Medical Question When Relocating to Different County (Same State)

Sounds to me like it's just a formality. I would have to think this happens all the time in the Bay Area. It's not like San Mateo is on the other side of the earth - it's 10 minutes away from San Francisco! Have you spoken to the doctor about this? I would imagine they see this type of situation all the time, especially if the doctor specializes in elder care. I would start with the doctor, and if the doctor seems unclear on what to do, then ask the County if they have any written guidelines that they use to make such decisions. I would imagine that the fact that she needs a doctor who speaks Russian would weigh in her favor - it's not like Russian-speaking doctors who accept Medical/Medicare are a dime a dozen, exactly. :)

The people who review the letters are human beings but there's always some critera upon which decision are based. If this request meets their critera it was be appoved. However, realize that becuase it's an ongoing relationship (primary doctor I'm assuming?) they may not becuase the administrative burden of making an exception every time a bill is paid may be too much for their system. (Most claims are either submitted electronically or are scanned when recieved - computer programs actually pay the claims if they're routine.

The letter should be simple - be sure to include name, medicaid number, old address, new address, new insurance #. The simply state that the patient has XXX medical condition and has been treated by Dr Smith for 20 years because he speaks the same language as Mrs. Jones. Say that you've not been able to find a Russian speaking doctor on their network.

If the criterea requires that a non-network doctors are only approved if the netowrk doesn't have a doctor in that specialty then your request won't be approved. Maybe call back and ask what conditions are required for approval. You may find a kind person who is willing to give you that kind of information.

Good luck!

I have no experience with this but one thing did come to mind. In the letter where the medical condition and diagnosis is explained, make sure to include the need for a Russian Speaking doctor. This can make a big difference. San Mateo may not have a Russian Speaking doctor and this makes a difference in her care. If you have a doctor that is not able to communicate with your relative it will make it hard to care for them properly.