Health Insurance Basics: Which Doctors Take Medicaid? | Health Insurance Basics
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Health Insurance Basics

Where to go for Care with Medicaid

If you get your health coverage through Medicaid, you likely know that Medicaid covers a number of benefits, including:
  • Doctor visits
  • Inpatient and outpatient hospital services
  • Mental health services
  • Medications
  • Prenatal and maternity care
  • Preventative care, like immunizations, colonoscopies and mammograms1

 

For a full list of benefits click here:

Learn More

 

It’s also good to know where to go when you need medical attention.

 

Primary Care Physician

Your doctor, usually your family’s doctor or child’s pediatrician, is a good place to start. You see him or her for most of your healthcare needs. They can point you in the right direction if you end up needing more specialized care.

 

When you’d see them:

  • When you are well—to help you stay healthy
  • When you need vaccinations
  • When you’re sick with things like an earache, sore throat or cough
  • When you have a health concern
  • To manage ongoing issues

 

Specialist

Sometimes your doctor may ask you to see a specialist if you need expert care that they cannot provide. These specialists provide patients with care for certain types of health issues and may focus on areas like care of the heart, lungs or bones. You may need a referral so be sure to check with Gateway and your PCP before seeing a specialist.

 

When you’d see them:

  • When you need to get specialized care for a new or ongoing health issue

 

Behavioral Health Provider

You may see a behavioral health provider if you need care for a mental or substance abuse issue. Psychiatrists, psychologists and therapists all fall into this category. You may need a referral so be sure to check with Gateway and your PCP before seeing a behavioral health provider.

 

When you’d see them:

  • When you need to make sure your medicine is working the way it should
  • When you need therapy or counseling
  • When/if you start noticing worsening mental health symptoms
  • If you need help and support in treating a concern about alcohol or drug use

 

Urgent Care or Walk-In Clinic

If you are sick or hurt, but it is not an emergency. If your doctor isn’t available, you can visit an urgent care or walk-in clinic. Most are open evenings and weekends and an appointment isn’t necessary. However, if you see a doctor at an urgent care or walk-in clinic, it’s important to follow-up with your PCP. You should also check that the urgent care or walk-in clinic is a part of your health plan provider’s network.

 

When you’d see them:

  • When you have an injury such as sprains/strains, minor cuts or burns
  • When you’ve got an illness such as an earache, sore throat, low-grade fever or rash and can’t get an appointment with your PCP within 24 hours

 

Emergency Room

If you have a serious or life-threatening illness or injury, the emergency room will provide the care you need. Emergency rooms are not used for care that could be provided by a PCP or specialist. It is important to follow-up with your PCP after you visit the emergency room as he or she can help you make a plan for continued care.

 

When you’d see them:

  • When you have uncontrolled bleeding, chest pain, or symptoms of a stroke
  • When you’re having a hard time breathing
  • If you’re experiencing vomiting or diarrhea that won’t stop
  • If you’re experiencing blackouts
  • When you may have poisoning of some kind
  • If you’re having thoughts of hurting yourself or someone else

 

If you’re unsure about the type of care you need and your PCP is not available or you have a health related question, you can call Gateway Health’s 24 Hour Nurseline at 1-800-392-1147.

  1. https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/ProgramBasics.pdf

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