Wellness

[151949]

This is clearly the OP's own fault but rather than accept responsibility she wants to be appalled and try to hang it on the doctor's office.

[Cakers3]

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@shoekitty wrote:

@151949

My dermatologist cancelled my medicare advantage insurance mid year!  Yup, I am changing my insurance come this october.  I thought an advantage would be better, but for me it is not.  More Drs are canceling my insurance, they gave me pre warning. 

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@shoekitty  Do you have a PPO or HMO?  Many, many doctors around here no longer accept HMO's.  Our PCP dropped them years ago.  Same with my eye doctor.

[BirkiLady]

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@Cakers3 wrote:

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@shoekitty wrote:

@151949

My dermatologist cancelled my medicare advantage insurance mid year!  Yup, I am changing my insurance come this october.  I thought an advantage would be better, but for me it is not.  More Drs are canceling my insurance, they gave me pre warning. 

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@shoekitty  Do you have a PPO or HMO?  Many, many doctors around here no longer accept HMO's.  Our PCP dropped them years ago.  Same with my eye doctor.

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@Cakers3@shoekitty  Our community does not offer any type of HMO any longer. It was a disaster and patients opted out of those HMO's after a few years. They went out of business in our State sometime in the late 1980's.

Health care is too important for our citizens. Everyone realized "you get what you pay for" and chose to pay the extra costs associated with quality care. 

[Cakers3]

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@BirkiLady wrote:

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@Cakers3 wrote:

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@shoekitty wrote:

@151949

My dermatologist cancelled my medicare advantage insurance mid year!  Yup, I am changing my insurance come this october.  I thought an advantage would be better, but for me it is not.  More Drs are canceling my insurance, they gave me pre warning. 

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@shoekitty  Do you have a PPO or HMO?  Many, many doctors around here no longer accept HMO's.  Our PCP dropped them years ago.  Same with my eye doctor.

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@Cakers3@shoekitty  Our community does not offer any type of HMO any longer. It was a disaster and patients opted out of those HMO's after a few years. They went out of business in our State sometime in the late 1980's.

Health care is too important for our citizens. Everyone realized "you get what you pay for" and chose to pay the extra costs associated with quality care. 

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@BirkiLady  There are still HMO's around here but it seems only the new doctors take them now-I know our PCP used to take them long ago when he was new but dropped them.

Years ago (many years ago) the HMO DH and I had was superb-and the PPO's were a pain.  Now it seems to be the opposite.

[Evie2004]

The Little Clinic (in our Kroger store) costs the same as a visit with our PCP, $5.00, with our advantage plan..i’m sure the NP there would refill your BP med immediately..

Maybe sign up for auto refill with your pharmacy, so you don’t run out again.

Assuming you have something similar to our Little Clinic..

[mousiegirl]

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@lovesrecess wrote:

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? I am appalled!

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@lovesrecess  I had an issue trying to get a monthly prescription refilled, because the office was busy, so the pharmacy gave me an emergency refill for three days.  I raised heck with the doctor's office, told them it should be an automatic refill each month, and now I have a six month refill.  One has to be a squeaky wheel these days.

[mousiegirl]

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@viva923 wrote:

my doctor office will no longer fill any scripts either. I have to call my pharmacy to have them call the doctors (send a certified email request) asking to refill all scripts. 

Getting harder and harder to fill scripts. I too am getting low on BP meds, nothing can be filled till 19th september, then sent in the mail which will take another week, so will be totally out by then but that is only way I can get my meds now a day is mail order pharmacy.

@viva923  this is one reason I don't go through the mail for prescriptions.  My pharmacy will give me an emergency refill if they have not heard from the doctor in several days, and my calling the pharmacy to say I  have one pill left since the office was too busy.  I gave the office heck, and now have a six month refill.  

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[drizzellla]

I needed additional pills for one of my prescriptions. After reading all these posts, I was wondering if it would be a problem. I called this morning at 10AM and left a message that I needed more pills. And got a call from the Doctor's office at 10:30AM saying the prescription was sent to the pharmacy and an email from the pharmacy saying they were filling my prescription.

[mousiegirl]

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@151949 wrote:

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@viva923 wrote:

my doctor office will no longer fill any scripts either. I have to call my pharmacy to have them call the doctors (send a certified email request) asking to refill all scripts. 

Getting harder and harder to fill scripts. I too am getting low on BP meds, nothing can be filled till 19th september, then sent in the mail which will take another week, so will be totally out by then but that is only way I can get my meds now a day is mail order pharmacy.  

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This doesn't make any sense . Of course the doctor's office doesn't fill any scripts - they aren't a drug store. 

My doctor's office gives me a Rx for a 6 month supply of drugs when  I go to the doctor and I make my next appt. to get my new Rx before that runs out when I'm leaving the doctor's office.  As long as I keep my scheduled appts I have no problem running out of meds.

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@151949  I am sure that @viva923 meant that her doctor has to okay the refill by faxing or emailing the authorization.  Not all doctors approve even a monthly prescription automatically, but one needs to speak up about the issue in order to get the routine changed.

[NYC Susan]

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@151949 wrote:

This is clearly the OP's own fault but rather than accept responsibility she wants to be appalled and try to hang it on the doctor's office.

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I think she's appalled for two reasons:  1) She couldn't get an Rx refill, and 2) She was told that her insurance will no longer cover visits with her doctor.  

I agree that she should take responsibilty for the Rx issue.  As a doctor in my family always says, "The patient's lack of planning shouldn't become an emergency for everyone else".  When she saw that she had no refills left, when she saw her supply dwindling, or when she took the second-to-last pill when clearly only one was left - Those were the times she should have done something.  Ignoring "no refills" or "no refills without MD authorization" and requesting a refill at the last minute is irresponsible.  She ran the risk of running out and being without medication, and that's on her.   Doctors can't simply refill prescriptions indefinitely - They require rechecks and re-evaluations, and I thought that was common knowledge.  

As for the second part, she should call her insurance company and get clarification.  As I think you posted way upthread, an Advantage plan can't simply change the terms partway thru the year.  So either the doctor's office made a mistake when they told her she could no longer see the doctor, or she misunderstood.  I'm betting she misunderstood, but the only way for her to get a clear answer is to call and ask.