Childrens Medical Service(CMS)

Updated on August 28, 2009
B.W. asks from Tampa, FL
9 answers

I recently found out my daughter has a mild hearing loss in her Left ear. We are with a Medicaid HMO (United Health Care) I was told I should also sign up with CMS. Was told they are like a secondary insurance. The delimma is that I was told I could only have CMS with Medipass. I could not find out what Medipass covers to compare it with my Medicaid UHC ? I looked online but it did not give anything but an overview. What is the difference between Medipass and Medicaid UHC? Is CMS worth the change if I did change coverage? Right now we have not had any problems with UHC and only want to change coverage if CMS and Medipass is worth changing for. I am worried about switching and finding out I should have stayed with UHC. Thanks for any help

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So What Happened?

Thank You for all the responses. It turns out that ENT explained that her loss of hearing was on the edge of normal and only had a small problem with real low tones. She said that if her hearing got worse then she would need to see her again. She is leaving it up to audiologist to detrimine weather or not my daughter needed a hearing aid. If it turns out that her hearing does get worse or does need other things we will switch to Medipass and CMS. Kayla already does get speech therapy through Child find through the school district for a year now. It just took till now through many hearing test attempts for them to want to do the ABR. The audit want to have to audioligists did not want to have to sediate her.

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K.S.

answers from Tampa on

Hi B. W, My name is K. S. My kids are on Medipass and CMS. Medipass covers more than 6 visits of therapy (OT, PT, speech), if you are carless, it will cover transportation from a company called MMG Transportation(only to doctor appointments, therapy, anything medically related), 0 copays on meds, office visits, x-rays, etc; anything medically related. The only thing that I know of that Medipass doesn't have is the $25.00 credit for OTC drugs, like Healthease, and those other medicaid HMO health plans. Hope this helps. K.

2 moms found this helpful

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J.M.

answers from Gainesville on

Hello: My experience with UHC, Medipass, and CMS is based on my working at UF dental clinic. And basically, medipass is accepted across the board for treatment, as well as CMS. When you have an HMO with medicaid, there has to be a contract with that specific HMO with whatever clinic or dr you are going to. And basically, if your daughter has Medipass, the dr will bill medicaid first and whatever medicaid/medipass doesnt pay for something, CMS will. But, if you only have the HMO and it doesnt pay for something then you will have to pay out of pocket for the difference. I would recommend switching to Medipass when you are able to.

1 mom found this helpful
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D.R.

answers from Daytona Beach on

Hello B. W,

My 9 years old son has severe hearing loss. my 7 years old daughter has mild-moderate hearing loss. there are alot of ENT,Audiologist,speech therpist,etc...accept medicaid and medipass togehter simply under CMC much easier. medicaid only there may very difficult to get specialists some wait long line and another not accept only medicaid. I have no problem both insurance under CMC. My kids recieve new hearing aids every 3 years these insurance covered cost 100 percent, A hearing aid only one cost around $1,000. Arnold Palmer hospital for children accpet these insurance and prove children to get anything what they need. There are many clinic like Shands,Nemours accept CMC like that. You can question with medipass CMC about that and get more information before you add medipass as secondary insurance.

good luck,
D.

1 mom found this helpful
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J.J.

answers from Orlando on

I don't know the difference between medipass and madicaid, but I can tell you I have on shild enrolled in CMS and theother on Medicaid UHC. When I signed them up and told them about the one childs disabinlities, I was not given any choice in the matter. The medicaid is a lot "easier" to use. CMS requires you have a nuse case manager and everything outside of routine pediatricia visits has to be aproved in advance, or you will be billed. Emergency room visits have to be called in to the case manager within 24 hours. It is a good program, but has a ot of specific "rule" to follow. Often times, if you miss an appointment, you can b dropped from the program.

1 mom found this helpful
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J.L.

answers from Sarasota on

My daughter had extensive medical problems,and CMS was great to have! I switched to staywell because my peds office only took that. I would check with your pediatrician they know a lot more about the insurane and different restrictions of each program. Good Luck!

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K.G.

answers from Sarasota on

I highly recommend CMS. They use coordinated care, which means less testing and more communication between doctors. It also means you have a central point of contact, which is a nurse who helps coordinate things for you. I would contact CMS and have them help you with your insurance questions. They are very good. If they do not know the answers, they can help you figure out who does have the answers.

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D.W.

answers from Gainesville on

Having CMS makes it easier to get things approved for kids that need more medical attention. Get in touch with the local CMS office. One of the nurses will be happy to go over everything with you. Our nurse thru CMS was super!

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C.

answers from Boca Raton on

CMS does take only medipass and you would have to see only their doctors.But CMS does have access to a wide variety of specialist and it is much easier to ger linked to who you need.Your daughters needs who be managed by CMS. For example, the audiologist, occupational therapist, speech therapist, etc would all be set up by CMS without referrals needed and follow up on her care would all be coordinated by your CMS case manager. I would take the advice of the previous poster and talk to your local cms nurse. You should also check with your local school board to see if they have a dept called Child Find. They start working on the educational needs of children 3-5 y/o of children with special needs so they are ready to start school. This might be another option if you are happy with your current insurance and pediatrician. Good luck to you both.

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H.J.

answers from Tampa on

Yes Yes Yes!! CMS is totally worth it. We just got on it over the summer and I cannot even tell you how awesome it is. They covered everything so far without issue or complaint. my son has sensory integration issues and needs OT and councelling and we just took him to the best Developmental Ped. in the area and it was all covered!!! With our previous insurance U.Health they weren't covering much anymore with out exorbitant co-pays plus high premiums every month. We just couldnt afford it anymore. I highly recommend CMS you will not be sorry.

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