19 answers

Why Would a Doctor Deny Me Care?

I am 24 weeks pregnant and just recently got approved for Medicaid since I had to relocate in the middle of my pregnancy (couldn't get private healthcare). Well, it's been the biggest headache of all time! Once I got coverage, I am now trying to find a doctor that will accept me. I had to send my records/paperwork from my past Obgyn to the doctors I am looking at. Then they have to "approve" me for care. So far, I've been denied by one doctor. (this doctor accepts medicaid).

Does anyone have experience with this or understand the reasons why I would be denied? Is it because I am so far along in my pregnancy? I just hate that it's so hard for someone like me to find a doctor! It shouldn't be like this.-

The only "medical issue" I have is thyroid disease. But, other than that, nothing strange with my pregnancy.

Suggestions please!

What can I do next?

Featured Answers

Have you considered working with a midwife? I had a homebirth, and my midwife was very professional, personal, and great to work with. It was a great experience, and a LOT cheaper than OBGYN and hospitals.

1 mom found this helpful

You don't need a referal to get seen by an OB. I just had my baby a few weeks ago and never did I have to do that. With tyroid issues, theyw ould probably consider that as a high risk pregnancy and some doctors aren't willing to treat those because they are afraid (I had a doctor admit that once...) I don't think it's because you're 6 months ...I switched to the dr who delivered my baby at 6 months pregnant and had no issues....
Best bet is to call Medicaid and ask them for high risk OBs or call around (did they send you a booklet of doctors?)

More Answers

Many doctors will only take a certain number of Medicaid patients because they receive much less money for them. If they take X number of Medicaid patients, it still looks good to the government and insurance companies, but leaves enough time for patients with regular insurance who will bring in more money. The doctor who denied you has probably already hit their limit.

3 moms found this helpful

I do not know what goes on in your state, but I do know in ours not all doctors accept Medicaid. They are like the insurance companies, they do not accept all of those either. I suggest that you call Medicaid and inquire the names of those who will see you. I also know some doctors are around for years and just don't accept new patients. Get a list of who will take you pronto. It doesn't have to do with how far along you are. You just need to get someone that is available. Also, you did not mention any other issues, those are the only ones that I can think of why you would be denied.

2 moms found this helpful

It's probably because you have medicaid. not all doctors take medicaid. In many cases it can take YEARS to get payment from the govt, so most doctors will only accept a certain % of their patients as medicaid so that they can still pay their bills.
You should be able to get a list from the your medicaid office of ob/gyn's who are accepting new medicaid patients.

It may also be because you are so far along. I switched Dr's midway through my pregnancy and I had a lot of Drs say they wouldn't take me.

Good Luck!

2 moms found this helpful

You have to have a referal from your primary care physician first for medicaid to cover obgyn. Then just because the obgyn accepts medicaid does not mean they accept your type. In indiana there are 3 coverage providers and some doctors do not accept all of them...here it is anthem, medwise and something else. They also have to have an opening for newe patients. I would call your medicaid customer service number and they will be able to tell you who is available and sign you up for them. You also should do this with your primary care first if you dont have one yet.
Unfortunatly there are typically very few drs that accept medicaid anymore especially pediatricians so good luck it is a frustrating process.

2 moms found this helpful

The answer is simple, sorry to say.
Doctors are not obligated to take Medicaid patients. Fewer and fewer of them will because they get paid such a low percentage of the actual costs and expenses. This isn't just pregnant women, it's elderly and people on disability.
It won't make you feel better to know that you aren't alone, but what you need to concentrate on is finding a doctor who WILL accept medicaid. You likely won't be able to pick and choose. Many doctors don't accept new patients at all, even if you have good insurance.
Get out the phone book, start calling around and find the ones that take new patients and accept medicaid. If they say they won't take you, ask them if they know of other places and just keep trying.
I broke my leg, in California, and had to go on disability and medi-Cal, and you would be surprised how many doctors and physical therapists would not even take me. It took 8 weeks just to get an authorization for an MRI and then another 6 weeks for autho to get physical therapy that was over an hour away and I couldn't even drive with a broken right leg.
Call your county Department of Public Health and explain your situation. Ask them for a list of doctors who can take you and deal with your pregnancy. It will be a lot quicker, I would imagine. At least you'd have a list of docs who will take medicaid patients.

I wish you the best and I'm sure you'll find someone.
Take care!

2 moms found this helpful

Well, I'm sorry to say you've received a lot of bad information.

Each state administers Medicaid slightly differently. Elizabeth from Kokomo, IN is correct that we have 3 managed arms of Medicaid in addition to traditional Medicaid (that covers ~10% of lives). However, Indiana is one of the few states that administers with the managed arm in addition to traditional Medicaid services.

Your OB likely accepts Medicaid but isn't accepting new patients. The level of payment they receive for Medicaid is a small fraction for a patient with private insurance. Most offices simply can't take all the patients who need care despite being a provider because they can't afford to. Typically, a physician has 10-20% of their practice in Medicaid, ~70% in traditional insurance and ~10% cash paying patients.

It sounds like your OB/GYN is a Medicaid provider but isn't taking new patients from how you've described in your statement. You really should call your state's Medicaid program and ask the questions. You should be able to access a list of offices that accept Medicaid, and you'll likely have to call around until you find one accepting new patients.

You may also be able to find a family practitioner who still has OB privileges and covers new Medicaid patients.

I used to cover the Kokomo, IN area (which is why I'm so familiar with Indiana's Medicaid system) as a pharmaceutical rep. I had one office with over 90% Medicaid patients. Some had to travel over 2 hours to the office because they were the only one accepting new patients.

Good luck.

2 moms found this helpful

I am a military dependant and we must first go through a Primary Care Physician and get a referral to an OB/GYN. Do you have a general practicioner you are currently under care of? Or are you seeing a specialist regarding your Thyriud Disease? I would speak with one of them to obtain guidance as to how to find a doctor to treat your pregnancy.

Otherwise, I would contact Medicaid directly and get them to find you a doctor.

Best wishes!

1 mom found this helpful

Have you considered working with a midwife? I had a homebirth, and my midwife was very professional, personal, and great to work with. It was a great experience, and a LOT cheaper than OBGYN and hospitals.

1 mom found this helpful

I was denied care during my pregnancy. The reason was that I was two months preg and I couldn't get an appointment for another month. The doctors would not take someone over three months. I had to do alot of looking. I didn't find a ob until I was almost four months. You just have to call around and you can find one. Ask your insurance provider for a list of doctors that accept your medicaid. And just go down the list. It is a head ache, but you can find one if you are persistent.

1 mom found this helpful

You may also want to carefully consider certified nurse midwives.

Good luck.

1 mom found this helpful

I am so sorry for you! We were having lots of trouble affording my husband's insurance (at $800/month) so we dropped the kids and put them on Chip and Medicaid. It was a horrible experience. I hated the very small choice of doctors we could see and waiting 3+ hours. Medicaid dropped my son when we moved and for some reason they wouldn't accept him again (they kept sending back the paperwork saying that they were lacking info). Finally, after 6 months of dealing with long waits and my son not having insurance, we put him and my daughter back on insurance in Jan and took me off (of course it's still $400, but worth not having all the hassle).

Long story short....it's a horrible experience dealing with the medicaid system. I hope you are able to find a doctor and that they treat you nicely. Good luck!

1 mom found this helpful

It's more that a doctor doesn't want to accept possible "liability" should there be an existing problem (Even though there may not be) some doctors like the idea of being your doctor beginning in the first trimester, but thereafter, seeking out a new one can be a challenge. Same applies with POST pregnancy as was my case whereby I wanted a NEW doctor and when I went to search for one the first question they asked, well why aren't you doing your POST pregnancy appointments with your previous doctor.. of course, I couldn't tell the real reason which was.. that doctor totally dropped the ball.... a doctor did eventually take me.. you may have to search around a bit more

good luck

1 mom found this helpful

An Obgyn is considered a specialist , so just like every specialist you might need a referral from your primary care Dr.
Also you are over halfway done with your pregnancy, that may have something to do with it.

1 mom found this helpful

I would suggest contacting the Medicaid office and finding out what other physicians provide care for this insurance. I would also visit your local hospital because they may have a clinic for people with Medicaid.

Get with Medicaid and have them help you find a doctor that accepts Medicaid AND will accept you. You can ask the doctor but my guess is he may accept his current patients w/ Medicaid but is not accepting new patients w/ Medicaid.

I got delined Madicaid, so have no insurance at all and have been going to Health Dept from the start. I am 29 weeks and care has been wonderful....lines are long but doctors are great. I would check your local HD.

You don't need a referal to get seen by an OB. I just had my baby a few weeks ago and never did I have to do that. With tyroid issues, theyw ould probably consider that as a high risk pregnancy and some doctors aren't willing to treat those because they are afraid (I had a doctor admit that once...) I don't think it's because you're 6 months ...I switched to the dr who delivered my baby at 6 months pregnant and had no issues....
Best bet is to call Medicaid and ask them for high risk OBs or call around (did they send you a booklet of doctors?)

reason that they may deny u is that you are so far in your pregnacy and for billing reasons. OB care is a global care which means they get paid a xxx amount of money for everything. which the first doctor may have gotten paid for the service and the new doctor will not be paid for your care.

i don't know about your state but in ma only certain docs take certain medicaid plans there are few different ones here to choose from. You need to call and get a list of obs in your area and then call them and find out which ones are taking on new patients.

Required Fields

Our records show that we already have a Mamapedia or Mamasource account created for you under the email address you entered.

Please enter your Mamapedia or Mamasource password to continue signing in.

Required Fields

, you’re almost done...

Since this is the first time you are logging in to Mamapedia with Facebook Connect, please provide the following information so you can participate in the Mamapedia community.

As a member, you’ll receive optional email newsletters and community updates sent to you from Mamapedia, and your email address will never be shared with third parties.

By clicking "Continue to Mamapedia", I agree to the Mamapedia Terms & Conditions and Privacy Policy.