topic Re: Doctors in Wellness

Doctors

Nightowlz — Fri, 09 Nov 2018 17:33:53 GMT

I have to find a new doctor again. Mine is opening his own practice but not excepting Insurance.

His practice will be Direct Primary Care. One on one with the patient so he can say what he needs to his patients. No Ins hoops etc.

You have to pay $75 per month to be a member. You get unlimited office visitis, phone calls, texts etc. $25 extra if you want in home visit.

They work with you to get a good Ins plan with a higher deductible which would be used if you end up in the hosptial.

He has set up with labs, hospitals etc for lower price tests plus lower price medications. Not sure how much any of that would cost since it's all new.

If I did not have good Ins. at the moment I would switch over to this.

If he's still excepting patients when we retire & move to Medicare I will see if he's still taking new patients if we don't move.

You can still use your Medicare outside of his practice to pay for things.

Re: Doctors

Laura14 — Fri, 09 Nov 2018 17:57:12 GMT

Does he have a relative doctor near me? That is fantastic! My sister and her family would jump all over that and me too. $75 a month? My insurance premiums are double that and I have to insure myself for over $6000 before it even exists.

Re: Doctors

Vivian — Fri, 09 Nov 2018 18:13:06 GMT

My friend, who lives in the San Francisco suburbs, has a primary care physician who works under similar rules. My friend has plenty of money and she wanted to have a primary care physician who guaranteed call-backs and/or office visits within 24 hours. Our health care system, like our infrastructure and our politics, is completely broken. There will be innovative ways to work within our loony health care system, but they are often loony, and expensive.

Re: Doctors

Icegoddess — Fri, 09 Nov 2018 18:21:15 GMT

@Laura14 wrote:
Does he have a relative doctor near me? That is fantastic! My sister and her family would jump all over that and me too. $75 a month? My insurance premiums are double that and I have to insure myself for over $6000 before it even exists.

@Laura14, my premium will be over $800/month and a $6700 deductible. The fear of a catastrophe is the only thing keeping me buying insurance. I would jump all over that deal if I liked the doctor.

Re: Doctors

Travone — Fri, 09 Nov 2018 18:21:23 GMT

This is very interesting. I wonder how he is doing this with the high cost of malpractice insurance? When you become a "member" are you giving up your rights to sue?

Re: Doctors

IMW — Fri, 09 Nov 2018 18:39:17 GMT

Terrific deal. My md stopped taking Medicare and almost all insurance. My last, very last visit was $450 without any tests.

Another of my primary care mds wants $1800 a year to be a “concierge” md. Would do that (I have multiple health issues) but he is not a great doctor.

Re: Doctors

Nightowlz — Fri, 09 Nov 2018 18:42:13 GMT

@Laura14 wrote:
Does he have a relative doctor near me? That is fantastic! My sister and her family would jump all over that and me too. $75 a month? My insurance premiums are double that and I have to insure myself for over $6000 before it even exists.

@Laura14

I know he has a brother that lives here which is a Pharmacist.

I'm thinking if it goes over well for him which I think it will more doctor's will move his direction.

Before they changed out our plan I had to pay the office visits until the deductible was paid which it never was. I was paying $90 to $125 per visit. Now it's $25 or $30 not sure since I have not used it yet. Our deductible is only $250 now.

We have been lucky so far we have not had to pay out a lot on medical bills.

I have had 2 surgeries. First one I paid 0 out of pocket except for prescriptions. Second one I had to pay some Co-Pays but was not out thousands of dollars.

Re: Doctors

Nightowlz — Fri, 09 Nov 2018 18:45:27 GMT

@Vivian wrote:
My friend, who lives in the San Francisco suburbs, has a primary care physician who works under similar rules. My friend has plenty of money and she wanted to have a primary care physician who guaranteed call-backs and/or office visits within 24 hours. Our health care system, like our infrastructure and our politics, is completely broken. There will be innovative ways to work within our loony health care system, but they are often loony, and expensive.

@Vivian

That's the way he set this up. You will get same day or next day appt if needed. I could not believe he's even doing house calls or hospital visits for an extra $25.

I could see me doing this face to face using my computer.

Most of the things I have seen a doctor for could be done this way.

Re: Doctors

Nightowlz — Fri, 09 Nov 2018 18:48:38 GMT

@Travone wrote:
This is very interesting. I wonder how he is doing this with the high cost of malpractice insurance? When you become a "member" are you giving up your rights to sue?

@Travone

I found his website online & read the FAQ's. I did not read anything about the right to Sue. I'm sure you would find that out when you sign up? Never thought of that.

I thought I would get more feedback about other doctor's already doing this.

Re: Doctors

VaBelle35 — Fri, 09 Nov 2018 18:48:33 GMT

This is a new model of care that many doctors are moving to.

We have a few practices like this in my area.

I like the idea, but I don't have any issues that requires me to sign up. But if I did, I might.

Re: Doctors

Nightowlz — Fri, 09 Nov 2018 18:50:38 GMT

@VaBelle35 wrote:
This is a new model of care that many doctors are moving to.

We have a few practices like this in my area.

I like the idea, but I don't have any issues that requires me to sign up. But if I did, I might.

@VaBelle35

The main thing keeping me from signing up right now is paying the $75 per month for nothing. LOL!!!

I only go to the doctor once per year.

If I did not take thyroid mediction I doubt I would ever go.

Re: Doctors

Laura14 — Fri, 09 Nov 2018 19:14:16 GMT

Regarding right to sue, almost every medical practice has an arbitration clause. If he's smart and I am sure he is, you are probably agreeing to go to arbitration in the event of a dispute.

Re: Doctors

Mj12 — Fri, 09 Nov 2018 20:11:19 GMT

Concierge medicine. It's been around a while - at least 10 years that I know of, probably longer. So many doctors are being suffocated by insurance companies.

Re: Doctors

BirkiLady — Fri, 09 Nov 2018 21:38:22 GMT

Several clinics in Lincoln have been doing this for about two years. So far, it has been very successful for both the physicians and the patients. I do think private insurance is coming for all of us in the future. The Insurance Companies have priced themselves out of the market of group policies.

Re: Doctors

LTT1 — Fri, 09 Nov 2018 23:03:27 GMT

@Icegoddess

This idea is not for everyone, but you are paying $7200 per year for a “just in case” situation. Plus, you must pay the deductible before it kicks in?

So, what is your total vs paying out of pocket?

Maybe the “catastrophic” type insurance plan would be better?

Re: Doctors

Icegoddess — Sat, 10 Nov 2018 16:14:04 GMT

@LTT1, I would love a catastrophic plan if it were available here. The only thing available here are the ACA plans which, by law, must cover everything whether I need that care or not. Prior to ACA and before my husband retired we were on what was termed a high deductible plan which WAS $6500/person but the premium was much lower. I have no problem paying for my maintenance out of pocket. Even those freebies we were supposed to get end up not being free because the doctor uses an out-of-network lab for the pap smears or an out-of-network doctor to read the mammogram. And there's no way to find out what labs or doctors might be in-network for that. Sure, you can look for in-network doctors, but that means you have to know what doctors are on the list at the mammogram facility first. Even knowing what facility might be in-network is a problem. It's not on the webpage and even when I called customer service they couldn't tell me. But, I digress.

Re: Doctors

LTT1 — Sat, 10 Nov 2018 17:26:56 GMT

@Icegoddess

I was on an ACA plan before retiring (now on MEDICARE).

I don’t know the newer situation, but in our area, in the past when we were using private insurance, we started specifying up front that we would only have the procedure if “in network” providers were used.

It was always tricky, because at first, yes the main doctor was, but let’s say, the anesthesiologists were not and we would get a bill.

I also cannot imagine the company you use does not have an online, in-network provider search?

Re: Doctors

Icegoddess — Sat, 10 Nov 2018 17:57:24 GMT

@LTT1 wrote:
@Icegoddess

I was on an ACA plan before retiring (now on MEDICARE).
I don’t know the newer situation, but in our area, in the past when we were using private insurance, we started specifying up front that we would only have the procedure if “in network” providers were used.

It was always tricky, because at first, yes the main doctor was, but let’s say, the anesthesiologists were not and we would get a bill.

I also cannot imagine the company you use does not have an online, in-network provider search?

@LTT1, my provider is BCBS, but they have different plans depending on if it's open market vs employer-provided, and what might be in-network for one may not be in-network for the other. If I put Mammogram in the search bar I get nothing. When I went to get my Mammo I told them the doctor needed to be in-network and they just kinda looked at me. The website said I needed to use an in-network facility but nowhere does it tell you what facilities are in-network. I even called them and the only info the CS girl could give me was the exact same info I found on their webpage. Sure, I can look up in-network primary care physicians and specialists, but that's different than looking up labs and the doctors that read mammograms.

Re: Doctors

LTT1 — Sat, 10 Nov 2018 18:05:04 GMT

@Icegoddess

Oh yes, I see what you mean.

You sure are paying a lot. Those medical personnel should be kissing your feet!

Stay well!❤️

Re: Doctors

Icegoddess — Sat, 10 Nov 2018 19:23:35 GMT

@LTT1, those medical personnel have no idea what I pay. Ha ha. I'm doin' my best to stay well since I sure can't afford to get sick. Affordable care? That's a joke.