Why would I be refused care for having Medicaid if I am paying 100% out of pocket?

My primary insurance is Aetna, which I recieve through an employer, but I am also enrolled in Medicaid because of my financial situation.

I recently signed up for a membership with a specialized clinic that does not accept insurance whatsoever. They charge you for a membership, which is supposed to include all visits, tests, referrals, etc. and I signed up for a year and have already paid for it.

After my first appointment I got a prescription that required a pre-auth before Aetna would cover it. I guess while talking to the pharmacy my doctor found out I also have Medicaid. They just contacted tonight to inform me that I cannot be a patient there.

I know Medicaid tends not to reimburse doctors well, but if I’m paying for the services in full, then why does it matter that I’m enrolled? Is there any chance I can get my membership fee back?

submitted by /u/mrCabbages_
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My primary insurance is Aetna, which I recieve through an employer, but I am also enrolled in Medicaid because of my financial situation. I recently signed up for a membership with a specialized clinic that does not accept insurance whatsoever. They charge you for a membership, which is supposed to include all visits, tests, referrals, etc. and I signed up for a year and have already paid for it. After my first appointment I got a prescription that required a pre-auth before Aetna would cover it. I guess while talking to the pharmacy my doctor found out I also have Medicaid. They just contacted tonight to inform me that I cannot be a patient there. I know Medicaid tends not to reimburse doctors well, but if I’m paying for the services in full, then why does it matter that I’m enrolled? Is there any chance I can get my membership fee back?
submitted by /u/mrCabbages_ [link] [comments]Read Morer/HealthInsurance

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