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Post by Karen Cole on Nov 7, 2014 23:22:28 GMT
So last year when we had to have insurance or be fined we applied online for blue cross, somehow we ended up with Medicaid honestly we were trying for affordable insurance. Anyway, so we take the Medicaid offered and it's been just horrid with the exception of using it for the boys. our portion of the insurance has changed, we now pay for RXs pricey for me but ok and Dr. office visits ok we can handle that too. But now when something might be wrong I can't get into the Dr. for a month or more because they can't keep Dr.s! they are back to one Dr. and her hours are very limited. I tried an office my sister uses but they are not taking new clients, I called the office they recommended but they won't take Medicaid? Doesn't matter that I'll have to pay cash to begin with they don't want me. Hopefully over the weekend I'll get osme more contact numbers and can get in.
and now Iam not signed in? guess I'll have to figure out my password....arggggghhhh |
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Post by horselover4life on Nov 8, 2014 0:30:52 GMT
To my understanding when you have Medicaid your cash outlay is severely reduced or none.
Co-pays for drugs are minimal if any and yes there is a formulary to be followed. Your doctor knows what is covered and what is not based upon your insurance. There is no reason you need to be spending large outlay for a drug when there are others on the market that can do the same thing,...unless you have a allergy to a drugs component and then it would be covered in full as it is prescribed because of medical necessity.
Get in touch with your actual provider assigned and have them send you a list via email of participating physicians accepting new clients and see if your doctors are participating.
I hear a load of crap having appointments cancelled and such....next time they pull that line of B/S tell them "Really, really you have "0" availability to see me? Is it my insurance? Wow...I'll have to notify the state and insurance provider that the information I was just supplied with that you are accepting, seeing and being compensated for care is wrong... You turned me away and refused my case."....
In the case of them not being able to keep physicians on staff....that is not your concern or problem but theirs. You are a patient of the group and deserve to be seen and not have your health jeopardized because of their office staffing issue... To me, sounds like near negligent care happening.
Interesting what your outcome will be....
You should also be able to get a clear description verbally of what is covered, what is not in office visits, prescription coverages and such. Your provider should have a access number just about 24/7 to reach someone that can give you information {look carefully at the card back}.. You might not be able to get all the information on a weekend, but you should be able to be told who has availability for clients so you are not walking into a ER of a hospital for care...
Best of luck.
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Post by Karen Cole on Nov 8, 2014 0:49:12 GMT
That was the case when we first got it, now I pay whatever the pharmacy charges for my perscriptions and my office calls have been about $90. Anything under $700 a month we pay cash for which is not as easy as it sounds. We have to pay up front because enough people don't pay at all but since normally it's all billed to insurance companies the receptionists don't know what to charge cash customers. My most expenisive RX is my inhaler, the least expensive my muscle relaxers. If I get all my meds each month they run over $100.
I didn't even try to get into the office I normally use, last month they had 2 Dr.s now they have one and she is trying to get used to everything. Now though they are only open for clients on Monday, Tuesday and 1/2 day on Thursday. Before she came in they were only open Monday and Wednesdays and booking a month or more out. I do have to admit I missed an apt, my Grandmas wake was the same day/time I zombied out and forgot my apt. But still the new Dr. doesn't know me and will probally leave in a few months, do I really want to go to a Dr. once then have to get a new one? NO Iam tired of it. One reason I called the other clinic that said they are full is my sister has HUGE health issues and goes there, she loves her Dr., of course that's the one not taking new clients. So I asked about other Dr.s in the practice and no they are not seeing anybody new either. I didn't ask about Medicaid there I know they take it I've taken people there but not sure the one Dr. they have open would take additional Medicaid clients. I may call back on Monday. Iam also waiting to hear from a friend who knows a lot of people in the next town over, her mother has health issues and she knows a lot of the Dr.s.
I will be calling the provider and can ask more questions then. I need to get my mammogram done and am told that Medicaid has to cover it. I don't know I had no idea it was this difficult. I do know Iam going to keep trying reguardless I need to be checked out. My BP is normal/high but my resting heart rate is crazy high 108-120. My guys PT insisted his reader was wrong than was shocked when I told him it wasn't and the Dr. wasn't concerned....which has also led me to belive I need a new Dr.
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Post by horselover4life on Nov 8, 2014 0:59:15 GMT
To my knowledge part of the Obama medical care act covers ANY WOMEN for mammograms and paps...FREE!
there is no charge.....
Ummmm.... yea not being concerned about those kind of numbers is very negligent IMO....
I know if it were me, my doctors would be sending me for tests after a office EKG was done and while doing those tests have me on medication to slow it down...
Based upon that information you gave...I would be seeking and finding a new doctor and office for care...something is wrong id they are Ok with those numbers. I get "white coat syndrome" but that is crazy!
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Post by karencole on Nov 8, 2014 1:11:08 GMT
To my knowledge part of the Obama medical care act covers ANY WOMEN for mammograms and paps...FREE! there is no charge..... Ummmm.... yea not being concerned about those kind of numbers is very negligent IMO.... I know if it were me, my doctors would be sending me for tests after a office EKG was done and while doing those tests have me on medication to slow it down... Based upon that information you gave...I would be seeking and finding a new doctor and office for care...something is wrong id they are Ok with those numbers. I get "white coat syndrome" but that is crazy! That's what the lady said when I called about the free ones they were doing in October.
The PT that works with my guy wasn't overly concerned with the numbers but then he started to ask questions. I guess my answers were not what he wanted to hear, he told me I was grounded  No more working out with my guy during PT until I get checked out. Kinda bummed about that we were having fun. I will get something figured out in the next week for sure.
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Post by 1fatmule on Nov 8, 2014 23:24:53 GMT
Medicaid surely has it's up's, and down's!! i have been on total disability since 1999, and on medicaid since 2008. what you personally qualify for is all based on your income, what, and how much they pay is based on that. all of my oral surg. qualifies, but the closest oral surgeon that accepts medicaid is 300 miles away, one way. i let medicare chose my drug plan, and they cover my $150+ a month, more later supper time.
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No more working out with my guy during PT until I get checked out. Kinda bummed about that we were having fun. I will get something figured out in the next week for sure.