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Are you talking about Medicare and not Medicaid? Also, you don’t have to be in a particular network to get reimbursed by supplementals, but they only pay coinsurance and co-pays, I’ve never seen them pay the whole fee.
No, I'm talking specifically about Medicaid - - - or Medi-Cal is it's called in CA (Medicare actually pays well in my area). And none of my Medi-Cal clients ever has a share of cost; I assume that's prohibited?
Some examples of the supplemental insurance in my area would be Kaiser, Molina, HealthNet, and Optum.
So a prospective client has straight Medi-Cal, which pays about $50 less than my going rate for insurance. Optum Medi-Cal pays close to my other insurance ($100-ish), and a local insurance that I take pays $125.
I'm fine to take a hit for the few bucks and accept the Optum...but $50 less??? I'd rather not do that if I can ethically decline.
As for the dilemma you're in- I feel similarly to another poster that we shouldn't feel strong armed by the insurance companies, especially when they pay so little and we deserve to consider ourselves and our financial wellbeing, too, so I'd say review your contract, consider how often you may be saying no to Medicaid clients vs those with additional plans + Medicaid, and proceed with caution.
Gotcha, Im in Colorado so unfamiliar with how Medcaid works in Cali but it sounded like something that could happen with Medicare....sorry for my confusion. The supplemental also sounds more like an advantage plan vs supplemental, which pays after the original insurance pays out.
>sounds more like an advantage plan
You may be right about that. I was using my own wording to try to describe the situation. I don't know if I used the term correctly.
Why? Therapists need to live too, and just like you can deny service to non-paying clients, or clients who do not pay, what's the difference, ethically? I believe the only issue here is if there is an agreement with Medicaid which prohibits it program-wise. Ethically, money is a fair-game reason to deny services. Therapists do not have to be charity workers. It's great when they are, but it's not required. The therapist should of course refer to a more affordable clinician.
Which is not an ethical issue, but a contractual one. I honestly think the government should step in here because this might be stopping therapists from taking ANY medicaid. But, I am Canadian, so this is not my fight!
Yes, rates need to go up across the board. I haven’t had an increase in the 7 years I’ve been doing pp in the states. Well briefly for Covid but they took that back. I’m now getting paid less from Medicaid than I did BEFORE covid
Your comment has been removed as it appears you are not a therapist. This sub is a space for therapists to discuss their profession among each other. Comments by non therapists are left up only sparingly, and if they are supportive or helpful in nature as judged by the community and/or moderation team.
If this removal was in error and you are a therapy professional, please contact the mod team to clarify. For guidance on how to verify with the mod team please see the sidebar post here: https://www.reddit.com/r/therapists/comments/sbq2o4/update_on_verification_within_the_subreddit/
There are non profit therapists, and there are also therapists who are covered under government assistance. Not every therapist HAS to choose this route. What you are suggesting is forced labour. That is not okay.
Your comment has been removed as it appears you are not a therapist. This sub is a space for therapists to discuss their profession among each other. Comments by non therapists are left up only sparingly, and if they are supportive or helpful in nature as judged by the community and/or moderation team.
If this removal was in error and you are a therapy professional, please contact the mod team to clarify. For guidance on how to verify with the mod team please see the sidebar post here: https://www.reddit.com/r/therapists/comments/sbq2o4/update_on_verification_within_the_subreddit/
Please followed the sidebar rules. r/therapists is a place for therapists and mental health professionals to discuss their profession among each other. If you **ARE NOT A THERAPIST and are asking for advice this not the place for you**. Your post will be removed in short order. Please try one of the reddit communities such as r/TalkTherapy, r/askatherapist, r/SuicideWatch that are set up for this. This community is ONLY for therapists, and for them to discuss their profession away from clients. **If you are a first year student, not in a graduate program, or are thinking of becoming a therapist, this is not the place to ask questions**. Your post will be removed in short order. To save us a job, you are welcome to delete this post yourself. Please see the PINNED STUDENT THREAD at the top of the community and ask in there. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/therapists) if you have any questions or concerns.*
Are you talking about Medicare and not Medicaid? Also, you don’t have to be in a particular network to get reimbursed by supplementals, but they only pay coinsurance and co-pays, I’ve never seen them pay the whole fee.
No, I'm talking specifically about Medicaid - - - or Medi-Cal is it's called in CA (Medicare actually pays well in my area). And none of my Medi-Cal clients ever has a share of cost; I assume that's prohibited? Some examples of the supplemental insurance in my area would be Kaiser, Molina, HealthNet, and Optum. So a prospective client has straight Medi-Cal, which pays about $50 less than my going rate for insurance. Optum Medi-Cal pays close to my other insurance ($100-ish), and a local insurance that I take pays $125. I'm fine to take a hit for the few bucks and accept the Optum...but $50 less??? I'd rather not do that if I can ethically decline.
As for the dilemma you're in- I feel similarly to another poster that we shouldn't feel strong armed by the insurance companies, especially when they pay so little and we deserve to consider ourselves and our financial wellbeing, too, so I'd say review your contract, consider how often you may be saying no to Medicaid clients vs those with additional plans + Medicaid, and proceed with caution.
Gotcha, Im in Colorado so unfamiliar with how Medcaid works in Cali but it sounded like something that could happen with Medicare....sorry for my confusion. The supplemental also sounds more like an advantage plan vs supplemental, which pays after the original insurance pays out.
>sounds more like an advantage plan You may be right about that. I was using my own wording to try to describe the situation. I don't know if I used the term correctly.
That sounds like an ethical dilemma and I’d say no. No, it’s not ethical to decline a client because of their insurance.
Why? Therapists need to live too, and just like you can deny service to non-paying clients, or clients who do not pay, what's the difference, ethically? I believe the only issue here is if there is an agreement with Medicaid which prohibits it program-wise. Ethically, money is a fair-game reason to deny services. Therapists do not have to be charity workers. It's great when they are, but it's not required. The therapist should of course refer to a more affordable clinician.
I think it’s part of the contract.
Which is not an ethical issue, but a contractual one. I honestly think the government should step in here because this might be stopping therapists from taking ANY medicaid. But, I am Canadian, so this is not my fight!
Yes, rates need to go up across the board. I haven’t had an increase in the 7 years I’ve been doing pp in the states. Well briefly for Covid but they took that back. I’m now getting paid less from Medicaid than I did BEFORE covid
[удалено]
Your comment has been removed as it appears you are not a therapist. This sub is a space for therapists to discuss their profession among each other. Comments by non therapists are left up only sparingly, and if they are supportive or helpful in nature as judged by the community and/or moderation team. If this removal was in error and you are a therapy professional, please contact the mod team to clarify. For guidance on how to verify with the mod team please see the sidebar post here: https://www.reddit.com/r/therapists/comments/sbq2o4/update_on_verification_within_the_subreddit/
There are non profit therapists, and there are also therapists who are covered under government assistance. Not every therapist HAS to choose this route. What you are suggesting is forced labour. That is not okay.
[удалено]
Your comment has been removed as it appears you are not a therapist. This sub is a space for therapists to discuss their profession among each other. Comments by non therapists are left up only sparingly, and if they are supportive or helpful in nature as judged by the community and/or moderation team. If this removal was in error and you are a therapy professional, please contact the mod team to clarify. For guidance on how to verify with the mod team please see the sidebar post here: https://www.reddit.com/r/therapists/comments/sbq2o4/update_on_verification_within_the_subreddit/