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01/13/2012 04:11:50 PM · #1
Health insurance. Doctors. Aarrrghhh! OK, so I went to the same doctors office for 15 years. Over the years, the main doctor took an associate and divided her patients and I went to the new doctor. I hated him. He was a complete jerk. They added another doctor and I switched to her. It worked out well, she was a lovely woman with incredible knowledge and seemed to genuinely care. I saw her for many years. One day out of the blue she left the practice. The jerk doctor had left a couple years before. They added another new doctor, I started seeing him. I saw him twice, then he left. Then the main doctor left. At this point, I had moved, no longer had insurance and had never seen any of the doctors that are there now. So, I found a clinic in my new area. I went, loved the doctor. Spent an hour going over my history, etc. Went back for a follow up after blood work and she had left! Jeezus! I didn't like the new doctor. Just as well, my insurance changed Jan. 1st to an HMO through medicare and I needed to find a new doctor anyway. So I did what most people seem to do now, I picked a name out of the book. LOL! I called there for the first time today after calling an eye doctor and finding out I need a referral. I explained that I was going to be a new patient, what my insurance was and what I needed. I was informed that I need to actually see the doctor first & pay the co pay in order to get said referral. No problem I said. But we don't have any appointments open until February. Then I got an interrogation about why I was switching doctors, what my medical needs were, what medications I currently take and a big long explanation that they don't prescribe narcotics. Fine I said, I don't take them, I've only had them a few times and don't tolerate them well and I have no need for them. But she was relentless about this. If a broke a leg, I'd have to go to a pain management doctor for pain meds. OK? What? Are things really that bad for doctors that they're afraid to write scripts for pain if needed? Bizarre. But anyway, it almost felt like she was discouraging me from coming in. Why? Should I find another doctor and just forget this one?
01/13/2012 04:35:27 PM · #2
Originally posted by Kelli:

... after calling an eye doctor and finding out I need a referral. I explained that I was going to be a new patient, what my insurance was and what I needed. I was informed that I need to actually see the doctor first & pay the co pay in order to get said referral. No problem I said. But we don't have any appointments open until February. Then I got an interrogation about why I was switching doctors, what my medical needs were, what medications I currently take and a big long explanation that they don't prescribe narcotics. Fine I said, I don't take them, I've only had them a few times and don't tolerate them well and I have no need for them. But she was relentless about this. If a broke a leg, I'd have to go to a pain management doctor for pain meds. OK? What? Are things really that bad for doctors that they're afraid to write scripts for pain if needed? Bizarre.

Yes, it's that bad. If they accept you as a patient without a referral from your primary care provider they

1. Can't bill your insurance
2. Become responsible for any other health problems (e.g. broken leg, cancer) you may have/get

Ever since copies of all narcotics prescriptions began being forwarded to the DEA in the 1970's they have been routinely under-prescribed, even though they are among the safest pharmaceuticals we have when used properly, simply because of the over-demonization of their addictive potential. I mean, someone dying of cancer with maybe six months to live might become addicted to pain-killers? So what, as long as they can kill the pain?
      


Message edited by author 2012-01-13 16:40:51.
01/13/2012 04:41:15 PM · #3
Dang. Canada is so much easier, in my experience. :-(
01/13/2012 05:01:39 PM · #4
Paul, you misunderstood. It's not that I care about needing a referral, it's that I can't get a referral for an eye doctor without first "seeing" the primary doctor and paying a fee. I really have no need to see the primary doctor. It's really a waste of both my time and hers. But, in order to get the referral, I have to do it. And I'm fine with that. But, they can't even give me an appointment for a month. So that's another month I have to put off the eye doctor while my vision gets worse by the day. And who knows how long it will take to get that eye doctor appointment after I finally do obtain the referral.

I could have stuck with the regular medicare, no referral needed, but they don't cover eye care or glasses. And you end up with big bills in the end. Trust me, I found that out the hard way. My six month cardiologist appointment along with an EKG & stress test cost me $600 (co pays & deductibles). For sure not something I can afford on a regular basis. And they use extortion measures to get you in there. If you don't come, you can't have the meds that keep you breathing on a daily basis. LOL. Fun stuff. I'm just fed up with all the red tape.
01/13/2012 06:49:53 PM · #5
If it makes you feel any better, I end up getting a bunch of the same sort of crap - but I pay $500 a month and it still only covers 80% of my cost - after my copay.. sheesh.
01/13/2012 07:58:00 PM · #6
I pay zero per month. To see an optometrist I just make an appointment, but the appointment costs $25. Beer's on me, Cory. ;-P
01/13/2012 08:03:41 PM · #7
This is the future for Obamacare....My brother is a doc and now is having to do things he has never done before and he is HIGHLY against Obamacare
01/14/2012 06:12:17 AM · #8
Kelli, I think you need to go visit Slippy's Eye doctor.
01/14/2012 08:48:25 AM · #9
Originally posted by cowboy221977:

This is the future for Obamacare....My brother is a doc and now is having to do things he has never done before and he is HIGHLY against Obamacare


hilarious. I knew someone would blame Obama for this. like US Health Care was wonderful until he became president.
01/14/2012 09:23:56 AM · #10
Originally posted by posthumous:

Originally posted by cowboy221977:

This is the future for Obamacare....My brother is a doc and now is having to do things he has never done before and he is HIGHLY against Obamacare


hilarious. I knew someone would blame Obama for this. like US Health Care was wonderful until he became president.


I was thinking the same thing yesterday, but I was too pissed off to write it. What this is about is making some HMO CEO richer. The amount of paperwork that goes into running these things is tragic. Trust me Slippy, if it wasn't so damn cold in Canada, I'd have moved there years ago, just for the healthcare.
01/14/2012 09:49:21 AM · #11
managed care and greed is what ruined healthcare in the US not Obama.
01/14/2012 10:28:55 AM · #12
Originally posted by Strikeslip:

I pay zero per month. To see an optometrist I just make an appointment, but the appointment costs $25. Beer's on me, Cory. ;-P


I'm getting a discounted rate on my medicare now for choosing an HMO. I pay $100/month for my premium. To see the optometrist will cost me $35, plus the $15 to see the PCP. I no longer have deductibles, unless I go in the hospital. Then it's $190 per day.
01/15/2012 01:32:24 AM · #13
Originally posted by Kelli:

Originally posted by Strikeslip:

I pay zero per month. To see an optometrist I just make an appointment, but the appointment costs $25. Beer's on me, Cory. ;-P


I'm getting a discounted rate on my medicare now for choosing an HMO. I pay $100/month for my premium. To see the optometrist will cost me $35, plus the $15 to see the PCP. I no longer have deductibles, unless I go in the hospital. Then it's $190 per day.


Part of the reason the rate is discounted is because you have agreed to let your PCP discern whether you need to see a specialist. The theory is this cuts down on Patient X making an appointment with the expensive cardiologist for their panic attacks (or something else not heart related). There may also be an idea to get you to see a PCP regularly for preventative medicine. This is all, of course, in an ideal world. Most of us don't even think about the doctor until something is wrong and then if you haven't established with someone you are stuck in the exact position you find yourself where you have to make two appointments to see the proper doctor. At least once you've established you may find it runs smoother, but then again maybe not. HMOs can run on the "gatekeeper" model where the PCP controls all access to other docs.

Good luck with everything.
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