I have guardianship of my adolescent niece, who is covered under my employer-provided PPO plan. We also just learned she was qualified for medicaid (Nevada) and got her signed up for a managed plan with Molina. She needs an extended (months vs weeks) stay at a residential psychiatric hospital. You could count the number of residential psychiatric facilities serving adolescents in the state on one hand, and all of them are out of network with my primary insurance, which has no out of network benefits for mental healthcare, but two are in network with Molina medicaid. One of the local facilities (which turns out to be out of network with both) told me that if it’s out of network with the primary insurance, then I would be on the hook for the out of network out of pocket maximum, even with the medicaid coverage. Is this true, or can anyone shine a light on how this works out?
The only in network facilities for my primary insurance are out of state, and I may have trouble sending her out of state since I am her guardian and not her parent.
submitted by /u/LadyBrig
[link] [comments]I have guardianship of my adolescent niece, who is covered under my employer-provided PPO plan. We also just learned she was qualified for medicaid (Nevada) and got her signed up for a managed plan with Molina. She needs an extended (months vs weeks) stay at a residential psychiatric hospital. You could count the number of residential psychiatric facilities serving adolescents in the state on one hand, and all of them are out of network with my primary insurance, which has no out of network benefits for mental healthcare, but two are in network with Molina medicaid. One of the local facilities (which turns out to be out of network with both) told me that if it’s out of network with the primary insurance, then I would be on the hook for the out of network out of pocket maximum, even with the medicaid coverage. Is this true, or can anyone shine a light on how this works out? The only in network facilities for my primary insurance are out of state, and I may have trouble sending her out of state since I am her guardian and not her parent. submitted by /u/LadyBrig [link] [comments]Read Morer/HealthInsurance