The New Medicaid System in Kentucky

Starting at the end of 2011, the State of Kentucky outsourced its Medicaid program to three insurance companies to run three separate managed care systems, called MCO's (managed care organizations). Patients have the choice of which MCO they would like to join. The three offer basically the same amount of coverage, but have many small differences in minor services and drugs that are covered. There are VERY MAJOR differences in the DOCTORS that you may see under each plan.

If you already see Dr Voakes:

If you are an established patient of Dr Voakes, and you have Medicaid, you must choose WellCare for your MCO, or you will no longer be able to see Dr Voakes.   Most of Dr Voakes' patients were randomly assigned to other MCO's, but you had the opportunity to switch to WellCare.  After Feb 1, 2012, you will not be able to switch until it comes time for your Medicaid recertification. This might be every 6-12 months.

If you don't have a doctor yet:

If you are a new Medicaid patient, and you wish to join Dr Voakes' Medical Home Practice (see Health-byte on Medical Home), you must choose WellCare as your MCO. Then you must request Dr Voakes as your Medical Home provider. You will be sent a WellCare membership card with a doctor's name on it. Unfortunately, that may or may not be your actual Medical Home Doctor. Be sure to call WellCare to find out who your actual PCP doctor is, and you may request to change to Dr Voakes as your PCP (primary care provider).

Over-the-counter Medications

WellCare provides an extra benefit that provides over-the-counter (OTC) medications and supplies for members each month. You just have to call the phone number on your card each month and order whatever you might need. For example, in winter months, you may need some cough medicine or ibuprofen. In summer you might need cortisone cream and bandaids. WellCare will send these items directly to your house.