Ky Coventry Cares what you should know
Posted in the Louisville Forum
#1 Jul 26, 2012
First off not here to discuss lazy people who fraud or whatever. This is for people who need and receive medicaid legally and need it.
Coventry is starting to bleed and bleed bad. Trying to change over too quickly and to cheaply is starting to bite Coventry in the butt. And Medicaid patients WILL suffer.
They are constantly "re negotiating contracts" and then conveniently offer such low and slow or nonexistent reimbursements that pretty soon, I'd say in the next 12 months the availability of medical care for medicaid patients will be an absolute nightmare.
The emergency rooms will be even more over run than nowadays.
If you, your grandparents, or your children have a medical need and they/you are on Coventry you had better get it taken care of quick.
Providers are dropping like flies hourly.
And the providers that are still accepting Coventry are going to be absolutely packed and overworked.
If you look at the Coventry web page under providers, the list looks wonderful even many states and fine hospitals are listed, however when you call and ask about the providers, they tell you that most doctors listed have dropped Coventry and that the list has not been updated.
Also the provider book is no longer valid.
Providers are dropping so fast they cannot keep it updated.
So make your appointments and get your problems looked at , and get your medicine cabinet stocked because its goin to be tough, and deaths from simple illnesses will be accumulating
#2 Jul 26, 2012
The black horseman rides.
#3 Jul 26, 2012
wrath of the white man, who hates the poor.
Obama is trying to improve medicaid and help the sick poor.
Romney will cut it even further, people will start taking from the rich to get their kids meds
When you got nothin you got nothin to lose.
#4 Jul 27, 2012
half true...about the nothing to lose part, however....dont blame ''white'' people, and Also dont forget the more government controls the more they will take away...Obama care is not what you think it is...if you dont have healthcare or you cant care for your kids, dont have em...its not my job to, and the government is not supposed to force me to either...If im breaking my back every day at work, and punch in the timeclock I should get first dibs
#5 Jul 27, 2012
There are legit welfare cases, but paying for Laquesha's fat butt and her 5 kids when she knew she shoulda stopped at one, is not my responeability, I dont have kids and im 33, i shouldnt be forced to pay for these whores kids that spread their legs for every gangta that shows them attention....say bye bye america, once the middle class starts fighting back no ones gettin paid
#6 Jul 27, 2012
WTF is this person talking about ????? This post is so f**ked up as to be almost impossible to understand. WTF is Coventry ????
#7 Jul 27, 2012
Coventry was one of three companies that replaced KY medicaid. Because the state was wasting billions due to not managing access to care, medicaid recipients were allowed to doctor shop, go to the emergency room for ear aches and other things that you and I would have thought twice because it would cost us out of pocket.
So because the state was broke they brought in Coventry, Wellcare and Ky Spirit.
I agree Coventry is no angel, but the state basically outsourced a problem they couldn't manage and let the shit hit the fan.
Billions have been wasted over the years and this came from our pockets, not the government.
#8 Jul 27, 2012
And if you want to see real waste and abuse wait until Obamacare takes full effect.
What expansion of government has ever lowered cost? And if you get it free, do you think you'll take better care of yourself or use it wisely? All see this as feeding at the trough.
#9 Jul 27, 2012
Thanks, Now I know......
#10 Jul 28, 2012
This is a common myth. That people who have medicaid just willy nilly use the emerancy room because they dont have to pay. Yes in life there is always a few people who abuse things but here is the truth to what really goes on.
Medicaid trys to lowball doctors. They know that people are poor and have no where to go and that doctors will feel guilty and treat them becaus ethey dont want to see humans suffer with curable afflictions.
However when doctors case load became almost all medicaid patients the doctors started to bleed money ....and they STOOPED seeing medicaid people...stopped accepting new medicaid patients.
When you dont have a primary care doctor willing to see you..and you live in a small country town with no after hours or express care to see you....you have ONE option.....emergency.
I once had a Medicaid rep tell me to call Louisville for a primary acre doc…...she said there was plenty there that would take me…….I live in Paducah……???? Sound feasible?
The EMERGEANCY room. If more primary care/family/ or nurse practitioners would accept medicaid....these people would gladly go there for treatment.
This IS the problem. If you have no one to see you (also medicaid does not allow a patient to pay any extra toward a visit) you will seek out whoever is left…..ends up being emergency. Because the system is set up that way. They wont guarantee you a primary care doc, but they will guarantee you access to emergency rooms. Funny huh?
Doctor shopping is a myth also, you have to have a referral to see any new doctor. Cant just pick a doc and go. Never was able to do that. Every doctor I ever saw I had a referral and a reason.
#11 Jul 29, 2012
Some written above is factually correct.
The medicaid contractors do low ball the physicians/providers or in other words pay less than a private insurance would.
However, there is a reason. One in nine Kentuckians is on medicaid. This is guaranteed volume to the physician/providers which most private plans can't promise. Medicare has even more recipients in KY and offers similar low payment.
So if you are a provider of healthcare services, are you going to eliminate one-half your clientele and stay in business? Some really good ones can, but most cannot.
As for dr. shopping, facts prove you wrong. Medicaid recipients are 175% more likely to use the emergency room and seek paid medication than someone with private insurance. The recipients also have higher obesity rates, smoke, abuse drugs and other lifestyle choices.
And as for referrals and picking docs. The outsourced medicaid companies now require primary care physicians, referrals and other controls. KY medicaid run by the state did not. Just get your dr to write the order and show up with your card and you got whatever the order said. Specialists were widely abused.
The facts show "myth" the bigger picture. The facts also show that anytime you get government involved waste, abuse and fraud occur. This is my money as a tax paying citizen infuriates me. I most definitely agree that there are those that need help, but when 50% of citizens don't pay a dime to support the needy we have a serious problem. It is time for true reform and elimination of the nanny state. If you see what is going on in Europe that will soon happen here.
Vote in new leaders that will end this!
#12 Jul 30, 2012
Wellcare is horrible, as well. They tried to stop paying for a medication that my child takes for an incurable disease. They didn't even notify us, and my child nearly ran out of the medication before we got the problem straightened out. They DO NOT care about these patients at all.
#13 Jan 22, 2013
I agree with I Know. I am a Coventry patient, and i take a medication that is VERY DANGEROUS to just stop, therefore I CANNOT just go without bc they r having a bad day. some weeks when i get my prescriptin, they will cover it, along w my 2.00 copay, some weeks they will NOT cover it, and im stuck paying out of pocket for my daily dose of 15.88 or 8.95 per pill, OR 110.00 for a week supply, im suppose to get a refill every 2 weeks, that is ALOT of money and i ACTUALLY do need the help from coventry. They do not care if people withdraw from their meds that these doctors have put us on, or the people for whatever reason may be, that NEED their meds. I have had nothing but crap fro mcoventry since being signed up, and from what i hear the other two are just as bad. What has this world come to? we cant have medecine we need not even for our children. GIVE US SOME PEOPLE WHO GIVE A FLIP ABOUT THE PATIENTS!!! NOT just the dang money, that's ALL ANY of them want, IF YOU ASK ME
#14 Jan 22, 2013
You're right, we don't care about the member, only about controlling costs and trying to make a profit.
You should hear about the strategies used to control costs. Suboxone exclusions, locking a member into only seeing a limited number of providers, not including the best providers in the eastern part of the state.
And if you think they treat their members poorly you should try working for them. You are belittled, given the work of several and not appreciated one bit.
#15 Nov 26, 2013
does it also upset anyone that illegal aliens get medicaid ? no...i guess we only don't want usa citizens to have healthcare. i won't post dollar figures, i will let you look it up online and see for your self.
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