Community Chat

[pinkskates4]

On 1/3/2014 Sox2 said:

On 1/3/2014 Gooday said:

On 1/3/2014 Qwackertoo said:

We need more Doctors and Nurse Practitioners and Physician's Assistants to staff those clinic. We either have to import them . . . or . . . graduate more medical students which will take time.

I think the health industry would be benefited by the paying of students medical school or portion thereof and a contract to work so many years in a clinic . . . which I think they already do similar, maybe a state does it like Virginia, for very rural areas. Much like the military doctors . . . get their education paid for, return their service in payment for that debt . . . and then continue on later in private practice. But this will take both Time AND Money.

I saw an NP for the first time in October and again a few weeks later. I was quite impressed. A new clinic opened up just one mile away. While I am here for the winter, I will continue to see him if need be. The problem is there a hospital 2 miles a way who as of two months ago will NOT take BC/BS. ?????? I have my PCP back home but I wanted to establish myself in the area in case I needed to see someone.

I'm just curious, Gooday ... did the hospital give you a reason for not accepting BC/BS?

Most likely BC/BS dropped that hospital from coverage. This is happening all over. Insurance companies - even major ones - are dropping doctors and hospitals and limiting their areas of coverage.

They have been told they have to cut costs - and that's what they are doing.

This is what the President and others wanted. Well we are getting it in spades.

[SoX]

Thanks for the information, Terrier ... this hits home because we have a PPO with BC/BS ... thought I could use it anywhere we travel. Guess I'm wrong

[Qwackertoo]

On 1/3/2014 Sox2 said:

Thanks for the information, Terrier ... this hits home because we have a PPO with BC/BS ... thought I could use it anywhere we travel. Guess I'm wrong

Hopefully they will keep their out of network system up . . . when I fractured my ankle, I was almost 1,000 miles from home. BC/BS. Didn't cost me a penny. Not even the ever increasing . . . co-pay which is now 30.00 per office visit. We started out at 15.00 maybe 10+ years ago.

[terrier3]

On 1/3/2014 Dagna said:

On 1/3/2014 Sox2 said:

On 1/3/2014 Gooday said:

On 1/3/2014 Qwackertoo said:

We need more Doctors and Nurse Practitioners and Physician's Assistants to staff those clinic. We either have to import them . . . or . . . graduate more medical students which will take time.

I think the health industry would be benefited by the paying of students medical school or portion thereof and a contract to work so many years in a clinic . . . which I think they already do similar, maybe a state does it like Virginia, for very rural areas. Much like the military doctors . . . get their education paid for, return their service in payment for that debt . . . and then continue on later in private practice. But this will take both Time AND Money.

I saw an NP for the first time in October and again a few weeks later. I was quite impressed. A new clinic opened up just one mile away. While I am here for the winter, I will continue to see him if need be. The problem is there a hospital 2 miles a way who as of two months ago will NOT take BC/BS. ?????? I have my PCP back home but I wanted to establish myself in the area in case I needed to see someone.

I'm just curious, Gooday ... did the hospital give you a reason for not accepting BC/BS?

Most likely BC/BS dropped that hospital from coverage. This is happening all over. Insurance companies - even major ones - are dropping doctors and hospitals and limiting their areas of coverage.

They have been told they have to cut costs - and that's what they are doing.

This is what the President and others wanted. Well we are getting it in spades.

They have actually been doing this for years.

Hospitals and insurance companies have always had an interest in keeping costs as low as possible and profits as high as possible. They are businesses.

[kdgn]

On 1/3/2014 Dagna said:

Most likely BC/BS dropped that hospital from coverage. This is happening all over. Insurance companies - even major ones - are dropping doctors and hospitals and limiting their areas of coverage.

They have been told they have to cut costs - and that's what they are doing.

This is what the President and others wanted. Well we are getting it in spades.

Hold on there Dagna. Before you go spouting off with all sorts of theories.... We have two hospitals in this area, one takes my BC/BS and the other one doesn't. It was the HOSPITAL who refused to accept the insurance and this happened many years ago. They didn't like the negotiated fees the insurance company was proposing.

[terrier3]

On 1/3/2014 Qwackertoo said:

On 1/3/2014 Sox2 said:

Thanks for the information, Terrier ... this hits home because we have a PPO with BC/BS ... thought I could use it anywhere we travel. Guess I'm wrong

Hopefully they will keep their out of network system up . . . when I fractured my ankle, I was almost 1,000 miles from home. BC/BS. Didn't cost me a penny. Not even the ever increasing . . . co-pay which is now 30.00 per office visit. We started out at 15.00 maybe 10+ years ago.

Some insurers & policies have out of network...some don't.

Policies change every year as agreements with hospitals/doctors/other providers change.

This has been going on forever.

My local BC/BS policy thru the NY exchange has just $15 MD co-pays. I could have signed up for a policy with high co-pays, there are lots of options.

[Lila Belle]

On 1/3/2014 redtabby said:

Urgent Care can sometimes be an option, here none of the urgent cares are open after 7pm or on Sundays. My husband had food poisoning and we ended up at the ER anyways, no urgent cares were open.

That is something I think we will see change soon.

Two more urgent care centers have opened in my area in the last 5 months.

I found this from the AAUCM:

On June 28, 2012 the Supreme Court ruled that the Affordable Care Act’s requirement that everyone have health insurance is constitutional.

Just as Urgent Care Medicine has been part of the solution to the Emergency Room crisis, Urgent Care will be available to meet the healthcare needs of the estimated 32 million individuals that will be entering the healthcare market.

Urgent care clinics have become part of the medical safety net upon which people are increasingly relying, and with the huge influx of newly insured patients, Urgent Care will fill this role now more than ever. In addition, with a national shortage of primary care physicians, and average wait times for appointments with a primary care physicians averaging from 60 to 90 days, Urgent Care will be ready to accept those patients seeking care.

The public is learning that Urgent Care is a great choice for their immediate healthcare need; healthcare needs. The AAUCM will continue to improve the ability of patients and their physicians to achieve better health outcomes, and gain additional access to the Urgent Care centers.

[corita]

On 1/3/2014 Dagna said:

On 1/3/2014 Marianne is said:

Case in point today. We are fortunate to have (and pay for $$$$) very good insurance; however, I called this am for my son who is sick. No answer (snow here). Even if they were there, chances are they would not be able to fit him in (and it is a Friday, so he would have to wait until Monday).

The good news…our insurance also covers Urgent Cares and Minute Clinics, with the same $20 copay as the regular doctor. So, he will be seen today (he is there now, I believe).

The doctors' offices are difficult to get into for "emergency" (non-scheduled) appointments, but he does not need an ER visit--so clinics are great for the stopgap.

And you think it will be easier for all the folks on newly expanded Medicaid to get doctors appointments?

Around here, many docs are not accepting Medicaid. And the ones that do take it are definitely not on the best doctor list!

[pinkskates4]

On 1/3/2014 Sox2 said:

Thanks for the information, Terrier ... this hits home because we have a PPO with BC/BS ... thought I could use it anywhere we travel. Guess I'm wrong

I think emergency care (actual emergency care not treatment for a sore throat) would probably be covered by most plans even out of state.

While my plan - Kaiser - has dropped some local hospitals, they clearly state that emergency care to the closest hospital is covered - even if that means I would need to be transferred after stabilization.

[Qwackertoo]

Oh and ER co-pays . . . last time I took one of the kids to the ER, small burn mark on her arm from a sleepover in-which they accidentally left the universal plug to the keyboard laying on the bed . . . and I guess moisture from the body overnight and the plug left a small little black circle on daughters arm . . . heck I didn't know IF it was a brown recluse spider bite or what had happened to her . . . co--pay to the ER with our BC/BS is One Hundred & Fifty Dollars . . . which I will gladly pay in a true emergency . . . vs. a 30.00 office visit co-pay.

But . . . depending on the situation . . . they make darn sure they have a check or cash or credit card payment before the doctor ever lays eyes on you . . .

Except two trips with son . . . it was really urgent and money issue was handled afterward.

Thank goodness knock on wood I've only had to go to ER with kids these 3 times.