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Thread: Do you take Medi-caid?

  1. #1
    OptiBoard Professional
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    Do you take Medi-caid?

    Do you take Medi-caid? Adults age 21+ now are covered for frame and lenses.
    How has this affected your office?
    Last edited by optician2601; 02-18-2020 at 03:07 PM.

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    Master Jedi King of the Lab's Avatar
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    We do not take it, it is not worth it.

    My demographic has little demand for it anyway.

    If I were to take, I would have a better package deal for patients to choose from so that they receive a better quality lens & frame.
    Erik Zuniga, ABOC.

  3. #3
    OptiBoardaholic
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    We quit taking it and have never looked back.

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    Do you take Medi-caid? Adults age 21+ now are covered for frame and lenses.
    Is that a recent change? In my state, Medicaid used to cover all ages, but there was a change in state law a few years back (2009? Maybe?) that decreed only juveniles (that is, patients under the age of 21) would be covered in full for a comprehensive exam every year in addition to a pair of glasses. The adult (21+) program provides an exam every two years, but patients that want glasses would have to pay at lab cost (some providers call this a 'co-pay') through a contracted provider. Since the adult program doesn't fully pay for glasses (and the lab that makes the glasses takes a long time), there's only one provider in my city that contracts with that benefit. This was my understanding in Washington state until the end of this past year, did California have a similar system?

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    Medicaid patients are not the best in my area and the reimbursements are generally not worth it from what I've seen.

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    In our state we have a VSP plan called Wellsense for a lot of the medicaid plans (as well as NHHF). The biggest problem you have is huge practices will take it for their exam and then leave the pt high and dry trying to find a retailer to fill another offices prescription. Which is a major inconvenience for the pt and should not be allowed. IMHO

  7. #7
    OptiBoard Apprentice IIxIPariahIxII's Avatar
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    We take it, but since the adult roll out, we've only seen maybe four. Not a huge increase. I will say though, getting the adult kit has been huge. So many teens now have better fitting and looking frames to choose from. It's worth it for us with the kids because we see so many kids as a practice.

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    OptiWizard OptiBoard Bronze Supporter pezfaerie's Avatar
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    We take it but it's been a huge mess here in CA since the adult roll out.
    Pez:D

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    Master OptiBoarder OptiBoard Silver Supporter Jubilee's Avatar
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    I am in Indiana. We take medicaid. Between Medicaid, the Healthy Indiana Plan (Medicaid Expansion for adults) and the Marketplace plans, it comprises about 25% of our practice. We are fee for service, so I get to choose labs or make it myself. It pays for us. Decent exam payments, frame allowance for kids suck. However if you know how to do it right, you can make more $$ than you can on a "covered in full" 3rd party plan. We are also allowed to offer/charge for upgrades (ABN needed!) and many are willing to pay extra for AR, Trivex, etc.
    "Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland

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    OptiBoard Novice ogfullmelt's Avatar
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    Quote Originally Posted by pezfaerie View Post
    We take it but it's been a huge mess here in CA since the adult roll out.
    wow I can't believe they actually did it.

    Yes, it's hit or miss.

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