Wellness

[gertrudecloset]

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@CrazyKittyLvr2 wrote:

@gertrudecloset   I have been on these pills since Oct. of 2016.  The only blood work I had done was part of the pre-op stuff for my hip replacement in 2018 and knee replacement in 2019.

I never had to get it any other time.

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@CrazyKittyLvr2 Well, obviously something has changed.  My meds are prescribed by a Cardiologist and not my primary care physician.  Because I take other meds besides the HBP meds, I'm glad they are willing to do the bloodwork for me to check my A1C, Cholesterol and Vitamin D levels (as I am always deficient).  What they are asking you to do is required by Medicare.  Medicare want this (as I explained upthread).  It is tied to patient outcomes and them continuing to get the contracts for Medicare.  When you have time search "Centers for Excellence."  It's tied to a program Medicare wants these medical insurers to.  It's supposed to benefit us.

Like I said if you don't want to do it, you don't have to.  Don't expect to get your meds.  Bloodwork is not a waste of time imho.  I only see my doc every six months so that he can monitor by bp.  I have nothing else to share.  I have been taking hbp for years and it has always come with bloodwork.

[aroc3435]

@CrazyKittyLvr2   In the summer of 2021 my dear Signifcant Other was diagnosed with cancer.  I dealt with all the details--Rxs, appointmeents, etc.

At one point I HAD to break through the "telephone tree" nonsense with CVS due to needing a special prescription mandated by his oncology team before certain tests and procedures could be done.

Try calling again and if there is a choice in the selections offered to be the "provider/doctor's representaative"-- some phrase like--that choose it. 

You will get a person.  I did and apologized for pretending to be a doctor's office to get to speak to a person explaining it was a script needed BEFORE a Monday test--and this was lateThursday afternoon--so I needed to talk to a human to check if this specific brand  would be available to take over the weekend so the testing/procedures could occur on Monday morning.

Turns out CVS didn't have it available at any of their DC locations so that afternoon I took the subway back to the hospital and got the prescription at its pharmacy  just before closing.  (Had spent ALL that morning into early afternoon) there in the main hospital where the pharmacy was.

The trick is to get to speak to a person at the pharmacy.  Then I believe they will give you your "tide you over" supply of the one type of pill you  need.

Hope this helps.   Your frustration is understandable.

aroc3435

Washington, DC

[chrystaltree]

Such a strange post.  

[Shiloh09]

New to Medicare in August. My Doctor's office called to set up a "Welcome to Medicare Appointment" He basically reviewed all my meds and medical history, suggested pneumonia and shingles vaccines, ordered a urinalysis. Nurse took vitals and conducted a memory assessment. Not sure how this was any different than any other visit I've had particularly since all my info was current from an appointment in July! 

UHC called and offered the "home visit" benefit. I basically said my PCP had all the necessary health information. They called once again and sent a letter too. Home visits are suspect because they are looking for things that they canfall back on later when they deny a claim. On the surface the benefit sounds great, but I don't want an insurance representative making decisions/suggestions for me. That's why I pay medical professionals that I have known for years!

[gertrudecloset]

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@Shiloh09 wrote:

New to Medicare in August. My Doctor's office called to set up a "Welcome to Medicare Appointment" He basically reviewed all my meds and medical history, suggested pneumonia and shingles vaccines, ordered a urinalysis. Nurse took vitals and conducted a memory assessment. Not sure how this was any different than any other visit I've had particularly since all my info was current from an appointment in July! 

UHC called and offered the "home visit" benefit. I basically said my PCP had all the necessary health information. They called once again and sent a letter too. Home visits are suspect because they are looking for things that they canfall back on later when they deny a claim. On the surface the benefit sounds great, but I don't want an insurance representative making decisions/suggestions for me. That's why I pay medical professionals that I have known for years!

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@Shiloh09I agree.  However, they are already making decisions and suggestions for you and there isn't anything you can do about it.  Managed Care is managed care.  We have no control over it.  Now, if we were rich where money is no object, I suppose we could easily say that we don't want UHC to be making decisions for you.  Medicare gives them permission to do just that.  You'll probably just need to drop your Advantage Plan and get rid of the middle man (which UHC is).

[MoJoV]

@aroc3435  I hope all turned out well for your Significant Other and you after all the frustration.

[MoJoV]

Maybe this has to do with Advantage type coverage.  I have plain old Medicare and don't have to jump through those hoops. I have BC/BS supplemental. I read that they may make these insurance companies take the word Medicare out of their titles because they're different from Medicare.

[aroc3435]

@MoJoV   Thank you for asking.  His cancer was in a very advanced stage when it was discovered in late June and he passed away last October.  I suspect the cancer was coming on gradually and he ignored some of his symptoms, and definitely didn't share them with me.

Once the diagnosis was official he did his best to be a good patient and he was so loving and worried about me the whole time.  Such a sweetheart of a man. 

He had been extremely active and always healthy up until then but after one two-to-three week slight rally after a series of radiation treatments in August he went downhill rapidly and never had the chemo treatments that had been planned. 

My guy was a very active, hands on, physical type who could fix anything and loathed sitting still, so in many ways it was a blessing that his decline was relatively rapid.

I am grateful for the eighteen years and one week we had together.  There is a place in my heart that will always be his.

As to your other comment in a subsequent post I agree there SHOULD be federal legislation that prohibits the name Medicare from being used as part of the title of optional, commercial advantage plans.   It confuses people and is deceptive.

Many of the corporate mailings and commercials even mimic the Medicare colors and stripe from the Medicare card.  The disclaimer is in tiny print.  That should be stopped, too.

Regards,

aroc3435

Washington, DC

[Love to Run]

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@CrazyKittyLvr2 wrote:

DH and I I had UnitedHealth Care for years when he worked. It was great insurance. We both then went on Medicare and had United on and above Medicare. It was $96 a month for each of us.

DH died and I got the $96 cost for a year and it jumped to $300. OK, did that. Last year it was going to Advantage Plan. The price wasn't given when it was announced.

Went to another Advantage Plan. DH's brother and his wife have same thing and were happy with it. I met with someone and decided on the same as DH's relatives. $122 per month, UnitedHealth ended up being $160+.

I take BP pills, nothing else. New insurance has a bunch of wellness BS. Had Dr. appt today because I hadn't been there and no go on renewing BP scripts without hiking 30 miles round trip.  got there, I wasn't on the schedule. What?  Made me get blood taken (never, ever had to before) and see the idiot Dr. next week before I can get my scripts. I am completely out of one of them.

Nothing like having your prescriptions held hostage.

I hate drs., ins. companies.  I am half tempted to tell them to go p*ss up a rope. So much for having a say in your healthcare.

Last week I got a call about nurse visiting. I told the thanks, but no.  Former SIL said it part of their freakin wellness plan. Go over meds, take BP etc. If I'm sick I'll call you, otherwise back off.

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Wow. If more people took advantage of wellness initiatives there'd be a lot less sickness.

[Mindy D]

@CrazyKittyLvr2 @Love to Run @aroc3435 @MoJoV