Friday, March 21, 2014
HMO Nightmares
So turns out that if you have cancer AND an HMO, life can become extremely difficult!! Now more than ever, I really really wish we had a different health care system. I truly can not believe how difficult is to get care and I always thought I had good insurance. I've seen one surgeon that is just a general surgeon and does not specialize in breast surgery and isn't familiar with all of the options of breast cancer surgery, so I figure well I will just get a second and third opinion and make sure I know all of my options and go with who I feel the most comfortable with, but turns out, it's really not that simple. In order to see anyone else, my Dr has to submit a request, which has to be reviewed and approved within 5-7 days and that is just to authorize to get a second opinion. This does not authorize the Dr to provide any care or testing of any kind, that is separate request that has to be made. And this is before I even have a chance to talk to the Dr to determine if I even like them. And if I want to actually go to a breast cancer center or specialty hospital then of course authorization has to be requested and they require notes from all the doctors you've seen, and they are out of the office in and unable to finish their notes to provide to the medical group that they have 5-7 days to respond and may just send me a denial after all of this wasted time while I await treatment for CANCER!!! No big deal, I guess!! I've paid for insurance since I was 18 and rarely needed it and now that I am sick, you would think that all that time of paying for something I didn't need would all be worth it now!!! As if I didn't have enough problems and things to figure out, I have to make phone calls all day long to harass doctors, and insurance companies and office assistants to push through paperwork so that I can even try and get any care. Best health care system in the world, huh?!??!
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Don't know if it would help you but I have Aetna HMO as my suppliment with medicare, not sure if you could get this too. worth a try. When I was going to get my Chemo the Insurance co. I was with was going to charge me $2500 each time and a lady net to me told me she was only paying $250. thru Aetna. I called and was accepted by them... Call and see if you are able to get on a plan with them..It is worth a try..God Bless and I'm keeping you in my prayers Katrina..
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