Wellness

[Icegoddess]

@SeaMaiden , I go to a Concierge doctor.  Same doctor I had before all this ACA ******.  I don't have a lot of medical issues, but I do want continuity of care and don't want a doctor sitting in a corner spending more time at the computer giving the government all my medical information than he spends actually listening to me.  The cost of a conceirge doctor is way more affordable than the ACA insurance, and you get more for the money.  Besides continuity of care and getting in right away, you get a complete physical every year.  I have even called him on a weekend night and he was able to help me without having to go to the ER.  

ACA insurance is the joke.  You pay $700+/month for it and get pretty much nothing out of it until you've spent $6500 in a year on medical costs.  Free mammograms, free pap smears?  No, not really.  They'll pay the exam, but then claim the doctor reading the radiograph is out of network or the lab is out of network so you have to pay even though you went to an In-network doctor/facility.  And thank you BCBS for only making me pay $681 for that free colonoscopy you were bugging me to get.  I would rather pay all of that out of pocket and have a decent premium payment even with the high deductible.  I don't care about the high deductible.  We already had a high deductible plan prior to ACA because I don't expect my healthcare to be all free. We mainly wanted an insurance to cover me in case something catastrophic happened.  Hubby is on Medicare, so all those costs are for one person, not a couple.

[Pook]

All the ones I have heard of do not take any type of medical insurance.  Some medical insurances will reimburse some of the cost but many will not.

[kitty60]

Oh wow, I hear your!  So looking forward to going on medicare in August.  I will be saving over $11,000 a year in premiums and the $3,000+ I've been putting in my HSA.  Actually, I had a grandfathered plan high deductible, it was $3,500 deductible.  The past few years I have checked out the O plans and they were more expensive with triple that for a deductible!  I can't change the fact I'm aging but I can benefit from the savings.  When I priced my plan I also checked on changing my husband's supplemental and was able to save another $100 per month.  He was accepted, feel like we've hit the jackpot! 

[SeaMaiden]

ThankYou for all the feedback🙂..very helpful. Still deciding. Will do more research!

[haddon9]

I'm looking for a new PCP and was considering a local dcotor who offers concerige service.  However it's pricey and I don't have enough health issues to make it worth it.

Maybe in the future if I feel that I need it.

[haddon9]

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@Icegoddess wrote:

@SeaMaiden , I go to a Concierge doctor.  Same doctor I had before all this ACA ******.  I don't have a lot of medical issues, but I do want continuity of care and don't want a doctor sitting in a corner spending more time at the computer giving the government all my medical information than he spends actually listening to me.  The cost of a conceirge doctor is way more affordable than the ACA insurance, and you get more for the money.  Besides continuity of care and getting in right away, you get a complete physical every year.  I have even called him on a weekend night and he was able to help me without having to go to the ER.  

ACA insurance is the joke.  You pay $700+/month for it and get pretty much nothing out of it until you've spent $6500 in a year on medical costs.  Free mammograms, free pap smears?  No, not really.  They'll pay the exam, but then claim the doctor reading the radiograph is out of network or the lab is out of network so you have to pay even though you went to an In-network doctor/facility.  And thank you BCBS for only making me pay $681 for that free colonoscopy you were bugging me to get.  I would rather pay all of that out of pocket and have a decent premium payment even with the high deductible.  I don't care about the high deductible.  We already had a high deductible plan prior to ACA because I don't expect my healthcare to be all free. We mainly wanted an insurance to cover me in case something catastrophic happened.  Hubby is on Medicare, so all those costs are for one person, not a couple.

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@Icegoddess   I hear you!  Last month I finally got on Medicare but before that my ACA plan ws close to $1000.00 a month....just for me!  Not much was covered either.

[Kachina624]

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@SeaMaiden wrote:

I am going to start seeing a concierge doctor.   Anyone here do this?

I look forward to being treated better...no waiting room spent with coughing sick people....no rushed visit....and all the tests done not based just  on just what insurance will pay for or not 

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For the past 20 years I've seen a physician affiliated with the University of NM.  I haven't paid one penney for medical care other than my standard Medicare premium and I have been fortunate to receive all those benefits plus more.

[Carmie]

Since I now have Medicare, there is no way on God's green acres that I would even consider going to a concierge doctor.

It really makes little sense.  First, you are paying monthly for Medicare Part B and either a supplement or Advantage Plan, plus an RX Plan with some plans.

Paying $1200 a year would be just for Office Visits.  If the doctor runs lab tests or blood work or X-rays, those services would still have to go to your insurance, along with RX drugs.

If you need to go to a specialist those claims would go to your insurance also.

$1200 a year for office visits only from your primary care physician for most people who have insurance is just nuts, IMO.

Now, if you didn't have any doctor within a 30 minute drive of your home except for the concierge doctor, it might make sense for a few people.

[tansy]

Do you think the doctors are more qualified?  I highly doubt it.

The concierge practice that I know about requires you to bill your insurance for reimbursement.  

It seems like a waste of money, especially if you don’t have a health condition that requires frequent monitoring.

[Carmie]

In today's insurance world, it is almost impossible to send your bills to your insurance company for reimbursement. 

The government has rules in place for how claims are to be filed, and they are done electronically.  It doesn't matter if the provider is in network or not.

it is possible,to send in your own bills for foreign claims ( another country)  but you will probably wait quite a while for a payment.  The bills have to include all of the information required, or they will be rejected for more info.

Some Doctors are setting up concierge practices to avoid the government laws regarding what they must do to submit claims to insurance for payment.  Others are going into group practice with a large number of providers in their medical system.  These laws and regulations are very expensive to put in place and to be in compliance.