Need to change rheumy

[Guest guest]

Hi friends,

I switched insurance plans in October, and before doing so, I made

several calls to ensure that my daughter and I could both continue to

see the specialists we have. Assured there would be no problem, I

switched to a cheaper plan that requires referrals. Fast forward

through a blur of bills, phone calls, frustration and confusion to

yesterday, when I finally learned that my rheumy is not (no longer?)

in network. So now I am looking at a switch. I've liked this doctor

very much. I had a good cry while on the phone with the insurance

rep. (she was quite compassionate) and continued to cry after I hung

up. Getting decent medical care seems like so much damn work! The

positive I see is getting a second opinion on my case. I'll be

interested in that. A new doctor might even be better; I'm open to

that possibility. The disruption in care is no small thing, though.

Sierra

[Guest guest]

Sierra,

Can you go out of network and meet a deductible and then get reimbursed

80%? I know you can't with every insurance. That's what I did until my

wonderful Rheumy retired. After all was said and done it was costing me

$200 out of pocket but for me it was worth it because he was excellent. He

even was good about letting me pay him in installments.

>

> Hi friends,

> I switched insurance plans in October, and before doing so, I made

> several calls to ensure that my daughter and I could both continue to

> see the specialists we have. Assured there would be no problem, I

> switched to a cheaper plan that requires referrals. Fast forward

> through a blur of bills, phone calls, frustration and confusion to

> yesterday, when I finally learned that my rheumy is not (no longer?)

> in network. So now I am looking at a switch. I've liked this doctor

> very much. I had a good cry while on the phone with the insurance

> rep. (she was quite compassionate) and continued to cry after I hung

> up. Getting decent medical care seems like so much damn work! The

> positive I see is getting a second opinion on my case. I'll be

> interested in that. A new doctor might even be better; I'm open to

> that possibility. The disruption in care is no small thing, though.

>

> Sierra

[Guest guest]

Sierra,

I am on Medicare which pays 80 % of my medical bills and I have a

supplemental insurance that pays the other 20%. The cost of the

supplemental insurance is outragous. It cost me just over $305

per month. That's almost half my social secutity check. It pays a

measly 10% on my medicine which eats me up. I am contemplating

in changing over to AARP. My Dr's nurse told me that AARP pays good.

I'm hoping they have a policy on medicine which I think is seperate.

This past Thursday my Dr had to give me a shot of Prednisone in

my lower back and this coming week he will start a series of shots of

Hyalgan in my left knee. It's a series of five shots. You get one

shot a week for five weeks.. He said it was going to be expensive.

I know Medicare will cover 80% of the cost and I am hoping my

supplemental insurance will cover the rest. But with them paying

only 10% I'm not sure what I'll be paying out of my own pocket......Joyce M

----- Original Message -----

From: " snowdrift52003 " <snowdrift52003@...>

<Rheumatoid Arthritis >

Sent: Saturday, March 05, 2005 10:55 AM

Subject: Need to change rheumy

Hi friends,

I switched insurance plans in October, and before doing so, I made

several calls to ensure that my daughter and I could both continue to

see the specialists we have. Assured there would be no problem, I

switched to a cheaper plan that requires referrals. Fast forward

through a blur of bills, phone calls, frustration and confusion to

yesterday, when I finally learned that my rheumy is not (no longer?)

in network. So now I am looking at a switch. I've liked this doctor

very much. I had a good cry while on the phone with the insurance

rep. (she was quite compassionate) and continued to cry after I hung

up. Getting decent medical care seems like so much damn work! The

positive I see is getting a second opinion on my case. I'll be

interested in that. A new doctor might even be better; I'm open to

that possibility. The disruption in care is no small thing, though.

Sierra

[Guest guest]

Hi Sierra,

What a frustrating experience! However, I know that docs come in

and out of networks all the time. Your rheumy probably was in the

network in October when you made the switch, but decided not to

renew his contract with the health plan. When doctors join a plan

they agree to accept reduced fees in exchange for having a

population of patients who have a financial incentive to see them.

If they don't like the terms of the new contract, they often drop

out. It is a shame for the patients, but it is a business decision

on the part fo the doctor.

I hope you can find a good rheumy in your new network. If you

haven't already, you might want to call your current docs office and

ask them to make a recommendation from among your new choices.

You seem to have a positive attitude about the switch which should

make things easier on you. Let us know how it goes.

Beth

>

> Hi friends,

> I switched insurance plans in October, and before doing so, I

made

> several calls to ensure that my daughter and I could both continue

to

> see the specialists we have. Assured there would be no problem, I

> switched to a cheaper plan that requires referrals. Fast forward

> through a blur of bills, phone calls, frustration and confusion to

> yesterday, when I finally learned that my rheumy is not (no

longer?)

> in network. So now I am looking at a switch. I've liked this

doctor

> very much. I had a good cry while on the phone with the insurance

> rep. (she was quite compassionate) and continued to cry after I

hung

> up. Getting decent medical care seems like so much damn work! The

> positive I see is getting a second opinion on my case. I'll be

> interested in that. A new doctor might even be better; I'm open to

> that possibility. The disruption in care is no small thing, though.

>

> Sierra

[Guest guest]

Well, Sierra, I sincerely hope that all

the best

endings are shown for you here!

I’m sorry you had to battle the

insurance armies.

Peace to you

yellow

Improve it. Agitate. Promote freedom and

justice. Educate and empower.

Use your resources to reach those who have

not been where you have been, nor seen what you have seen. In doing this we

build a stronger nation.

-----Original Message-----

From: snowdrift52003

[mailto:snowdrift52003@...]

Sent: Saturday, March 05, 2005

11:55 AM

To:

Rheumatoid Arthritis

Subject:

Need to change rheumy

Hi friends,

I switched insurance plans in October, and before

doing so, I made

several calls to ensure that my daughter and I

could both continue to

see the specialists we have. Assured there would

be no problem, I

switched to a cheaper plan that requires

referrals. Fast forward

through a blur of bills, phone calls, frustration

and confusion to

yesterday, when I finally learned that my rheumy

is not (no longer?)

in network. So now I am looking at a switch. I've

liked this doctor

very much. I had a good cry while on the phone

with the insurance

rep. (she was quite compassionate) and continued

to cry after I hung

up. Getting decent medical care seems like so much

damn work! The

positive I see is getting a second opinion on my

case. I'll be

interested in that. A new doctor might even be

better; I'm open to

that possibility. The disruption in care is no

small thing, though.

Sierra