Testing for Medicaid Patients

[plumbago]

Does anyone have any experience with or knowledge of how frequently/routinely/easily Medicaid patients (public health clinic patients) are tested for celiac disease? My suspicion is that this is a very rare event, but I just wanted to ask. Thanks.

Plumbago

[ravenwoodglass]

I don't know the answer but I do know that my younger brother who clearly is celiac and quite advanced is on Medicaid. Even though I have seen on his med record that he has told his doctor that it is in his family he has never been tested.  He goes often to the doctor ($) and is on many very expensive meds ($) for issues that would resolve if he was gluten free.  Since his doctor doesn't think he needs to be tested he, of course, refuses to even think about trying the diet.  The amount of money that could be saved by the government if they would just test the folks that have symptoms and give some support to low income folks that are diagnosed is IMHO astronomical.  To say nothing of the suffering that would be relieved.

[kareng]

MY neice's little boy was tested at about 5 years old.  He was having some GI issues.  His mom said they had Celiac in the family and they tested and did an endo.  But he was seen at a children's hospital with a Celiac center.

I think Medicaid varies by state.  the actual doctors that accept Medicaid makes a big difference, too. Many doctors will not accept Medicaid or only accept a limited number of patients on medicaid.

Public health clinics are different.  And the rules on who may use them differs based on who is running them, etc.  Around here, most of them are just for basic care, vaccinations, well child, basic screenings for diabetes or eye, etc.  Anyone can use them, not just Medicaid patients.    They would refer you to a GI or eye doctor, etc

[plumbago]

2 hours ago, kareng said:

I think Medicaid varies by state.  the actual doctors that accept Medicaid makes a big difference, too. Many doctors will not accept Medicaid or only accept a limited number of patients on medicaid.

Public health clinics are different.  And the rules on who may use them differs based on who is running them, etc.  Around here, most of them are just for basic care, vaccinations, well child, basic screenings for diabetes or eye, etc.  Anyone can use them, not just Medicaid patients.    They would refer you to a GI or eye doctor, etc

My guess is that there are precious few tests eligible on the formulary for Medicaid based insurances, unfortunately. Public health clinics don't have their own formularies, as far as I know, but deliver care based (usually) on what the patients' insurance covers. (Public health clinics do eat a large amount of costs not paid by either patient or insurance, but that's neither here nor there.) I think the insurance coverage is dictating doctors' thinking - let me soften that: I fear that it is. And that if she or he could order up any test in the world, celiac panels would be ordered more, and not only that (more paranoia possible here!) but my fear is that insurance is constricting doctors' outside reading and thinking.

Medicaid may vary by state, but I'm not sure if, in any case, Celiac gets much love.

Plumbago

[plumbago]

2 hours ago, ravenwoodglass said:

I don't know the answer but I do know that my younger brother who clearly is celiac and quite advanced is on Medicaid. Even though I have seen on his med record that he has told his doctor that it is in his family he has never been tested.  He goes often to the doctor ($) and is on many very expensive meds ($) for issues that would resolve if he was gluten free.  Since his doctor doesn't think he needs to be tested he, of course, refuses to even think about trying the diet.  The amount of money that could be saved by the government if they would just test the folks that have symptoms and give some support to low income folks that are diagnosed is IMHO astronomical.  To say nothing of the suffering that would be relieved.

OMG. Just OMG.