Limitations of Medicaid   

As you transition to an older age, you may no longer be able to take care of yourself and manage your assets. With growing age, your ability to perform day-to-day tasks will decrease, and you might need to move to an assisted living home.

In Texas, more than a hundred thousand residents currently live in such facilities. Moreover, as per CDC, the numbers are expected to rise since they estimate that more than 25 million elderly citizens will depend on some type of assisted living in the near future.

While many of these living facilities offer good services, they are not cheap, and may cost you upwards of ninety thousand dollars. So, it is advisable to start planning early and chart out financial plans for the future, including planning for assisted living.

However, when it comes to paying for such facilities, you can either pay them privately, use long-term insurance, or medicare.

When using medicare, you must keep in mind that it comes with its limitations. Here are some common medicaid issues in Texas explained.


Limited coverage

Compared to other types of health care plans, Medicaid plans often have a lot of exclusions when it comes to treatments and other procedures. In many cases, even if the healthcare providers stress upon going through a crucial surgery or treatment, there are times when Medicaid denies considering it.

In such cases, most people often choose to forgo the essential treatment since paying out of pocket is not a viable option.

This does not make Medicaid a holistic healthcare plan as it might often deny you coverage for an important treatment leaving you with no other option besides forgoing the treatment altogether.


Limited healthcare provider options

In many cities in Texas, the number of healthcare providers that accept Medicaid is spiraling down. As per a recent survey, only 27% percent of all healthcare providers accept patients with Medicaid. This number has reduced from 67% in the early 2000s.

This is mainly because the reimbursement amounts are much lower than what many healthcare providers are used to billing. Moreover, the reimbursement window under Medicaid is more than other health care plans as it could take anywhere from 37 days to 155 days for a bill to be settled.

So, many small-scale health providers avoid taking patients who only have Medicaid as it does not pay well, and even if it does, the extended timeframe causes a cash crunch.


Inadequate treatment for the elderly population

It may not be the case with other healthcare plans but, the elderly with Medicaid are often subjected to discrimination in nursing homes. There have been instances where the nursing or assisted living facilities have demoted the quality of care they provide to patients who switched to Medicaid.

Moreover, in many cases, nursing homes have even denied giving care to people with Medicaid. Also, many nursing homes have a specific quota of the minimum number of patients they need to have on Medicaid, and once this quota is fulfilled, they can deny having more patients with Medicaid.

These are some of the common Medicaid issues in Texas explained in order to help you understand them better and make an informed decision.