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View Full Version : Can you give me feedback on health insurance & dr. visits for the poorly insured



Carolnnc
November 12th, 2015, 04:04 PM
If your health insurance stinks how do you manage your doctor visits? I lost my job and we had to go on my DH's terrible insurance. It has a very high deductible and pays only for a physical/well visit. It was time for a physical and my doctor left the practice so I was set up to see someone relatively new. She wanted me to come in for three visits and kept trying to tell me I needed several expensive medical tests and blood tests. I kept repeating, "My insurance doesn't pay for that and I don't have a job. She was very pushy and when I started to cry she said she didn't mean to offend me, she was just trying to give me good care. She actually put one of the tests on my sheet but I had the presence of mind to ask and tell the person drawing blood to take that test off. After I left I called the practice manager and of course she said it was just a communication problem and to see another doctor from now on. It's been a week and my prescription refills still haven't gone to the pharmacy and no tests results in the patient portal. I take good care of myself but I do need cholesterol drugs and HRT. Of course I was told by the pharmacy last time that my HRT was going to be $200 a month so I may have to give up on that one.
Does anyone have a doctor who will see them only once a year, give them prescriptions and say be well or do they not exist? How do you handle having almost nonexistent insurance?

GrammaBabs
November 12th, 2015, 04:13 PM
The only thing i can suggest is that in some states there is a system in place for low income or no income health care... My son had his own business in MA and there was something available to him that cost "according to his income"... it was a big savings. FF to his business having to close and a move to Florida... I must say they have a much better system... The clinic had him fill out paperwork with information about his job there which is minimal pay,,, but they operate on a system of cost according to income... only a fraction of what it would be... they also require a drug test for welfare recepients.. Not a bad idea i think...
Not sure if this helps,,, but I would call around or check with unemployment offices for information...It's worth a shot...GB

Midge
November 12th, 2015, 04:36 PM
Sorry for your troubles. You are in a boat that is still crowded despite the ACA reforms. I don't live in NC, so I have no idea what the resources are like there these days. But here are some places to start. Some states (like Ohio) chose to expand Medicaid eligibility when the ACA went into effect. Others did not. Find out which group NC belongs in. You and your hubby might qualify depending on income and assets. Some large health care organizations like university associated hospital systems still have a sliding scale of fees for those who do not qualify for public assistance. Worth checking out. What good is your current provider if you can't afford it? Next, the big drug companies still have Patient Assistance programs to help people like you. Check out what you are taking and do some research on their websites. See if there is a notice of Patient Assistance there and download the forms. You will probably have to fill them out and get fresh prescriptions so they can be mailed in. Different programs have differing criteria, so read the fine print. You can probably get both cholesterol lowering drugs and HRT using the brand name formulation. Also, shop around different pharmacies and ask for their pricing. You will be shocked how much they differ. Just a few ideas to get you started. Hope this helps.

K. McEuen
November 12th, 2015, 04:38 PM
Most doctors will not prescribe meds for an entire year. Usually they are done in 3 month increments so that they can check to see if any changes are needed. I would suggest checking into your county hospital/health clinic for help.

irishrn
November 12th, 2015, 05:35 PM
Depending on where you live in NC there are several choices for health care. Near Raleigh there are walk in clinics. In my county Harnett, there is the health department. NC did not expand its Medicaid program. But the health exchange is currently open for enrollment right now so you should go on the website healthcare.gov and see if you qualify for your own insurance and then you can come off your spouses.
Depending on what county you are in, I would start with on line search for your county. I will help in any way I can. Best to PM me as I can't get on here every day lately! Good luck.

shirleyknot
November 12th, 2015, 08:31 PM
If your health insurance stinks how do you manage your doctor visits? I lost my job and we had to go on my DH's terrible insurance. It has a very high deductible and pays only for a physical/well visit. It was time for a physical and my doctor left the practice so I was set up to see someone relatively new. She wanted me to come in for three visits and kept trying to tell me I needed several expensive medical tests and blood tests. I kept repeating, "My insurance doesn't pay for that and I don't have a job. She was very pushy and when I started to cry she said she didn't mean to offend me, she was just trying to give me good care. She actually put one of the tests on my sheet but I had the presence of mind to ask and tell the person drawing blood to take that test off. After I left I called the practice manager and of course she said it was just a communication problem and to see another doctor from now on. It's been a week and my prescription refills still haven't gone to the pharmacy and no tests results in the patient portal. I take good care of myself but I do need cholesterol drugs and HRT. Of course I was told by the pharmacy last time that my HRT was going to be $200 a month so I may have to give up on that one.
Does anyone have a doctor who will see them only once a year, give them prescriptions and say be well or do they not exist? How do you handle having almost nonexistent insurance?
Are you seeing my doctor? Same deal.

DeniseSm
November 12th, 2015, 10:43 PM
My health insurance is so bad it is actually cheaper for me to go to the local health clinic than to use my crappy insurance. Look for a clinic with good reviews. Mine gives excellent care.

Carolnnc
November 12th, 2015, 11:18 PM
Thanks so much for the suggestions and caring. I am usually a very positive person! I'll definitely do more research.

Valcross
November 13th, 2015, 12:32 AM
Carolnnc,
I'm so glad that you stood up for yourself! I'm sorry they made you cry. Healthcare is a business, is run like a business, and you are the customer. She was not listening to you. I've worked in healthcare since 1990, seen lots of changes.
I recommend that:
1. You go to the clinic and speak to the practice manager directly, tell her your prescriptions haven't been called in, and they need to be there by noon so that you don't have to go through the weekend without them.
2. Check into your local health district or health clinic. They often work on a sliding scale based on your income, and when possible adjust their testing according to what you can afford. Ask them to give you information on drug companies that help offset out of pocket expenses for their drugs. (I take a rheumatoid medication that is very expensive, the manufacturer pays my co-pay up to 8,000 a year) If they don't know, ask your pharmacist. Your pharmacist can also generally tell you which medications have cheaper alternatives.
3.Don't give up your current insurance to get an exchange plan until you know EXACTLY what it's going to cost and what it will and won't cover.The exchange programs are typically very expensive, with very high deductibles. (Example, friend who owns her own business pays 1,400 a month in premiums for her, her son and her husband with a 3,000 deductible. This is very typical) More doctor's offices are not accepting these exchange plans because the reimbursements to the Dr are so low, they can't take afford to take them and stay in business.
You have every right to stand up for yourself, and to have input into your care. I hope you find what you need.

snippet
November 13th, 2015, 02:48 AM
My doctor gives me prescriptions for a year. But then I've been her patient for a few years. I think most docs will want to establish a history with you to avoid any problems. Don't give up.

stationarymom
November 13th, 2015, 02:56 AM
Hi
You might want to call the local senior center and ask if they have a medical or insurance specialist that can help you find the insurance that is best for your needs.You could also talk to Dr's and tell them that you are considering becoming a cash only pt. and ask them what it would cost to see them and have test done if you paid out of pocket.Lots of times costs are inflated because it is being charged to ins, and not directly to the pt.

mary3100
November 13th, 2015, 10:42 AM
Try to go on the whole food plant based diet. It will reverse all the major diseases and you elimate the pill pushing Doctors. They are only taught to treat symptoms with pills, not the cause. It can be a good thing is you have ****ty insurance really. Fix your base, give your body what it needs and it will serve you well.
https://www.youtube.com/watch?v=30gEiweaAVQ