Medicare and Medicaid sound similar, but they work very differently, and that difference matters when it comes to getting care. Currently, Circle Medical isn't able to see patients who are eligible for Medicaid, even if you'd prefer to self-pay or have other insurance. Depending on your location, if you have Medicare, you may be able to have your appointments covered by your Medicare plan.
What is Medicare and which states can Circle Medical offer care to?
Medicare is a federal program with the same benefits and eligibility across all states. It is restricted to people 65 and older, or younger individuals with certain disabilities or health conditions.
Circle Medical currently accepts Medicare patients in these states:
Arizona
California
Colorado
Connecticut
District of Columbia
Florida
Illinois
Iowa
Maryland
New Jersey
New York
Pennsylvania
South Carolina
Texas
Virginia
Washington
Wisconsin
What is Medicaid?
Medicaid is a joint federal and state program that helps cover healthcare costs for people with limited income and resources. There is no age requirement for eligibility, and benefits vary by state. The federal government sets basic rules, but each state runs its own Medicaid program. This means eligibility, coverage, and program names can be different depending on where you live.
Many states manage Medicaid through insurance companies, so your Medicaid card may show a familiar name, like Aetna, Blue Cross Blue Shield, or United Healthcare, but is still Medicaid.
For example:
California Medicaid: Medi-Cal
Washington Medicaid: Apple Health
Oregon Medicaid: Oregon Health Authority
Colorado Medicaid: Health First Colorado
Unsure? The support team is here to help. Start a chat on our HIPAA-compliant mobile app or web portal.
Why Circle Medical can't see Medicaid patients
Medicaid is run separately by each state, and Circle Medical isn't currently set up to work with those state programs. We're unable to see patients who are eligible for Medicaid, even if you'd prefer to self-pay or have other insurance.
It's important to know that seeing a provider outside your Medicaid network can put your coverage at risk, even if you plan to self-pay or use another form of insurance.
One appointment may not affect your benefits right away, but ongoing care with a provider outside your Medicaid network could lead to Medicaid pausing or ending your coverage, no matter how you pay.
People can qualify for both Medicare and Medicaid. If you have both, Circle Medical is unable to provide care at this time.
Important note: Seeing a provider who isn’t in-network with Medicaid, even if you opt into self-pay or use another insurance, can put your Medicaid coverage at risk.
Patients with Medicaid insurance are advised to transition their care to the Primary Care Provider (PCP) listed on their Medicaid insurance card. For assistance, contact the member services line on the back of your insurance card or reach out to your local Department of Social Services.
Additionally, Circle Medical can assist with transferring medical records to a new provider upon request.