Navigating healthcare can be complex, especially when it comes to understanding insurance coverage. If you are a Medicaid member, it’s crucial to ensure your doctor is a Medicaid provider to guarantee your medical services are covered. This guide will help you understand how to check if your doctor accepts Medicaid and how to find new doctors within the Medicaid network.
Is Your Doctor a Medicaid Provider? For Traditional Medicaid Members
If you have traditional Medicaid, the quickest way to verify if your current doctor participates in the program is by using the IHCP Provider Locator. This online tool allows you to search for providers and determine their Medicaid participation.
Steps to Check Your Doctor:
- Visit the IHCP Provider Locator.
- Search for your doctor by name or specialty.
- Check if they are listed as a Medicaid provider.
It’s also wise to contact your doctor’s office directly to confirm they are accepting new Medicaid patients, even if they are listed in the provider search.
What if Your Doctor Isn’t Listed?
Some providers may no longer participate in the Medicaid program. If you cannot find your doctor in the search, you can refer to the list of terminated Medicaid providers. If your doctor is on this list or not found in either resource, services from this doctor may not be reimbursed by Medicaid.
Finding Doctors in Your Health Plan Network: For HIP, Hoosier Healthwise, or Hoosier Care Connect Members
If you are enrolled in the Healthy Indiana Plan (HIP), Hoosier Healthwise, or Hoosier Care Connect, your coverage operates through managed health plans. It’s essential to choose a Primary Medical Provider (PMP) within your specific health plan network.
Finding a Specialist and Referrals:
For specialist care, those in managed health plans might need a referral from their PMP. Always confirm with your PMP or health plan before seeking specialist services to ensure Medicaid covers the costs. Contact your health plan directly for any questions; phone numbers are available on the Contact Us page.
Provider Search Tools by Health Plan:
To find doctors within your network, use these resources based on your health plan:
- MDwise
- Anthem
- MHS
- CareSource
- United Healthcare
Ensuring Your Doctor Accepts Medicaid
It is critical to confirm that any doctor you visit is enrolled in Medicaid. Medicaid will not cover services from doctors who are not enrolled. If your preferred doctor is not a Medicaid provider, you can suggest they explore enrolling through the Indiana Medicaid Provider Website.
By using the IHCP Provider Locator and checking with your health plan, you can confidently find doctors that accept Medicaid, ensuring you receive the healthcare services you need with your coverage.
