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08-31-2018 10:50 PM - edited 09-07-2018 07:37 PM
Have been without my BP meds for four days because my PCP's office won't call the pharmacy and okay the refill. I take my BP a daily and so far, so good, but it is slightly elevated...bottom line, I should not have to go four days without it. I finally got someone at the doctors office to answer the phone and was told they couldn't refill until I scheduled an appt and came in. I said fine....then was told I could only see a nurse practicioner. I told them I would prefer to see the Dr. (Who has been my PCP for ten years). Was told my Medicare advantage plan would no longer cover office visits with a physician only with a nurse practicioner or a PA if it was a serious illness. I am sure the copay will be the same. Can a nurse practicioner prescribe medication? How do I get to see my doctor?
08-31-2018 10:53 PM
That doesn't sound good..........i know many are fans of PA or Nurse Practioners.....and for something simple i would agree....BUT i def prefer seeing the doctor...especially when they charge the same amounts for the appts.... i haven't had the greatest results with the PA i have dealt with.... 2 seperate offices.....
08-31-2018 10:53 PM
Sorry that you are dealing with this. Yes, a Nurse Practitioner and/or a Physician Assistant can do exams, order tests and prescribe medications.
I would contact your insurance and find out what changed with your plan.
Try to take it easy this weekend.
08-31-2018 11:00 PM
@lovesrecess I have seen 2 PA's on occasion and have been happy with them As a matter of fact, sometimes I prefer to see them! You probably do this already but watch your salt intake. As far as I know, take out food is the worst culprit for blood pressure. It's loaded with salt. Take care.
08-31-2018 11:04 PM - edited 08-31-2018 11:10 PM
You should call your advantage plan yourself to confirm what you’re being told.The doctors office may not be telling you the truth.I know for a fact that some doctors offices are backed up & try to push the P A’s on patients to keep the office moving.My friends daughter is a P A for a large practice & she said they do this all the time.They also bill for the doctors not the P A’s. Because the fees are higher.
Whenever I go to the doctor or Urgent Care I always say that I want to see a doctor & not a P A.They always oblige me.I personally haven’t had a good experience with a P A . Therefore, I always ask for the doctor for myself & DH.
08-31-2018 11:04 PM
An advantage plan can't just change things mid year - whatever is the policy in the fall during the sign up has to stay the same until the next year. If I were the OP I'd get in touch with my ins. co customer service line and clarify this - I'm thinking she misunderstood & they are saying there are only appts with the nurse .
08-31-2018 11:05 PM
For just a refill, I would see anyone who can help me.
If your doctor requires the office visit but the doctor can't see you, there's something wrong with that. Maybe the staff member was misinformed.
There's more to this story
08-31-2018 11:16 PM
@lovesrecess This seems like a very inportant detail to come as a surprise. Most plans note policy changes and policy prices in the annual manuals sent out near the end of the year or the coming new year. I don't believe your insurance company could have legally suddenly sprung such a significant change on its subscribers without written notice. I realize that doesn't help you get the medication you need, but it's not your doctor's office fault. Did you ask to speak directly your primary in the hope that the doctor may authorize the refill without you coming into the office? The answer is probably not, but you can try. In my experience regardless of how long you have been taking a medication some doctors (or their designated PAs and nurse practitioners) will only authorize for a certain number of refills and then they want you to come in for a visit before they issue another.
Please get your medication. I understand you may not want to see a PA or nurse practitioner, but if that is the only way you can get the refill then by all means you must do that.
08-31-2018 11:26 PM
I am on BP meds also. See anyone who can write a refill, you can't mess around with hypertension, it can lead to a stroke, or worse.
Your PCP's office may need to see you periodically to monitor you. Nothing strange about this.
How long since you've been to the doctor?
08-31-2018 11:30 PM
@NicksmomESQIs it even legal for a PA to bill separately from the doctor? I never checked into that, but now I'm trying to remember whether I've ever seen a PA working independent of a doctor's office. I'm thinking that the PA's in my doctors' offices are employees, not independent contractors.
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