Kelsey Seybold is a large healthcare provider in the Houston, Texas area. They offer a variety of medical services, including routine checkups, specialist care, and emergency room visits. Kelsey Seybold does not accept Medicaid as a form of payment. Medicaid is a government program that provides health insurance to low-income individuals and families. Kelsey Seybold accepts most major insurance plans, including Medicare, Blue Cross Blue Shield, and Aetna. If you have Medicaid, you can still receive care at Kelsey Seybold, but you will need to pay for the services out of pocket.
Kelsey Seybold Medicaid Coverage Options
Kelsey Seybold does not accept Medicaid directly. However, patients may be eligible for coverage through the KelseyCare Advantage Plus (HMO) plan, which accepts some Medicaid beneficiaries. This plan provides comprehensive health coverage, including preventive care, primary care, specialty care, and hospitalizations. To be eligible for this plan, patients must meet the following criteria:
- Be a Texas resident.
- Be eligible for Medicaid.
- Have a primary care provider (PCP) within the KelseyCare Advantage Plus network.
To enroll in the KelseyCare Advantage Plus plan, patients can visit the Kelsey Seybold website or call the customer service number. Once enrolled, patients will have access to all of the benefits and services covered by the plan.
In addition to the KelseyCare Advantage Plus plan, Kelsey Seybold also offers a variety of other health insurance plans that may be suitable for Medicaid beneficiaries. These plans include:
- KelseyCare Advantage (HMO)
- KelseyCare Select (PPO)
- KelseyCare EPO (Exclusive Provider Organization)
- KelseyCare HDHP (High-Deductible Health Plan)
Patients can compare the benefits and costs of these plans to find the one that best meets their needs and budget. To learn more about these plans, patients can visit the Kelsey Seybold website or call the customer service number.
The following table summarizes the Medicaid coverage options available through Kelsey Seybold:
| Plan | Eligibility | Benefits |
|---|---|---|
| KelseyCare Advantage Plus (HMO) | Texas residents who are eligible for Medicaid and have a PCP within the KelseyCare Advantage Plus network | Comprehensive health coverage, including preventive care, primary care, specialty care, and hospitalizations |
| KelseyCare Advantage (HMO) | Texas residents who are eligible for Medicaid | Comprehensive health coverage, including preventive care, primary care, specialty care, and hospitalizations |
| KelseyCare Select (PPO) | Texas residents who are eligible for Medicaid | PPO coverage, including a wider network of providers and the ability to see out-of-network providers |
| KelseyCare EPO (Exclusive Provider Organization) | Texas residents who are eligible for Medicaid | EPO coverage, including a narrower network of providers and lower out-of-pocket costs |
| KelseyCare HDHP (High-Deductible Health Plan) | Texas residents who are eligible for Medicaid | HDHP coverage, including a high deductible and lower monthly premiums |
Patients can contact Kelsey Seybold for more information about their Medicaid coverage options.
Eligibility Requirements for Medicaid Coverage
Medicaid is a government-sponsored health insurance program that provides medical coverage to individuals and families with low incomes and limited resources. To qualify for Medicaid, you must meet certain eligibility requirements, which vary from state to state. Below are some general eligibility criteria:
- Income: You must have an income below a certain level to qualify for Medicaid. The income limit varies by state, and there are different income limits for different categories of people, such as children, pregnant women, and people with disabilities.
- Resources: You must also have limited resources to qualify for Medicaid. Resources include things like bank accounts, stocks, and bonds. The resource limit varies by state and category of person.
- Citizenship status: You must be a U.S. citizen or a qualified immigrant to be eligible for Medicaid. There are some exceptions to this rule, such as for children and pregnant women.
- Age: Depending on the state, Medicaid may be available to individuals of all ages or may have specific age-based eligibility requirements.
- Disability: Individuals with disabilities may be eligible for Medicaid regardless of their income or resources.
To apply for Medicaid, you must contact your state’s Medicaid agency. You can find contact information for your state’s Medicaid agency on the Medicaid website.
| Criteria | General Information |
|---|---|
| Income | Must be below a certain level set by the state. |
| Resources | Must have limited resources, such as bank accounts and investments. |
| Citizenship status | Must be a U.S. citizen or a qualified immigrant. |
| Age | Varies by state. |
| Disability | Individuals with disabilities may be eligible regardless of income or resources. |
once you have applied for Medicaid, you will receive a decision within 45 days. If you are approved for Medicaid, you will be sent a Medicaid card. You can use your Medicaid card to get medical care from any provider who accepts Medicaid.
Eligibility and Covered Services
Medicaid eligibility is determined by state-specific income and household size guidelines and can vary across states. Covered services typically include:
- Doctor visits
- Hospitalization
- Prescription drugs
- Mental health services
- Substance abuse treatment
- Long-term care
Exclusions and Limitations
Medicaid coverage generally excludes certain elective or cosmetic procedures, such as:
- Elective abortions (except in cases of rape, incest, or to save the life of the mother)
- Cosmetic surgery
- Dental services beyond basic care
- Vision care beyond basic screenings
- Hearing aids
- Durable medical equipment not deemed medically necessary
Prior Authorization Requirements
Some Medicaid programs may require prior authorization for certain services, such as:
- Hospitalization
- Surgery
- Outpatient mental health services
- Prescription drugs
Prior authorization ensures that services are medically necessary and appropriate before they are covered.
In addition to these general exclusions and limitations, each state Medicaid program may have its own specific rules and regulations regarding covered services and eligibility.
| State | Medicaid Expansion | Income Eligibility Limit (% of FPL) | Covered Services |
|---|---|---|---|
| California | Yes | 138% | Comprehensive coverage including dental, vision, and mental health services |
| Texas | No | 133% | Limited coverage primarily for low-income families and children |
| New York | Yes | 150% | Comprehensive coverage including long-term care and substance abuse treatment |
| Florida | No | 138% | Limited coverage primarily for children, pregnant women, and individuals with disabilities |
| Pennsylvania | Yes | 138% | Comprehensive coverage including prescription drug coverage and mental health services |
Does Kelsey Seybold Accept Medicaid?
Kelsey Seybold does not accept Medicaid. Medicaid is a government health insurance program for low-income individuals and families. Kelsey Seybold is a private health insurance company that offers a variety of health insurance plans to individuals, families, and businesses.
Alternative Health Insurance Plans
If you are looking for health insurance that is accepted by Kelsey Seybold, there are a number of alternative health insurance plans available. These plans include:
- Employer-sponsored health insurance: Many employers offer health insurance plans to their employees. These plans are typically paid for by the employer and the employee.
- Individual health insurance: Individual health insurance plans are available to individuals who do not have access to employer-sponsored health insurance. These plans are typically more expensive than employer-sponsored plans, but they offer more flexibility in terms of coverage and providers.
- Medicare: Medicare is a government health insurance program for people who are 65 years of age or older, or who have certain disabilities. Medicare is divided into four parts: Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage plans), and Part D (prescription drug coverage).
- Medicaid: Medicaid is a government health insurance program for low-income individuals and families. Medicaid is administered by the states, and eligibility requirements vary from state to state.
You can find more information about alternative health insurance plans by visiting the website of the Centers for Medicare & Medicaid Services (CMS) or by contacting a health insurance agent.
| Health Insurance Plan | Who is Eligible? | What is Covered? | How to Apply |
|---|---|---|---|
| Employer-sponsored health insurance | Employees of companies that offer health insurance plans | Varies depending on the plan | Contact your employer |
| Individual health insurance | Individuals who do not have access to employer-sponsored health insurance | Varies depending on the plan | Visit the website of a health insurance company or contact a health insurance agent |
| Medicare | People who are 65 years of age or older, or who have certain disabilities | Hospitalization, medical care, and prescription drug coverage | Visit the website of the Centers for Medicare & Medicaid Services (CMS) or call 1-800-MEDICARE (1-800-633-4227) |
| Medicaid | Low-income individuals and families | Varies depending on the state | Contact your state Medicaid office |
Well, folks, that’s all we have for you today on the topic of “Does Kelsey Seybold Accept Medicaid?” We hope this article has been helpful in answering some of your questions. If you’re looking for more information on Kelsey Seybold or Medicaid, be sure to check out their respective websites. And don’t forget to come back and visit us again soon for more informative and engaging content. Thanks for reading, y’all!