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Questions For Those Of You Who Are On Medicaid--About Hospitalization, Partial Hospitalization/Day Programs


LoneSquirrel

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Hi guys!!

 

Questions for those of you who are on Medicaid...

1.) Does Medicaid cover inpatient stays for Depression/Anxiety?  

2.) Does it cover "partial hospitalizations" (where you go to the hospital during the day, but go home in the evening)?

3.) What sort of roadblocks have you encountered regarding coverage when you required more intense care than normal?

I may have an option to keep my insurance, but it would put me in a bad situation with my family for awhile.  However, it may be worth it to me to suffer through the family problems if I can get the help I need.  In order to make an informed decision, I would like to know more about what I can expect if I wind up on Medicaid, seeking a hospitalization.  Will they pay for a hospital stay that isn't just a "psych hold," or would I wind up in the hospital for 72 hours and then be sent home?  Will they pay for a day program that you go to every day and get intensive therapy, or are you just told to go to group once a week for an hour and that's all they can offer?

I feel like I need a legitimate hospitalization, not "I'm sorry, we don't do that.  You can see your psychiatrist once a month, see your therapist once a week and go to group once a week."  I don't think that's enough.  I also don't think it's enough to go to a 3-day program or something like that.  I think I need inpatient where I get intensive therapy, or I need partial.  

So I need to know if Medicaid will cover it, or if I'll get the runaround and wind up with a half-a**  "solution."

 

Thank you in advance for your responses!!

 

--LoneSquirrel

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Hi Lonesquirrel,

Though I am uninformed about the specifics of your question, and I live in Canada, I did look up the Medicaid website and they do have a list of contact centers by state, as well as a general headquarters contact. I would suggest posing these questions to them directly, though I could understand it might be difficult to voice these things to a stranger.

The other thing would be, have you located a specific day program that you are wanting to do? Because you could ask the day program itself what the different options are for coverage (including medicare).

In the end though, if you really feel like doing a day program is the most feasible and beneficial option to you, and the alternative is a worsening of your symptoms then I think you should prioritize doing the day program. Still though, exploring all of the best options regarding financial and family available to you beforehand will be a good thing too. Because once you are better you will be in a state to persevere through aspects of your life outside of the mental health problems you are facing.

Anyways, I hope any of this can help you

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Thanks, @zzzsheepyzzz.  I am looking going to look into things today, but I was hoping someone here would have personal experiences to share.  We'll see if anybody else answers.

@Lunachick  Have you gone to healthcare.gov?  When you apply for a subsidy and you don't have a job, they refer you to the state to be approved for Medicaid.  Who did you talk to about it?  Maybe they just didn't know what they were talking about.

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Healthcare.org is who I talked with. They said Texas didn't expand Medicaid so it isn't being offered to unemployed young adults. Said the only thing I could get was a voucher keeping me from being penalized for not having insurance. I was like "so you're telling me there is no state program I can use to get health insurance while I am unemployed so I can continue my medical treatment?" and he said "unfortunately, not in Texas."  he said I could apply for Obamacare (which i would have to pay for... Which I can't do because I lost my job), and that the earliest I could even get that would be April.

 

Think I should call again?

Edited by Lunachick
Autocorrect goin cray
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20 minutes ago, Lunachick said:

Healthcare.org is who I talked with. They said Texas didn't expand Medicaid so it isn't being offered to unemployed young adults. Said the only thing I could get was a voucher keeping me from being penalized for not having insurance. I was like "so you're telling me there is no state program I can use to get health insurance while I am unemployed so I can continue my medical treatment?" and he said "unfortunately, not in Texas."  he said I could apply for Obamacare (which i would have to pay for... Which I can't do because I lost my job), and that the earliest I could even get that would be April.

 

Think I should call again?

Geez.  Maybe you should check with your county's department of health and human services.  If they know that you're struggling with depression, maybe there is something available to you that wouldn't be available otherwise.

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My suggestion for those who live in the US in states that did not expand medicaid, is to find out if there is a Federally Qualified Health Center (FQHC) in your area. FQHC's receive funding by the federal government to provide health care for low income folks who may not have insurance.  Many FQHC's  often have behavioral health providers working in the clinics. Generally FQHC's use a sliding scale to determine the what someone will pay for services (and the sliding scale can go very low). 

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1 hour ago, lex333 said:

My suggestion for those who live in the US in states that did not expand medicaid, is to find out if there is a Federally Qualified Health Center (FQHC) in your area. FQHC's receive funding by the federal government to provide health care for low income folks who may not have insurance.  Many FQHC's  often have behavioral health providers working in the clinics. Generally FQHC's use a sliding scale to determine the what someone will pay for services (and the sliding scale can go very low). 

Thank you! I will look into this tomorrow, too!!

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So, county mhmr says they accept clients who are unemployed/no insurance and that it will be sliding scale. You have to have an intake/diagnosis appointment, then z separate financial assistance appointment, and then an appointment with a caseworker to determine which services you may need (counseling, doctor, meds, etc), and then you get your doctor appointment. Process could take a while! But it is better than nothing. Hoping that telling them I'm about to be out of meds will speed up the process.

Edited by Lunachick
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On 2/22/2017 at 5:58 PM, lex333 said:

Sorry, know my post above was a bit off the subject of Medicaid, partial hospitalization, day programs... I was responding to

Lunachick's post about not being eligible for medicaid.  I am wishing you all well! 

It's okay, Lex.  It's relevant to being poor, and relevant to Lunachick's situation.

Thanks for the wishes. :rose:

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On 2/23/2017 at 11:47 AM, standup said:

I'm on Medicaid. I checked into partial hospitalization. It is covered, just in my case, it's not covered at any facility within a 60 mile radius of where I live. 

Thanks, standup!!  :flowers:  

I was talking to my aunt last night, and she said it was hell trying to find help for my cousin, who is on Medicaid.  However, my cousin needed rehab (with detox), not just depression and anxiety treatment.  She wound up putting $15,000 on a credit card to send my cousin to a private rehab place for a month, because there were no places here that could meet her needs.  Stories like that make me scared to go on Medicaid.

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Just now, LoneSquirrel said:

Thanks, standup!!  :flowers:  

I was talking to my aunt last night, and she said it was hell trying to find help for my cousin, who is on Medicaid.  However, my cousin needed rehab (with detox), not just depression and anxiety treatment.  She wound up putting $15,000 on a credit card to send my cousin to a private rehab place for a month, because there were no places here that could meet her needs.  Stories like that make me scared to go on Medicaid.

:sniffle1: that's so sad.

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