Oct
10
SD Medicaid Expansion makes a big difference for you, as a counselor, and for your clients. 
     — Anne Dilenschneider, SDCA Legislative Advocacy Chair
Medicaid Expansion would allow SD Medicaid to cover clients who have been uninsured, and who do not qualify for work-based or ACA health plans. (Note: Clients who make $1000 a month or more can get ACA coverage with Avera or Sanford act a very low cost, ~$15/month. Have them go to healthcare.gov and CALL the phone number listed to go through the process.). Under Medicaid Expansion, those currently uninsured clients would now be able to see counselors who take SD Medicaid. 
South Dakota Medicaid currently pays $121.88 per 60-minute session. The team is very easy to work with, and you always get a person to help you if there's any kind of issue that needs to be dealt with. 
Also, if a client has Medicare with SD Medicaid as a secondary insurance, there is a way for you to get paid for your work. (SD Medicaid really comes through for us!)
Here’s what you do to have SD Medicaid cover a Medicare-primary client (I can always walk you through this):
1) The client has a to file a paper Form 1490 S — the Patient's Request for Medical Payment — with Medicare in Fargo. I usually fill that out and have the client sign it and then we mail it. 
2) After a month or two, the client will get a Medicare denial in the mail. They then give that Medicare denial form to you. 
3) At that point, you send the Medicare denial form with a paper copy of the CMS1500 for Medicaid services to Pierre. 
4) Once approved (3-4 weeks later), you will be able to directly and electronically bill SD Medicaid for that client, going back to the initial date of service, and skip the Medicare step for good.
So, Medicaid Expansion is legislation we should be supporting!