What is the healthcare system like here for those with Medicaid ? And how are mental health services?

Submitted by Riverrun221 t3_yvg4jx in Pennsylvania

I am moving from California to Pennsylvania. I am low income. I currently have California’s version of Medicaid which is called Medi-Cal. Everything is covered under my health insurance right now. My ER visits, medication, hospitalizations and doctors. The care is also pretty good and I am happy with my doctors.

When I move in December I will cancel my current insurance and try to apply for Pennsylvania Medicaid. I am low income but I am scared I willl be denied for some reason or it will take a long time. This would be bad because I rely on multiple medications. If there is a delay in getting covered, and I run out of my meds , I would have a very bad reaction. Best case scenario I get approved quickly. However I am still curious to how Medicaid healthcare is in Pennsylvania. I’ll need a psychiatrist, primary care, and endocrinologist. Also how is the mental health resources there?

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Odd_Description_2295 t1_iwe4o09 wrote

Mental health services are good if you live in a populated area. If you are a rural, you are going to have to drive.

Medicaid is great, if you can get on it. My wife and kids are covered and the coverage is far better than my private insurer in every way.

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RedStar9117 t1_iwei9jd wrote

Months of waiting if you're a new mental health patient

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Riverrun221 OP t1_iwejcq9 wrote

That is a bit alarming to me . Maybe if I get health care in an emergency I can get my medication from an urgent care?

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PinsAndBeetles t1_iwemzpi wrote

I’m sure if you speak to your current provider they can work with assisting in getting records transferred ahead of time and possibly give you a cushion supply of medication. The wait to see a psychiatrist depends on the area, and a primary care doctor may assist until you get an appointment. Telehealth is an option as well. When you apply in PA for Medicaid your application is usually processed in under 30 days as long as you provide a signed application, income verification, etc. If you’re in an area where UPMC is available it is one of the best Medicaid plans. You’ll get an enrollment packet when you’re approved and can select. Dental coverage is not the best. Make sure you show proof of your closure date in your previous state.

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secret-bid1121 t1_iwetb4q wrote

Is it a $0 pay plan with UPMC? I have Aetna -0- pay plan & didn’t get a lot of things they said I would. I’m looking for something that covers Specialists (Aetna is $35 & PCP $5) but from what they told me everything is increasing on all carriers. I was supposed to have no cost for generic meds & just had to pay $100 for a new one so now being told it depends what grade it falls into.

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PinsAndBeetles t1_iweva13 wrote

The UPMC for You is a Medicaid managed care plan that is $0 pay and has little to no copays. There is $0 copay for in network doctors and nearly all medications. Again, this specific UPMC plan is a Medicaid plan, but overall I’ve had positive experiences with UPMC overall. I had it at my old job vs Aetna at my current one and the UPMC was better overall.

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RedStar9117 t1_iwekjgz wrote

Yeahbthats probably easier but I'm trying to get my kid a psychiatrist and it's going to be months

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RedStar9117 t1_iweklgx wrote

I'm near Gettysburg so it's not a very populous area

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MungoJennie t1_iwjn8gn wrote

This is a big issue in PA. I used to be able to have my PCP write all my scripts, including the ones for my ADHD, and anxiety, but now I have to rely on mental health services for them.

Whatever you do, if you can, avoid WellSpan Philhaven at all costs. They don’t have nearly enough dr’s, so it can take six months to a year to even get in for your first appt. Then you can only book three follow-up appts at a time. Once you’ve had those appts and you go to schedule your next ones, the dr’s schedule has filled, and you have to wait another six to eight months to be seen again. This effectively bumps you off of your dr’s patient list, which means not only do you need to start all over from the beginning, but you also can’t get your meds filled w/out being seen. The whole place is a giant clusterfuck.

TW: un-aliving I was referred to them Oct 2018, when my fiancé decided to kill himself. I didn’t get my first appointment until sometime around April 2019. I think I had two rounds of appts before they couldn’t fit me into their schedule anymore. My father died last year, and they still haven’t gotten me an appt for that. I finally went and found a grief support group on my own.

They also don’t return phone calls or messages, and they are terrible about getting refills to the pharmacy on time (and these are for meds that you aren’t supposed to go off abruptly). I still see a nurse via telemed, but that’s just to check up on my meds and make sure I don’t have the urge to hurt myself or others. 🙄 I’ve never actually seen the dr who actually prescribes them for me.

I don’t think the office is actually malicious, so much as it is incompetent. They don’t seem to have adequate communication amongst themselves, and no two departments know what each other is doing. If you go anywhere else, take my advice and do that. If you must go to Philhaven, bear in mind what I’ve said.

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RedStar9117 t1_iwjokpa wrote

I'm going to look in Maryland for someone hopefully the waits will not be as crazy

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spoookytree t1_iwf8tsm wrote

Honestly with telehealth available, it may be just more helpful and worth it to try and find someone quicker that way

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scorpiogre t1_iwemh1u wrote

Have you tried to get it set up in Pennsylvania when you arrive? I mean from. California now call Pennsylvania and explain you'll be there xyz date and want to be already set.

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Riverrun221 OP t1_iweop8w wrote

I’m going to try

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Important_Kangaroo41 t1_iwk6l39 wrote

If you know where you will be living, ask your soon-to-be state representative or state senator for help. I’m glad to help you find out who that is if you’d like. Just send me a direct message.

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timg430008171976 t1_iwew82r wrote

I hear certain scripts a urgent care dr won’t write that you will have to be seen by a psych dr to get that’s a big issue in pa

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Riverrun221 OP t1_iwfi0d5 wrote

That’s really awful because if anything happens and I am without medication it is very bad. So in the past where I don’t have a doctor I just go to urgent care . Or emergency room

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myrealusername8675 t1_iwgth9v wrote

Tell your current health care providers about your move ASAP. They can help you figure out the transition. Include in that, as someone else said, talk to the PA medicaid people as well to see if there's anything you can do to get the process started before you move.

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Riverrun221 OP t1_iwhkpqz wrote

I told them, they are going to give me back up medication. But they can’t really do anything else

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spicynuggies t1_iwgi7fz wrote

I went to the emergency room and was able to get a referral and that sped up the process to about 1 month of waiting for me. I now have the psychiatry services I need.

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susinpgh t1_iweth0a wrote

Can you get a referral from your current caregiver?

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Riverrun221 OP t1_iwf2asc wrote

I don’t know how they would refer to another state

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susinpgh t1_iwgyjcp wrote

Couldn't hurt to ask! Maybe there's a related system.

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VeeTheBee86 t1_iwhulak wrote

Your PCP can generally write for most everything except some of the stimulant level CIIs. The only hard time getting in is the initial visit. There’s a lot of demand, and they have to spread our care. Once you’re in, they’re pretty good at keeping you regularly scheduled.

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Riverrun221 OP t1_iweboyn wrote

I would be in Allentown

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Dredly t1_iwekuee wrote

St Luke and Lehigh Valley are the 2 big chains there. Lots of services available... but I would suggest getting the ball rolling now

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Argolock t1_iwfvs2y wrote

This is the comment here. Get the ball rolling on all the paperwork. Insurance providers are a pain to deal with anywhere and PA is no exception.

Also Welcome to PA!

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Fit_Awareness6752 t1_iwgroij wrote

If you qualify for medicare/medicaid you'll be fine Lehigh Valley has some of the best health systems outside of philly

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dancingprotein t1_iwhu8y5 wrote

Insurance options will be solid. You will have insurance options like Aetna and UPMC - had Medicaid for a couple months (Aetna and in the Lehigh Valley) when not employed. Also area is known for healthcare but I’ve not needed to make use of them

Also PA compass is incredibly fast

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Laaazybonesss t1_iwfyow4 wrote

I thought once you were married your spouse cannot be on Medicaid, and they’d have to get on your insurance. Am I totally wrong? Are you still within household income limits to qualify?

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cheesepoltergeist t1_iwebnzv wrote

Second that services are difficult in rural areas. My mom is on MA and she has to drive over an hour for a dentist that accepts MA and they have a 14 month waitlist for appointments.

If you can get the services coverage is good though. Living in more populated areas you should be fine though, I have a cousin in Philly who never seems to have difficulty getting services, including MH.

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Aes_Should_Die t1_iwgpu1e wrote

Depends on how rural. The exurban areas have hospitals that are maybe not good enough to a maybe a planned major surgery, but are good for most else. But if you need some heavy duty healthcare I’d say Pittsburgh and probably Philly are your best bets. I’m sure the other major cities in the east and Erie are fine too as honestly there are hospitals in the rather small cities that can handle most things.

Also how well our coverage is? Only other state I have lived in is WV and I can say it’s much better than there. But idk how it compares against ÇA. We do use our federal assistance. So I guess that’s a plus.

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Revolutioneerie t1_iwe4clm wrote

I used to be on United Healthcare Community, and they covered my PCP, Gyno, medexpress and Psychiatrist visits completely. Most of the places in my area stopped taking UHC, so i switched to UPMC for You -- they've been just as good if not better about covering everything (and they have a YMCA or gym membership for an additional 25 a month, which is super nice)

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G1naaa t1_iwe99bh wrote

Same. On it right now as a student. It is such a huge relief they cover everyyythinggg. Ive never had to pay a copay or if I ever did for prescriptions it was literally a dollar. Emergency visits, specialists, pcps, all available at no cost

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LowNo5584 t1_iwe4zh6 wrote

I use UPMC as secondary for medical to Medicare (GMC Gold), they are good.

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jasons_jukebox t1_iwecf16 wrote

Pennsylvania healthcare is amazing - truly. I moved home from Seattle and I can't believe the difference here. The state has issues, no doubt about it. But you'll be OK here.

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ask_the_fisherman t1_iweh7q3 wrote

People that lived here their entire life fail to see what they have. We have services some travel 100s or 1000s of miles to obtain. In some areas, a hospital may be a little bit of a drive. But you can find most services close to home.

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Riverrun221 OP t1_iwfjp2z wrote

I hope this is true. However, I feel like I’ve been spoiled in California. My health care coverage is universal and the care is amazing. All within 20 minutes of my house. No wait times. And I’ve always gotten free gyno care through planned parenthood. I feel like California is really good and easy to navigate and I am nervous that Pennsylvania will be hard. A lot of people mentioned month long wait times for mental health appointments. And that you can’t get psych meds at a urgent care. These are scary to me because Im bipolar and For the first time in a decade i am really healthy mentally. This is because of my medication. If there is ever a lapse in time where I have to go off my meds, it could be super bad for me. And if an emergency happened I would want to see my psychiatrist or therapist right away. These are things I am worried about but I have to make the move.

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ask_the_fisherman t1_iwhozt5 wrote

Bring your records. It will help you get your meds and services fast. In Pa. a lot of family doctors will write meds if you have the records to prove you take them. This will give you time to secure specialists in the field of health. My wife needed psych care. It took her 10-14 days to get to see a doctor, the counseling took about 3 weeks.

In cities, you will find a larger pool of providers. In rural areas, there are fewer but they tend to be less overburdened with a large number of clients. In either case, it takes about 2 weeks.

I suggest getting your provider to give you a 2-3 month supply of medications to be safe. In Pa, someone leaving for an extended period can get a 3-month supply. Plus having a script with refills is an option. I had meds refilled out of state while traveling. It does take a day or two but can be done.

I can see similarities between Pa and Cali in healthcare. Both states have a lot of universities with medical specialties. I live in the suburbs and doctors and other healthcare services have taken over strip malls or shopping centers. Some have taken over former grocery stores or bowling lanes.

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linkdudesmash t1_iweab3u wrote

Mental health is hard to come by in PA. Normally long wait times to get in.

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Riverrun221 OP t1_iwebz40 wrote

This scares me a bit. I have bipolar disorder and rely heavily on Lithium and an antipsychotic. I will have a 60 day supply of meds but I’m scared that I won’t get care and go off my meds

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linkdudesmash t1_iwed1vv wrote

If you know where you are moving maybe you can start calling now for lead times?

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Riverrun221 OP t1_iwee2pj wrote

I will try. I have to have the insurance though I think before I can make an appointment. But I will do the footwork. Thank you

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largeroastbeef t1_iweh0bz wrote

A lot of times I didn’t show insurance until my appointment I just explained what I will have

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TyeDyeAmish t1_iwf6v18 wrote

Lithium & risperidone are on the list of meds you can get at Walmart for $4. If that isn’t that anti psychotic you take you should be able to get your lithium at least, insurance or not. If it takes awhile to get Medicaid set up just have your CA doc prescribe lithium and send it to Walmart and then you should be able to get your meds.

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Riverrun221 OP t1_iwfk5v7 wrote

HOLY SHIT this comment!!! Thank you SO MUCH. This piece of information is very important to me. Going of my lithium would be my worst fear. Thank you so much

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TyeDyeAmish t1_iwfq2lf wrote

You’re welcome! There’s also GoodRx that can usually get you pills super cheap. Pharmacies may try & discourage you from using it. Push back a little. They don’t like GoodRx cause they lose money. Sucks to be them, I’m not gonna die because some insurance company’s ceo needs a new yacht.

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Riverrun221 OP t1_iwfqo79 wrote

Haha exactly. Thank you so much. Your comment really was the most important out of all 84 comments because I know wherever I am , if there is a Walmart nearby I will be able to have my medication. That is huge

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TyeDyeAmish t1_iwfqyo6 wrote

Aww you’re so welcome. There are other types of meds on that list as well. Weis (local grocery chain) also does something like Walmarts program. I can’t remember their prices though. Also coming from CA to PA, medical marijuana cards are easy to get lol

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Riverrun221 OP t1_iwfr104 wrote

Yes they have my thyroid medication and so many others! And you bet your ass I’ll be getting my medical card hahah

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TyeDyeAmish t1_iwfr5t8 wrote

Those kinda programs are great options!! And look for the Pa medical marijuana page. Great discussion area for medicine in PA.

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Gemsofwisdom t1_iwinby7 wrote

If you're low income, disabled, veteran, or a senior you can get discounts to get your card and to get medicine from some dispensaries. So make sure to ask.

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TyeDyeAmish t1_iwfr9ld wrote

Btw what brings you to PA?

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Riverrun221 OP t1_iwfrngt wrote

my boyfriend is from Newark, and so we are just making the move together, his best friend lives in Allentown in a nice condo and has a large cozy room for us for very cheap. More opportunities out there for what he does. He wants to be home and I’ve never experienced the east coast really. So I’m doin it and I’m very excited. I’ve listened to the song Allentown by Billy Joel a bunch of times and have been researching nonstop . I’ve had a bad year and this is gonna be good for me .

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TyeDyeAmish t1_iwfs3l9 wrote

My “brother” lived up in Allentown so I’ve been there a bunch. I live in Lancaster now. Home of the Amish. Allentown has some cool stuff. Look up White Castle. It’s delicious! That sounds cool though, you’ll defintely experience the east coast out here. Sorry you’ve had a rough year. Me too. Hope it starts getting better :)

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Riverrun221 OP t1_iwfs83e wrote

I think it will be cool when I see Amish people! And I want to go to the farmers markets. Hope next year is better for you as well!

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Riverrun221 OP t1_iwfkk80 wrote

Also I looked it up and they also would cover my thyroid medication. This eases my mind so much

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[deleted] t1_iwe5qfk wrote

https://wallethub.com/edu/states-with-the-most-and-least-medicaid-coverage/71573

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[deleted] t1_iwe5tuf wrote

The biggest challenge will probably be finding mental health resources if you’re moving to rural PA.

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Riverrun221 OP t1_iwebpqy wrote

I’ll be in Allentown

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CharacterBrief9121 t1_iwelf6y wrote

Call CCBH when you move here, on state insurance they’re what handles pretty much all behavioral and mental health aspects for the state insurance. Had to go through this for my son minus moving. My experience with them has been great, was able to get a real person who seemed motivated to help me, gave me several options and leads for new doctors. Did a follow up call a week later and helped me figure some more stuff out.

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ask_the_fisherman t1_iwehdli wrote

A lot of rural areas have mental health services. They do lack hospitals though.

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gr3ybacon33 t1_iwessyo wrote

I moved recently to PA. It was a fairly quick process to apply and get approved for Medicaid, but I have a disability that I think made it easier. Finding mental health care was trickier, every place I reached out to either had long waitlists or wouldn't take me as someone with a history of psych hospitalizations. I set up a new PCP and he agreed to prescribe my psych stuff for me until I found a new provider, and also gave me a referral to a psychiatrist who was able to get me in within a month.

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Riverrun221 OP t1_iwezuq4 wrote

They won’t take you if you have past of hospitalizations? What the hell? I have 5 hospitalizations in the past 10 years

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WinterWontStopComing t1_iwewrkl wrote

I’ve found the mental health service coverage better than any private medical coverage I have ever had

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Wordnerdinthecity t1_iwezis9 wrote

From my experiences:

  1. CCBH will be your mental health service provider. They can sometimes have longer waitlists, but if you call them and tell them you need to see someone soon, and are flexible about time and distance, you can almost always find SOMEONE.
  2. If you work, and take ANY medications at all, mark the box on the medicaid form that says you have a disability. You can get MAWD and it's sliding scale medicaid up to ~80k a year, with minimal premiums (A friend of mine makes ~50k/yr and pays ~$20/m, zero copays). You may need a GP to fill out a form saying you take "health or life sustaining medications or has other medical needs that require ongoing care".
  3. Specialists will have waitlists, but the same is true if you have commercial insurance, and IME my wait times have been the same or shorter with medicaid than my SO who has top tier commercial insurance through his dad's employer.
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Riverrun221 OP t1_iwflrec wrote

I take a lot of medications for bipolar 1 and hypothyroid. Someone else said that I should mark No on the disability box because they can deny me for that reason? Or were they wrong and I should mark it because it will help my case? I don’t know what to do .also how would I get a GP to fill out the form if I have no insurance ?

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Wordnerdinthecity t1_iwhm7rz wrote

I was approved for regular medicaid within 30 days (I want to say it was like, 2 weeks, but that was prepandemic) because I'd quit my previous dayjob and I was going self employed. My income from the self employment the previous year had only been ~7k because it was alongside my dayjob, and so limited what time and energy I could devote to it. Since I left the dayjob, they didn't count what I made there towards my income anymore. And then I was able to get the form by calling the medicaid customer service line, had my GP do it, and sent that in.

I'd highly recommend if you aren't sure, try calling the PA benefits center once you've moved. They can do the application for you/check if there's other benefits you can be eligible for while you're at it.

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Away-Living5278 t1_iweajhm wrote

The biggest thing you'll have to keep in mind is there's been a freeze on reviewing Medicaid eligibility since covid. It will likely expire in 2023. Many millions of people will lose coverage. If you've had income changes in the last few years this could affect you (in CA or PA). I would check this before you cancel your current insurance, even a few more months would be better than none. However if you don't qualify for Medicaid anymore, definitely sign up for the state's health insurance exchange. Won't be free most likely but will be heavily discounted.

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Riverrun221 OP t1_iwfl9e8 wrote

What does this mean?

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Away-Living5278 t1_iwgcpiq wrote

It means a lot of people make too much money to be on Medicaid but they don't know it because eligibility has been frozen since 2020 in order to make sure as many people as possible had coverage in case they got really sick with covid. And probably sometime in 2023 everyone nationwide will have to prove their current income to remain on Medicaid. BUT for most who don't qualify, they can get nearly free plans on the State Health Exchange.

If you haven't bounced in and out of Medicaid eligibility before, it's less likely this will affect you. Probably a lot of those affected will be women who qualified due to pregnancy since the limits are higher.

(Sorry if I'm scaring you with this, that's not my intent I just think it's terrible that most people don't know bc it's a lot of people affected).

https://www.kff.org/medicaid/issue-brief/10-things-to-know-about-the-unwinding-of-the-medicaid-continuous-enrollment-requirement/

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Riverrun221 OP t1_iwhhux5 wrote

Well thank you that’s good to know! I think I’ll be ok since I don’t work. And when I get a job it will be very part time.

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FFistDaddyKai t1_iweuapk wrote

I work for a treatment program in the greater Philadelphia area. I recommend you check the box for Keystone 1st. They have the most thorough coverage for long term health and mental care (including meds). You should know that your mental health coverage (including and addiction treatment if needed) will be managed through CCBH (Community Carw Behavioral Health), and all PA Medicaid is capitated to the local county where you reside -- your provider(s) have to accept Medicaid for your county of residence. In other words, you could live in Delaware County on the County line and seek care at a clinic close by, but in a different county, like Montgomery. If your Montgomery County provider doesn't take Delaware County Medicaid, you will have to pay out of pocket (or seek care elsewhere). You should be able to do a search ahead of time for providers through the CCBH website. Good luck! Welcome to PA (soon).

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artificialavocado t1_iwf3m33 wrote

Lots of good advice here. I’ve never been on it myself but from what I’ve gathered, which the expanded medicaid the application process is actually quite easy and doesn’t take super long. Back in the day it used to be a giant booklet.

As far as mental health services go it will of course be highly dependent on where you live. PA is a very “average” state overall in things like public services so my hunch is that we are pretty average in access. I live in a smallish town and access isn’t that bad although you typically do need to travel a bit for a specialist sometimes.

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jlebro12 t1_iwg4pd5 wrote

You won’t have any problems here at all. I am a provider in healthcare. I can use meds with the best evidence for Medicaid patients, they have monthly costs of > $1,000. Meanwhile they are unaffordable to many mid to higher income working people (pending their specific commercial plan benefits) and most Medicare patients. It is actually unfair in my view how much better Medicaid coverage is here. You have nothing to worry about. I hope we get better coverage for all someday.

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NeumaticExpert t1_iweakqf wrote

So my experience with therapy around here has been pretty solid from MY personal experience. HOWEVER, if you need to be admitted to a mental ward like I have good luck cus your treatment may vary greatly, I’ve heard awful things and ok things. Minus the food, the food service in every ward (to my knowledge) slaps.

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Riverrun221 OP t1_iwec6c0 wrote

I hope it never gets to a point where I need to be hospitalized , I had a very traumatic 14 day experience and swore I would never admit myself no matter how bad it got

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NeumaticExpert t1_iwecmpp wrote

Just be careful, it’s better to admit yourself than have the government do it for you, you lose a lot of rights if you get forcefully admitted. A big one around here is losing your gun rights, PA kinda be real big on guns

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Riverrun221 OP t1_iwfkn3r wrote

I don’t think it’s different by admitting yourself. Because once your 5150 you lose all your rights and have no say. I was recently held for 14 days against my will. Also I can’t own guns for 5 years

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NeumaticExpert t1_iwgkyru wrote

I’m sorry to hear that, I was on the cusp of being forcefully admitted but caved and signed myself in, so I still have my gun rights in that regard

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Riverrun221 OP t1_iwhizyw wrote

That’s crazy, how do u still have gun rights? In my state I admitted myself willingly and no matter what they put you on a 5150 hold and can hold you however long they want. And then you can’t have guns for 5 years. I’m glad about that because I never want guns and I shouldn’t have them because of my suicidal tendencies

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NeumaticExpert t1_iwhjekw wrote

When you admit yourself here you can leave when you want if they asses you to not be a threat to yourself or others (take that how you will), and assuming you comply with their rules you can keep your rights for the most part

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Riverrun221 OP t1_iwhoix7 wrote

Interesting. Admitting myself and getting put on a 5150 hold I was stripped from all my rights. I was treated like a criminal. Dehumanized for 14 days. I will never admit myself to a hospital ever again because of it.

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NeumaticExpert t1_iwi35zm wrote

For all the many many many many flaws this state has, being in the hospital is better than dying. The mental health system is a joke everywhere you go in this country, PA is no exception, but at least you might get some level of care, maybe

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Gigispeedy68 t1_iwee9bj wrote

Apply for medical insurance via Pennie (website). My son is no longer eligible under my employer plan (aged out) and applied and was eligible for Medicaid. It is basically the state’s insurance market place.

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trickytreats t1_iwepcmi wrote

I could be wrong but I think it’s hard to get Medicaid on income alone. If you have a pre-existing condition I think you would be able to, or if you’re low income and have kids. PLEASE don’t quote me on it though, this is just what I’ve observed. In rural PA here and it’s a little hard to find mental health services lately. Not impossible but therapists switching a lot and waiting for an ideal one

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Wordnerdinthecity t1_iweyh7u wrote

If you take ANY medicine, even if you get your GP to prescribe your allergy meds, and work, you can get MAWD coverage in PA which has sliding scale medical coverage up to ~80k. Talk to the PA benefits center if you don't believe me. It's how I get my medical coverage, including mental health services.

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Riverrun221 OP t1_iwfl4br wrote

When I apply for Medicaid, someone said they ask you if you have a disability or illness. They said they could deny me because I have one (bipolar and hypothyroid). So I thought I wouldn’t. But would it be better if I did? Im not sure

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olive_ate_my_pimento t1_iwf34c1 wrote

As a mental health provider, I see Medicaid covering therapy sessions completely (provided the therapist accepts Medicaid; not all do). Waitlists are often long. I would recommend getting on a couple now. Psychiatrist waiting lists are also long; again get on the waitlist or schedule the appointment now if you can (for your future date). Others recommend getting an extra perscription from your current provider; this is a good idea. You might also want to see if your current provider will see you via telehealth as you transition your care to PA. You will need to be aware of your stop date for your current insurance, but there may be some time to help you transition. It's worth asking.

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Riverrun221 OP t1_iwfm6bg wrote

I’ll need to cancel my insurance to apply for Pennsylvania insurance. So once I cancel it then I can’t see any of my California doctors anymore. In terms of wait list, without insurance how will I know which doctors to be on a wait list for?

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olive_ate_my_pimento t1_iwgiqyy wrote

Sorry, in a hurry and hit the wrong button and posted above. So, look up to see the answer 😉

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spoookytree t1_iwf8jf0 wrote

I’m in the process of waiting now for mine. As long as you upload everything they ask for the first time or upload what you are missing in a timely manor, the process is 30 days. (I had asked when I was in the phone getting help with something.) However I’ve lived in PA my whole life so I’m not sure how that works about moving from another state. Either way here is the contact page for COMPASS where you sign up to apply. I would maybe call the number under where it says “ Have a question about Department of Human Services benefits or eligibility?” And just ask how that process works and what to expect so to make sure this gets done quickly.

Good luck!

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gottarun215 t1_iwfg2a9 wrote

I'm on PA medicaid now and it's pretty good. Get choice of like 5 different health insurance plans at different companies and I never pay for anything except sometimes a $2 copay. I chose a UPMC plan and it's pretty good for medical care. I've had issues with physical therapy as the ones in network are not very good and they tried to deny coverage out of network after previously approving it for a specific issue. I haven't used their mental health services.

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QueenMabs_Makeup0126 t1_iwg1b0p wrote

Hi! I’m going to echo some things others have said:

  • Go asap to the office where your Medi-Cal is handled to start the process for transferring your MA to PA. Here in PA you have to go to the county assistance office (CAO) if you want to make any changes to your Medicaid coverage. That way there isn’t a drop in your coverage and you don’t have your medications disrupted.

  • In PA the move has been towards Medicaid Managed Care (MCO). There’s multiple MCO plans to choose from that cover the area where you plan to move: Geisinger Family, Health Partners, AmeriHealth Caritas, UPMC for You.

  • You should be able to find primary care and the specialists you need prior to moving. Places such as HealthGrades and WebMD do have lists of providers and hopefully what insurance they accept.

-One thing to keep in mind is that for PA Medicaid, providers can “close” their panel after a certain number of Medicaid patients. If you choose a provider, you need to confirm if they’re accepting new patients.

  • Start the process now to find the mental health services you need and ask your current provider now to assist. The rural areas don’t have as many behavioral health/mental health providers as the cities.

Welcome to PA!

PA Medicaid was expanded under Gov. Wolf

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Riverrun221 OP t1_iwhh3wz wrote

I want to make appointments now but I won’t know what insurance I would have. I will be in Lehigh valley and I want to try UPMC so should I just go for that?

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yorkkat18 t1_iwgfyvx wrote

I have Medicaid and almost everything is covered. It’s a real life saver. I have therapy covered and I’ve also been to multiple specialists for various things. All covered. Find your local county assistance office and talk to someone there, they are normally pretty helpful. And when you get a gp it may take awhile for an appointment so urgent care is a good option (covered under Medicaid)

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Hannah_Sea t1_iwgg7ln wrote

As a mental health therapist that used to work in Allentown, there are a bunch of great therapists that accept Medicaid. It can be difficult to find but a really good resource is Psychology Today. You can filter by what type of insurance you have. Good luck!

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spicynuggies t1_iwghs7k wrote

Mental health services are pretty decent. Even though they couldn't get me in with psychiatry right away I was able to see a Physician Assistant and get checked out within a month regardless.

Like others said, rural areas are much more underserved. You will likely have to wait a month or two for an initial appointment, a referral will always help speed up the process.

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olive_ate_my_pimento t1_iwgikli wrote

When you cancel ask what your last day of coverage is. When you call to schedule appointmwnts/get on the waitlist, ask the provider if they accept state insurance. That way you will know you are with a provider that accepts it. It generally does not take too long to get accepted. I have seen it happen pretty quickly. Also if someone has substance abuse problems, there is additional help at the county level (throwing that out there in case someone else needs the info).

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AlucardEmery t1_iwgmytz wrote

i’m on medicaid and it’s kind of a mixed bag. physical doctors appointments are covered and so are medications but dental is horrific. i was told i have to wait for my teeth to fall out (that’s literally what they said) because it won’t cover root canals or crowns. 🥴 mental health is sort of a mixed bag too. my current therapist doesn’t take medicaid and a lotttt don’t either but i love my therapist so i pay out of pocket because i can’t imagine seeing anyone else. that said, if you go through the list of medicaid approved therapists you should be fine. just be prepared to be on a wait list.

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chrisbarry3 t1_iwf2ax1 wrote

I'm afraid you are in for a rude awakening here in P.A.

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JoeK1337 t1_iwf9c32 wrote

Philadelphia is a dump

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HogwartsKate t1_iwfdrim wrote

No state beats CA on benefits. CA takes care of their peeps!

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Riverrun221 OP t1_iwfme94 wrote

They really do. There are endless programs to take advantage of .

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daywalkerredhead t1_iwhfl3n wrote

I live in Pa and also work in healthcare. Medicaid is starting to crack down on a lot of things simply due to the system being so abuse by those who really don't need it. A lot of people in Pa (which I'm sure it's everywhere) live on welfare as a lifestyle not because they actually need the help for one reason or another. So, that puts people, like yourself, in the dark. I have been finding that if you have a consistent track record with a family physician or other doctors and most of your health problems are medically necessary, backed up by said physicians, you should be very okay with getting the care/coverage you need.

As for mental health ... it's far and few between and even once you find somewhere, the waitlist is long. Last year I went to the ER for a severe panic attack, felt like I was having heart palpitations, thankfully I wasn't, it was just my nerves. The PA at the ER made a referral to psych just in case I decided to finally go on anxiety meds. I shit you not, a year and 10 days later, I was called to see if I needed an appointment. I mean, thankfully I have a good support system and have my anxiety in check for the most part but, dear God, what if I were suicidal and in real dyer need of care???

I saw you mention you will be in Allentown. Leigh Valley and St. Luke's are the two biggest providers in the area down there. St. Luke's is starting to do partnership with Geisinger so, I'm losing faith in St. Luke's. Geisinger is a HUGE provider throughout most of Pa with UPMC being the other major provider. Geisinger has some truly amazing physicians and services, HOWEVER, they see most patients as a number or $$$ sign and could give two shits less about actual care. This is coming from not only person and family experiences but now, being on the inside of healthcare, I truly see the bad that they do.

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ShortPark4671 t1_iwea3dz wrote

When I had Medicaid in PA it only covered preventative dental procedures (X-rays, cleaning). I don’t remember seeing anything about mental healthcare being covered. I didn’t use it very often but when I did, I didn’t pay anything for a regular doctor visit & medicine.

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Riverrun221 OP t1_iwebnm0 wrote

I feel like there should be no question if mental health care is covered , physical health problems are just as bad as mental health issues. That would be unsettling if not

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Riverrun221 OP t1_iwebvnh wrote

I would think mental healthcare should be covered along with physical health

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excusemydust t1_iweiiip wrote

I believe I saw elsewhere on this post where you indicated you’ll be living in Allentown, which is in Lehigh county. With Pennsylvania Medicaid, you’ll have your choice of several different physical health insurance providers, but each county has only one behavioral health provider. In Lehigh county, that will be Magellan Healthcare. This is their website which includes a directory of providers in the county. https://www.magellanofpa.com/for-members/county-info/lehigh-county/

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Extreme_Qwerty t1_iwegjfy wrote

Westmoreland County resident here (just outside of Pittsburgh)

Before Pennsylvania opted into the Medicaid expansion, there were (and may still be) mental health resources available on the county level.

My Rx and doctor visits were covered; I participated in Westmoreland Casemanagement and Supports, a nonprofit. I think they contracted with the county to provide MH services to low-income individuals.

They may have something like that in Allentown.

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Extreme_Qwerty t1_iwehioi wrote

Medicaid in Pennsylvania DOES cover mental health treatment.

I'm on Medicaid, but have not used the program's MH services myself.

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Euphoric-March-8159 t1_iwejzn1 wrote

Terrible compared to california

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Riverrun221 OP t1_iweobi3 wrote

I’m nervous and a bit worried about it

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curiousbanana_1 t1_iwew93k wrote

You shouldn't worry too much, you indicated that you're moving to Allentown over in Lehigh County. Allentown is considered a suburb of the city of Philadelphia, the state's largest city with plentiful access to all care, even on Medicaid. Greetings from Lancaster County PA.

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Wuz314159 t1_iwe58uz wrote

I don't think we have healthcare here. Nothing I can afford anyway. I just try not to get sick.

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Riverrun221 OP t1_iwe9eac wrote

There is Medicaid and it is for low income and is free

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Wuz314159 t1_iweakqs wrote

In my experience, I never quality for assistance even though I only make $10k a year.

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PinsAndBeetles t1_iwenwya wrote

You need to apply and provide all the necessary verifications. If this is your income you are under the limit, however perhaps you did not provide something requested and were rejected for that, not income.

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Wuz314159 t1_iwep69f wrote

You are 100% correct & I didn't say different.

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PinsAndBeetles t1_iwepl3i wrote

Apply again, provide what is needed and get your ass covered! Everyone should be able to go to the doctor when they’re sick. If you need help you can visit your local County Assistance office and someone can help you complete and application and let you know what you need.

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susinpgh t1_iweu9yr wrote

With that income, you should qualify. Can you talk to you legislator? Sometimes their office can help.

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Riverrun221 OP t1_iwebtan wrote

I’m so sorry that is awful! I don’t work and if I do get a job it would be part time . I hope I qualify !

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Wuz314159 t1_iwem7gn wrote

There are always hoops to jump through. When I applied for food stamps, You had to earn less than idk $30k, Own one home, (I owned none) own 2 cars {1 unlimited value, 2nd less than $50k} (I owned none), and have no more than $1000 in the bank, (I had a retirement account w/ $2000 in it, so I did not qualify)

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PinsAndBeetles t1_iwerdoh wrote

You haven’t applied recently I gather. I have worked at DHS administering SNAP/MA/TANF/LIHeap for almost a decade and at no point in my tenure there were these resource limits in place for SNAP. Reapply if you’re still interested.

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Wuz314159 t1_iwesdug wrote

I got the application. Saw the requirements & called to verify. I can take 'No' for an answer.

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Riverrun221 OP t1_iweonc3 wrote

What the actual fuck! So if you don’t own a home or have two cars you can’t get food stamps?! That’s so fucked up. In California I didn’t own anything just was low income and I got 500$ a month in food stamps

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PsychoCelloChica t1_iwfcx0d wrote

That poster is dead wrong about current SNAP rules. Almost no one is subject to a resource limit for SNAP these days due to something called Categorical Eligibility rules.

Same for Medicaid. While some categories have resource limits depending on your individual circumstances, they NEVER apply to children and most adults are exempt as well.

The current income limit for Medicaid in PA for a single adult (ages 19-64) is $1563/month.

A working disabled adult could earn up to ~$2300/month and still qualify for free Medicaid or up to $5664/month and qualify for MAWD, which is Medicaid with a premium based on your income. The publicly posted limits look lower, but don’t take into consideration the income deductions that many people qualify for.

If you want to be SUPER prepared and cautious, have one of your current providers fill out this form before you move so you have it on hand if they ask for it. (Although it will almost certainly be unnecessary if you aren’t working.)

PA is very strict on timeliness and over 95% of cases are processed within the 30 day time limit, but if you upload all the documentation they need to make a decision and answer when they call for a Food Stamp interview, they will process it right away. No caseworker wants to sit on your case and go back to it later. They seriously just want to process it and move on. They’re also required to call you the same day or next day if you apply for SNAP.

Even if something goes wrong along the way and you are denied, you can request an expedited appeal hearing due to it negatively impacting your health, which gets your appeal heard within about a week.

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Wuz314159 t1_iweoyyu wrote

No, No, No.... Those are limitations on assets. I had no assets... except $2000 in a retirement CD.

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