Wellness

[pdlinda]

I am planning on changing my Advantage Plan to one where my integrative med MD is in network.

I am having some pain in my right hip area and have an appointment with an ortho MD on 11/2.  I have some concern that I may need a THR(had my left hip replaced in 2008).

The ortho MD I'm seeing is in network now and also in the new Advantage Plan .

QUESTION:  If I go to the ortho appointment and surgery is contemplated (hope not, but don't know), is my present Advantage Plan going to be the one paying for anything that flows from my appointment on 11/2?

Also, I have appointments with Aetna and United Healthcare Advantage reps before the end of the month.  Do I have to disclose my current situation with my right hip?  Will this pending situation affect their decision to accept me into their plans?

Know you ladies are quite knowledgeable in the area of medicare advantage so will be very interested in whatever responses I receive!!

[meem120]

Whatever insurance you have on the date of the surgery will be the one paying for it.  Pre existing conditions are no longer applicable to anyone on any insurance. 

[pdlinda]

Oh, great!  Thanks so much!

[Mz iMac]

@pdlinda

"I have appointments with Aetna and United Healthcare Advantage reps before the end of the month."

Between now & then, write down all the questions you can think of to ask them.  Remember, stupid questions are the ones never asked!

Take notes from each rep

Have each rep go over the FINE PRINT & explain it to you in LAYMAN'S terms.  Don't be surprised if they whip out a microscope to read it.

Afterwards, take a few days to absorb all the info overload.

Then compare their answers to your questions by going the PROS & CON route.

hth

[Big Sister]

@pdlinda   Linda, I am wondering if you would benefit from Cortisone injections into your hip.  I say this because I have seen my ortho. recently for pain in my knees and bursa.  Two weeks ago when I had the First of Three injections into my right knee I was pain free that afternoon.  Wish I had done it sooner, but better late than never, as they say.

Good luck to you.

[pdlinda]

Thanks for info, Big Sister...actually the ortho doc told me I had bursitis in that right hip about 2 years ago...on the cortisone shot tx, are there any side effects that you are experiencing?  ...

[Big Sister]

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@pdlinda wrote:

Thanks for info, Big Sister...actually the ortho doc told me I had bursitis in that right hip about 2 years ago...on the cortisone shot tx, are there any side effects that you are experiencing?  ..

pdlinda,  You're welcome.  There have been no side effects to the Cortisone.  So far I've had one inj. in the right knee and one inj. the right bursa (for bursitis).  My only regret is that I did not do this sooner.  My dr. gives an injection two weeks apart.  Why not all at once?   Because Medicare says they have to be done one per ofc. visit.  Crazy, huh?

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[blackhole99]

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@meem120 wrote:

Whatever insurance you have on the date of the surgery will be the one paying for it.  Pre existing conditions are no longer applicable to anyone on any insurance. 

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That's what they say, but I was denied insurance from Cigna because I have afib and was hospitalized 6 months before I applied for the insurance. The agent said if I could stay out of the hospital for a year they would probably insure me.

[Mmsfoxxie]

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@blackhole99 wrote:

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@meem120 wrote:

Whatever insurance you have on the date of the surgery will be the one paying for it.  Pre existing conditions are no longer applicable to anyone on any insurance. 

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That's what they say, but I was denied insurance from Cigna because I have afib and was hospitalized 6 months before I applied for the insurance. The agent said if I could stay out of the hospital for a year they would probably insure me.

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Wow!  I thought that was against the law now.  My husband has many pre existing conditions so that is a concern of mine.

[meem120]

If you were denied insurance for any reason please report it to your state office.  This is absolutely against the law.