Foster Care FAQs
What extra benefits does Buckeye offer beyond the standard benefits required by ODM?
- 24-Hour Nurse Advice Line: A 24-hour, toll- free phone line through which callers can reach both customer service representatives and bilingual nursing staff. The nurse triage service provides access to a broad range of health-related services including health education, urgent pharmacy re-fills, transportation for treatment, and crisis interventions.
- Be Well Program: Buckeye members can take part in a member-only program called “Be Well!” This program will help you stay healthy and assist seeing your doctor for annual wellness services in each calendar year that you are a Buckeye member. Throughout the year mailing and calls will help keep you up-to-date and on track for staying healthy. Call Buckeye’s Member Services Department at 1-866-246-4358 (TTY 1-800-750-0750). We’ll give you more information about our services and the Be Well! Program for members.
- Start Smart for Baby: Buckeye’s Start Smart for Your Baby program offers specialized assistance for women who are pregnant and for moms who have just had a baby. This program helps women take care of themselves and their babies, and it also provides assistance for young women who want to become pregnant or take steps to avoid getting pregnant. Start Smart also includes an award-winning Addiction in Pregnancy Program for pregnant women who are battling addiction (for more information see: http://www.modernhealthcare.com/article/20150905/MAGAZINE/309059980/innovation-by-necessity-medicaid-emerges-as-aggressive-laboratory).
- Dental: Buckeye’s dental services include two periodic oral exams and cleanings per year (more than what is available with fee-for-service Medicaid).
- Optical Benefit: We provide an annual exam and for children under age 21 annual eyeglasses.
*CentAccount rewards do not apply to members within the Foster Care program.
Are you planning to offer any specific or extra benefits to Public Children Services Agencies (PCSAs) and/or kids in custody?
After we conduct outreach and care coordination for incoming members, we will assess the current benefit structure and identify and (if necessary) modify the services and service levels that are offered to these members. We believe the information from the initial interactions is needed to guide any benefit adjustments and best meet the needs of the individuals.
We know PCSAs have had difficulty accessing some specific types of providers, including psychiatrists and dentists. What can PCSAs do to make sure the MCOs’ networks will meet their needs in these areas?
- Each MCP has its provider directory online. Buckeye’s tool, called “Find a Provider,” is very user friendly and allows for searching by specialty such as provider, specialist, hospitals, etc. This tool provides the most up-to-date information on panel status, allowing for ease of use and noting additional providers by region and specialty as needed. Buckeye’s Member Service Department is always available as well to assist with locating providers
- Buckeye Health Plan, a wholly owned subsidiary of the Centene Corporation, offers a robust dental network that has been developed by our corporate sister Dental Health and Wellness (DHE). Our network includes 1,400 dental providers in all 88 Ohio Counties, and we are consistently adding approximately 25 providers each month. Buckeye believes good oral health is part of good health, and we are very proactive in helping members receive appropriate dental care. Working as a team that includes case managers, member services representatives and staff from other departments, we have been able to find an in-network dental provider for our members at all times.
- Buckeye’s behavioral health care management team has strong relationships established with psychiatric providers around the state and acts as a liaison in directing members to services which are currently covered by fee for service. Our experienced and dedicated behavioral health team is prepared to take a leadership role in managing both the behavioral health services to managed care is launched in 2018.
Are all of the Ohio children’s hospitals on your network? If not, which are not included.
Buckeye has existing contracts with all major children hospitals.
Are there any psychiatric hospitals in Ohio that serve children and youth up to age 18 that are not on your network? Please indicate those that are not included.
All general hospitals in Ohio are in Buckeye’s network. University of Toledo Medical Center and Cincinnati Children’s Medical Center are also in network with Buckeye via our specialty behavioral health vendor and sister company, Envolve, (formerly called Cenpatico) for inpatient psychiatric services for children. Additionally, Envolve works with all psychiatric hospitals (free standing and psychiatric units of general hospitals) to ensure medically necessary inpatient psychiatric care is covered regardless of whether or not the hospital is included in Envolve’s network. Buckeye’s behavioral health care management team has developed unique onsite relationships with the majority of the Ohio psychiatric hospitals, and works with the hospital social workers and parents/guardians to attend family meetings with the team prior to discharge. The goal of these meetings is to engage the member and family in Buckeye’s care management program, complete and initial needs assessment, and develop a person centered care plan to support the member as he or she transitions back into the community.
Where can I find Buckeye’s provider network search site?
Buckeye Health Plan’s provider link is below.
Medications and the formulary are an area we hear about consistently. Is your entire formulary posted so we can link to it? Can you send us the link?
- The links to our pharmacy information is provided below. The entire formulary is online. You can find both the PDL and list of medications requiring prior authorization using the link provided. You can also find the maintenance drug list. Please note that our PDL and list of medications that require prior authorization can change so it is important for you and/or your provider to check this information when you need to fill/refill a medication. You can also call the Buckeye Member Services Department to request information on our PDL and medications that require prior authorization.
What are the parameters of your transportation benefits? What are the limits, how many days in advance do members need to schedule, do you reimburse for travel, etc.
Buckeye Transportation Benefits:
- Unlimited trips to the doctor or healthcare appointment more than 30 miles away, if services are not available closer.
- Up to 15 round trips or 30 one-way trips for covered services less than 30 miles away; covered services include healthcare/dental appointments, WIC appointments and redetermination appointments (for Central Southeast Region the benefit is doubled)
- Unlimited trips for members who are confined to a wheelchair
- Must schedule transportation 48 hours prior to an appointment, unless it is urgent (urgent appointments require provider verification)
- Travel reimbursement is available for members who have family members assist in transportation
- Bus passes are available for members who prefer taking this method of transportation
Regarding engagement of new members of your plan, can you identify strategies that you employ that would be most helpful to the unique circumstances of youth in the custody of the PCSA.
Buckeye has been serving foster children in Lucas County for the last 10 years. Because of our successful track record in managing the care for this vulnerable membership, we are uniquely qualified to provide care management/care coordination services statewide. Buckeye care managers have been able to develop and implement processes to ensure a fast turn-around for obtaining everything from durable medical equipment to medications and the team is prepared to ensure that the foster parent has all of the supplies they need to care for a child when that child is removed from his/her home.
Medical care managers and behavioral health care managers work side-by-side to ensure any services needed to support the foster child and foster family are made available. Buckeye’s behavioral health intensive case managers have all received Trauma Informed Care Training. This additional high-level of training prepares our staff to meet the unique needs of children in custody and underscores our commitment to serving this population. In the coming year we plan to provide this training for our medical case managers as well.
What else do you think is important to call to PCSA’s attention as they make the enrollment decision?
- Previous experience with managing the population
- Experienced pediatric care managers
Is there any other info that would be helpful to know?
As part of the Centene Corporation family, Buckeye is able to tap into the experience and expertise of a multi-national, Fortune 500 (currently ranked #124) parent company that operates unique health plans in roughly half of the states. Our sister plans in 12 states have experience managing the care for children in custody. With Buckeye’s experience in Lucas County and Centene’s experience in other states, Buckeye is prepared to hit the ground running with this unique population. Our local approach to providing services also allows us to tailor our work to your local needs.