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Texas-Private Ins vs. Medicaide when on longterm SS

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Junior Member
Hello all, we live in Texas. Our son turned 18 last year and we went through the process of getting him on Social Security due to severe lifelong disability. Apparently, having Medicaid comes with the package, but we have private insurance for now until he turns a certain age (26? I think it is) and there is a program called the Texas Health Steps dental program designed to make sure people have access to regular dental checkups, cleanings, etc. Every time they call to set up an appointment we tell them that we have private insurance and don't need them, and this last time they've gotten much pushier and made us start wondering exactly what it is we're supposed to do. We are afraid to call the insurance company that covers us for fear that they will say since he is covered by someone else we should go with them and drop him, and we are afraid to call Social Security for fear this will somehow impact the benefits he is receiving. I was hoping someone had any insight into what exactly our responsibilities are in this situation. Are we supposed to go to both the dentists? Are we supposed to pick one? Are we obligated to choose the Medicaid dentist because it's available? Our son has been going to his dentist his entire life, change is very, very hard for him, and we don't know if this Medicaid place is good with special needs kids/adults. We want to stay with our private insurance dentist as long as we can. Do we have to tell our private insurance about this? Are we at risk for having to pay back private insurance in the future since we have not opted to go with the Medicaid dentist? Any advice would be greatly appreciated. Thank you so much.



Senior Member
You've lost me. Texas Health Steps isn't private insurance. It's an adjunct to medicaid to provide preventive services and some case management and covers only up to age 20.
Info here http://www.mychildrensmedicaid.org

I believe what you're talking about is HIPP. You report both the medicaid and HIPP-provided private insurance to the provider and they will report to both and the private insurance will be primary and medicaid will pick up the copays and some of the other uncovered stuff.

General assistance is available at the link above and also at http://www.gethipptexas.com/common-questions.html

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