI thinks its stupid and a waste of money, but I don't want to be in the gray shadow during a critical medical time. I've never had medicaid and I'm unsure of what to do. My mother says to keep BCBS. My main reason for applying was for streamlining the baby's coverage. I see the doctor this week and plan on asking the nurses at the desk if they know of anything as far as formulary goes.

My question is to nurses and current/previous medicaid recipients that have had solely medicaid while pregnant:

1. How was your treatment? Were you treated differently with medicaid during your prenatal treatment and L&D? Were things unavailable to you?

2. Nurses: do you treat patients differently because you know reimbursements are lower from the state? Or do you only go based off how a patient is treating you? Do you know if patients are treated differently with healthcare from your co-workers and doctors because they have medicaid?

Thank you sooo much!

Chelsey68 · January 2012

I had medicaid when pregnant with my son and he was on it until he was 3. As for the OB-GYN office and the hospital i was treated just as if i had any other insurance. Honestly my doctor didnt even know i had medicaid until i told him.

Now as for my regular doctor that was a different story. Because i had medicaid i was assigned a primary care doctor. But i didnt want to stop seeing my regular doctor so i just paid out of pocket for her. Now she was very against medicaid.

But with as many people that are on medicaid OBs and hospitals dont even think anything of it.

Now as for your child on medicaid the only one small thing i noticed that was different than if your child has other insurance, is that my childs pediatrician was sent a certain amount of medicaid flu shots, and a certain amount of paid insurance flu shots. They always ran out of the medicaid ones first so my son had to wait a few weeks for his. Which really wasnt that big of a deal.

I would not spend the $1200 extra. The hospital and OB will treat you the same either way.

tikilove81 · January 2012

This is my 5th pregnancy/ fourth child. I have had private ins as well as Medicaid. I was actually treated better with medicaid but it might just be the place I delivered. AT the OB usually Drd dont know only the billing/office people do.

Hope this helps..............

MelissaMiso · January 2012

In the hospital, the nurses are not getting paid via billing, they are on salary so there will be no bearing on treatment (of course, there shouldn't be regardless). The only time I have ever gotten treated differently was when I was uninsured and had to go to the ER after falling down a flight of stairs. My legs took a beating and the ER doc said, "well, when you're ready walk to the bathroom to give a urine sample, if you can walk on your legs, they're not broken" Really? Thanks doc!

mrskinsler04 · January 2012

I personally have not had medicaid for a pregnancy but my friend did. She said her regular OB appointments she felt like a normal person but when it was time to L&D she felt like she was last in line. She said they didn't respect her birth plan or her wishes for after care. She has told me she feels it was because she was on medicaid but who really knows.

My 2 children that were adopted from foster care had medicaid until they were adopted. I don't think that the care was sub-par but the environment that the clinic was in was less than desirable. That might sound like a snobby thing to say but it's the truth. I felt bad that they had to be there and as soon as we could, we put them on our coverage.

Mrs.Deputy · January 2012

The only difference for us is that I cannot give immunizations to medicaid patients because there is a free service that will provide them (I work in a pediatric clinic). I know when our patients have medicaid because the front office alerts me just so I won't give any immunizations...other than that there is no difference. I don't care what insurance someone has. I don't base my care on insurance or how nice someone is to me. I base it on how I would want my own child/family/myself treated....which is what I would expect of every nurse. If they cannot provide good care to every patient without regard to race, economic status, religion, etc, then they should find a new job.

mrs+harlow · January 2012

My mother sees Medicaid patients all the time and has to be aware of what insurance or social program someone has because that impacts where she can send blood work for lab tests, how certain things have to be done, what brand of something she can give, etc. she doesn't give them subpar care, though...no doctor does! It's against the Hippocratic Oath!

That being said, if you can afford private health insurance until you have a permanent position it is most certainly not a " waste of money" just because something like Medicaid is " free".

JAP09-02 · January 2012

I had DD#1 in FL, and my doctor quit accepting medicaid patients. You may want to check with your OB's office before making a final decision.

sulilina · January 2012

Thank you all. I have been doing a lot of research on it tonight. Most people say they don't notice a difference with treatment but there is a lot of red tape for a lot of things for pediatrics. I'm currently a pharmacy intern and am aware of some of those "red tape" barriers that medicaid patients get extremely frustrated with. Unfortunately I don't really have a choice with the baby as neither FI nor I have benefits yet. Fortunately, I will be able to discontinue medicaid for baby once I start working in 2013. The reason I bring up these questions and issues with difference in treatment is because through my education, rotations and work experience, I witness and hear personnel talking about medicaid patients all the time in a negative manner. And I notice pharmacists and doctors treating medicaid adult patients differently, subpar and rudely all the time. It is messed up, but that's the reality of this world. This is why I'm really hesitant for L&D. As for pediatrics, I know baby will be okay.

mrs+harlow - I wouldn't be applying for medicaid if we could afford private insurance, trust me. The only reason I would be able to pay the ridiculous $600/mo for two months only is because I would take out a private student loan to be covered as this is a potentially serious medical event coming in May. And even at $600/mo, the baby is still not covered. If I want the baby covered, it's $1400/mo. Not possible as a student that works maybe 12 hours a month and my FI the sole provider.

bridekimmie · January 2012

First I would discuss your concerns with your provider about medications and things like that. I NEVER treat patients differently based on ins. It's sad to say that some practices, hospitals and staff do do that. It is very unprofessional of them. I wish you the best of luck whichever route you decide to take!!

jmgcoggins · January 2012

Only the front desk clerks and/or receptionist knows what insurance you are on. And legally, as a nurse or doctor, you treat all patients equal....regardless of sex, race, religion, income level, insurance, etc. We could lose our license and pay a huge fine if we did these things. Save the 1200....

aeonish · January 2012

wife07mom09:
the things you hear about medicaid recipients are those that abuse the system.
case in point-most of my patietns are medicaid and I get really frustrated when they come in with fake nails, perfect eyebrows, designer purses adn an ipad or digital something for their kids. it isnt right that they get all that mess most working folks can only afford if saving up. please do yourself a favor-SAVE. if you need medicaid for a time for your LO fine but put money EVERY month into savings to accont for what you would be spening.
or go to work full time and school part time
therer are options

Sorry, I don't want to get into an argument about this, but I just have to interject here.

You don't know everyone's story, so you really shouldn't judge and make assumptions. While I certainly know there are people out there who abuse the system, you should know that there are also people who do not.

I'm still on my parents' insurance until I turn 26 (two months after LO is born), but DH and DS are on medicaid, and our whole family is on welfare because we don't have any other choice. I'm sure the people in DS' doctor's office or at the welfare office think the same thing about me if I'm sitting in the waiting room playing on my smartphone or my tablet, or rummaging in my knock off designer purse with my fresh pedicure (that I only get once in a while, but happen to have the one time these people see me) and perfect eyebrows. But I didn't pay for those things. They were given to me by very generous family members who insist on doing things like this for me and my family. Those things make me seem a whole lot more well-off them I actually am. So please, don't judge a book by it's cover because like I said, you DON'T know everyone's background.

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