Here in Indiana, getting on Medicaid as an adult is almost impossible anyway. Of course, the "Hoosier Healthwise" program for children is actually pretty awesome, so I don't complain too much about my own lack of health care. However, that doesn't mean I wasn't looking forward to possibly getting myself on Medicaid when the much-touted eligibility changes kicked in. After all, unless a miracle occurs, we're still going to be below 133% of poverty in 2014.
So, it was pretty disheartening today when I received a letter from the FSSA for each of my children. The letter, entitled IMPORTANT CHANGES TO YOUR MEDICAID BENEFITS EFFECTIVE JANUARY 1, 2011 detailed a few shifts in benefits.
Fortunately, for now, all the benefit changes only apply to people over 21 years old (I guess Medicaid doesn't have to follow the 26 year old rule). However, it's obvious that the changes are meant as "cost-saving measures" for when more adults become eligible, and I fully expect more changes to creep in over the next three years.
- You have to have prior authorization for any hospitalization except for labor/delivery or emergencies. Admittedly, that sounds about normal, but we've heard how the insurance company definition of emergency and the regular definition are sometimes two different things, so I'm leery. But, in general, I don't have many problems with this.
- Dental benefits are limited to $600 annually except for in emergencies. There was always a $600 cap in general, but there were some services that didn't count towards it such as regular checkups. Now, everything except emergencies counts. Again, I'm not sure what their definition of an emergency is. I assume that means that if a car wreck knocks your teeth out you can get them replaced. However, I do know that now, even if I do get on Medicaid, I still can't get my partials, which means I'm still going to be mostly toothless. Dentists that take Medicaid are a rarity anyway, and the local one I found charges about $80/visit just for a cleaning.
- You can have new glasses every five years. Now, instead of every two years, you get new glasses every five years unless your prescription drastically changes. Isn't that nice of them? It's already hard to find a provider who will make Medicaid glasses because they only cover $30 for frames. Wonder what would happen if you broke your glasses in there? I remember one year where I spent four months using duct tape and prayer to keep my glasses on my face because I had to wait until tax time to replace them. Guess that's not going to change.
- You get up to 25 therapy visits per type per year. So, each year you can only see the speech therapist every other week, the occupational therapist every other week, and the physical therapist every other week. And I hope you don't burn them all at the beginning of the year when you're still recovering from whatever made you need a therapist in the first place!
Now, I can't blame the administration for trying to open Medicaid up further. However, just like people wonder how much insurance providers will jack up their rates before insurance reform kicks in, now I'm forced to wonder how much more Indiana will strip from Medicaid between now and 2014. I'm also forced to wonder how many other states will do the same thing.