Reply to Autism Waiver and private services

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[quote=Anonymous][quote=Anonymous][quote=Anonymous]My child has Medicaid through Katie Beckett as secondary insurance (similar to autism waiver) in and that is not the case at all. Therapies go through primary insurance first and then to your secondary (Medicaid). Some providers will do this for you and others will have you do this yourself. Medicaid only covers services that are preauthorized and approved so it may not cover everything, but is good to have if you can get it.[/quote]

This assumes the providers take insurance which many do not. Correct? We’ve been contemplating Katie Beckett but think it may not be worth it since all our providers don’t take any insurance. How does Medicaid work for out of network people? [/quote]

Not necessarily. We have multiple therapists. Only one takes insurance anymore. For the others, I have to pay out of pocket, then submit to primary insurance. I can only submit to Medicaid once I have an EOB from the primary provider. When the primary covers the entire cost, I do not need to submit anything to Medicaid.

For the provider that takes insurance, my child has a Medicaid authorization for those services. This provider submits the bills to our primary insurance, I send back any EOB or payment and then the provider submits to Medicaid and is reimbursed the remaining amount.

One of our therapists previously took primary insurance and they would submit it to our initial insurance and then I would submit to Medicaid.

Your primary insurance should not deny coverage because you have Medicaid as a secondary. That's just not how it works in my experience.[/quote]

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