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Thread: Help choosing a Medicaid health plan provider

  1. #1

    Help choosing a Medicaid health plan provider

    Hi,

    I need to enroll to one of the following Medcaid HealthChoices available in Southeast zone, Pennsylvania.


    1. Aetna Better Health
    2. Health Partner Plans
    3. Keystone First
    4. United Healthcare


    https://www.enrollnow.net/PASelfServ...f/pa/SE_en.pdf

    I don't have experience with any of above. I kindly request your help in choosing a provider. As any SCI, my preference is with the provider who pays for urological supplies, physical therapy, necessary DME etc. without much hassle. BTW. I don't have Medicare or secondary insurance.

    Please help me.

    Thanks in advance.

  2. #2
    One way to evaluate is via NCQA ratings. Based on these, (2) and (3) garner the best ratings. From there, look at their networks in terms of number of DMEs and supply houses in your area, or any you want to keep dealing with. And since both are HMOs, check via the links above to see if your preferred doc(s), therapists and clinic(s) are in network. Keystone is a Blues plan so likely a broader network, but Health Partners is locally owned by area hospitals. They also offer free Teladoc visits, which might be important to you.

    If both have the providers you need, another way to break the tie is if you already have a local doc, PT and/or DME, also ask the office manager or biller which plan is less of a hassle from her standpoint. You will often get more from providers when you have a plan that they are comfortable working with.

  3. #3
    Quote Originally Posted by renard View Post
    One way to evaluate is via NCQA ratings. Based on these, (2) and (3) garner the best ratings. From there, look at their networks in terms of number of DMEs and supply houses in your area, or any you want to keep dealing with. And since both are HMOs, check via the links above to see if your preferred doc(s), therapists and clinic(s) are in network. Keystone is a Blues plan so likely a broader network, but Health Partners is locally owned by area hospitals. They also offer free Teladoc visits, which might be important to you.

    If both have the providers you need, another way to break the tie is if you already have a local doc, PT and/or DME, also ask the office manager or biller which plan is less of a hassle from her standpoint. You will often get more from providers when you have a plan that they are comfortable working with.
    Thanks for the response. The NCQA rating link was very helpful. I have decided to go with Keystone First as it seems widely accepted by Magee Rehab physicians which is my top priority.

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