I'm 27, uninsured, currently live in FL but travel to NY for school. My school doesn't offer student health insurance, just on-campus accident insurance included in my tuition. I've had NY Medicaid coverage in the past while I was pursuing my first degree but I had to move to FL to stay with my parents for financial reasons while I'm finishing my second.
Last week I was diagnosed with Multiple Sclerosis after being hospitalized for 5 days.
I didn't apply for FL Medicaid because I spend 8 months out of the year in NY so I thought re-applying for Medicaid in NY would be the way to go. At the very least, the medication I need is on their formulary.
Some things I've been pondering:
1. Does Medicaid discriminate against pre-existing conditions?
2. Do I have too find another neurologist in NY? If so, can I still keep my neurologist in FL but pay out of pocket?
I love the FL neurologist that oversaw my care in the hospital. I may be clinging to him like a deer in headlights but everyone says once you find a good one to stick with them. I had a really awful experience with my last neuro several years ago.
I know NY Medicaid won't cover any visits to my FL neuro but in the event that I can keep him,
3. Would NY Medicaid accept/approve a prescription written by a doctor from out of state?
The treatment I need is a box full of self-injection kits that are usually delivered by a mail order pharmacy. I can have someone pick up and re-ship them to me when I'm back in FL.
4. What about a lab test ordered from out of state?
I'd need blood work every 3 months and another brain MRI way down the line to check for lesions/activity.
5. Should I just NOT get insurance (I applied for a medication assistance program while I'm in limbo), but pay for my neuro visits/blood work out of pocket and get a free annual MRI through the National MS Society?
I have never seen declining to pay for Pre-existing conditions; however they do not offer coverage out of state the way a regular health plan does. If you are applying for Medicaid in NY & live there the majority of time, you will be better off finding a specialist in NY to manage your care & treatment.
In the event that you want to keep your original care giver in Florida in the loop, you can ask him if he will consider keeping your record updated based on the NY specialist's feedback. That way you can switch back to him if you need.
As for whether NY Medicaid will pay for your prescription by an out of state physician; I have not experienced drug benefits be denied based on who prescribed the drugs as long as the prescriber is qualified.
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