New Arizona Medicaid members: Keeping a primary physician may come at a price.

By October 19, 2010Uncategorized

One of the first questions that many who apply for Arizona Medicaid ask is whether they are able to keep a trusted family physician once they obtain ALTCS eligibility.  This is a valid concern, considering the strong relationship that many people have with their primary physician.  The answer to this question is that ALTCS members may choose whomever they want as their doctor, but ALTCS only pays for physicians with whom it is contracted.

Once Arizona Medicaid approves new ALTCS members, they work with a Case Manager to select health care providers that are covered by Arizona Long Term Care System.  New members are in luck if their physician happens to be contracted with ALTCS, but things do not always work out this way for new ALTCS/Medicaid members.  Where Arizona Medicaid does not cover a new member’s physician, the member may choose whether to select a new physician that ALTCS will pay for or to come up with an alternative means to pay for the out-of-network physician.

It sometimes works out that Medicare will cover a physician that ALTCS will not.  Other times, members have private health insurance that will cover their physician visits.  And, other times still, new members decide to pay out-of-pocket to keep a physician with whom they have established trust.  While these options may be available to Arizona Medicaid applicants, new ALTCS members should rest assured that ALTCS contracts with quality health care providers, and switching to a covered physician might not be a bad idea.