Ins. Co. & Docs (was Dr. Hulda )

March 27, 2004

Thronberry@... wrote:

>Dear Cat,

>

>You voiced some of my sentiments about doctors completely. It is a

>shame that insurance companies refuse to cover treatments that are not

>conventionally used in the U.S. And chiropractors.... don't even get me

>started on that one!! Medicare will pay only for spinal manipulation...

>they do not cover the exam or chiropractic x-rays. And ChampVA, which

>is my secondary insurance, does not cover chiropractors at all. I know

>from past experience that a chiropractor would help me, but I do not

>have the money to afford one so guess I will continue to take my pain

>pills, since my insurance would rather pay $79.11 for a 30 day supply of

>Oxycontin, rather than applying that money to a chiropractor which would

>hopefully eliminate the need for the Oxy, as well as some of the other

>meds that I take. And what is the difference between covering an x-ray

>by and M.D. as opposed to one by a chiro??

>

>Go figure....

Annoying as all get out, isn't it!

I actually found an acupuncturist who is also an M.D.

but the drive seemed almost too far across the state.

But I'll keep it in mind for some other time if I am desperate.

I wonder if there is such a thing as a chiropractor who is also an M.D. ?

That person would really do well I would think, but they'd probably be around

40 when they get out of school, LOL, & that isn't fair to anyone either.

I first got chiropractic in 1973. Someone thought he was going to break my neck

and wanted to go along to see that I left in one piece, LOL. How things have

changed. Somewhat.

It all comes down to who has the most powerful lobby ....

I was riding with a friend in her car and we were driving through the Cape two

years

ago and we were rear ended.

I had acupuncture and was hugely improved. I know that

I have a right in a car accident (her carrier was in NY) to chose my own

doctor, so I told the insurance company that I was getting only acupuncture.

The would call each month to find out if I had been to an M.D. (which would have

referred me to p.t. and would have taken a year longer) and I said that the

acupuncture was working, I was getting better, and that I didn't need an M.D.

for now.

When I was done with treatment in about 3 months,

I probably save them several thousands of dollars.

They paid the acupunturist completely.

She never had any trouble collecting her money.

So I think eventually in 100 years or more, if they can save money with

alternative

treatments, they might open up their policies (and their minds) to include more

holistic alternative medicines.

But I won't hold my breath that it will happen during my lifetime, so I'll have

to limp

along and pay outta my pocket.

After paying bills this week, I had to move my acupuncture appointment to next

week.

Burns my backside a bit. ;-) Maybe I will call that acupuncturist who is an

M.D. after all

and find out how he handles it, as physical therapy or what. . .. . .

Cheers, Cat

^. .^ ~

" Optimism is magic! "

March 27, 2004

Hi Cat & Sharon:

I am so sad today. Well, not sad, but disappointed somewhat. Get

this. I found a Naturopath Doctor who is actually part of the

hospital where my current doctors are. Interestingly, my doctors or

insurance never even told me this kind of thing existed, but I

digress.

I contacted her to see if she was taking new patients and she is.

So, I contacted the office to get information. Although she

practices at the hospital and is a licensed doctor AND naturopath,

the insurance won't cover her. She does take other insurances and I

may switch during open enrollment. I was just encouraged that I

would not have to start all over again because all my records and

tests are already in their computer system.

I'm not giving up hope. I believe I can find a doctor or

combination doctor who will treat the whole person. Cross your

fingers for me please!

Take care,

Star

March 27, 2004

mystardance wrote:

>I am so sad today. Well, not sad, but disappointed somewhat. Get

>this. I found a Naturopath Doctor who is actually part of the

>hospital where my current doctors are. .......

>So, I contacted the office to get information. Although she

>practices at the hospital and is a licensed doctor AND naturopath,

>the insurance won't cover her.

Don't ya just *hate* that.

So sorry. I had one doctor I wanted to see (Rhumatoid)

He was recommended by my husband's sleep clinic doc, and they didn't take the

ins. my husband had. Then he got a different job, and different

insurance and they are not enrolled in that program either.

It can become very discouraging at times.

>I'm not giving up hope. I believe I can find a doctor or

>combination doctor who will treat the whole person. Cross your

>fingers for me please!

Will send positive vibes your way wishing you the best of good luck!

Cheers, Cat

^. .^ ~

" Optimism is magic! "

March 27, 2004

Sharon,

Oh my goodness do I ever know what you are talking about. Chiro...

has saved my life many times over with back problems, etc.,

unfortunately, as many on the list I cannot afford to go anymore.

Sorry I haven't written more, been feeling poorly and can't seem to

keep up with the chats.

Gentle hugs,

Mahta

> >Dear Cat,

> >

> >You voiced some of my sentiments about doctors completely. It is

a

> >shame that insurance companies refuse to cover treatments that

are not

> >conventionally used in the U.S. And chiropractors.... don't even

get me

> >started on that one!! Medicare will pay only for spinal

manipulation...

> >they do not cover the exam or chiropractic x-rays. And ChampVA,

which

> >is my secondary insurance, does not cover chiropractors at all.

I know

> >from past experience that a chiropractor would help me, but I do

not

> >have the money to afford one so guess I will continue to take my

pain

> >pills, since my insurance would rather pay $79.11 for a 30 day

supply of

> >Oxycontin, rather than applying that money to a chiropractor

which would

> >hopefully eliminate the need for the Oxy, as well as some of the

other

> >meds that I take. And what is the difference between covering an

x-ray

> >by and M.D. as opposed to one by a chiro??

> >

> >Go figure....

>

> Annoying as all get out, isn't it!

>

> I actually found an acupuncturist who is also an M.D.

> but the drive seemed almost too far across the state.

> But I'll keep it in mind for some other time if I am desperate.

>

> I wonder if there is such a thing as a chiropractor who is also an

M.D. ?

>

> That person would really do well I would think, but they'd

probably be around

> 40 when they get out of school, LOL, & that isn't fair to anyone

either.

>

> I first got chiropractic in 1973. Someone thought he was going to

break my neck

> and wanted to go along to see that I left in one piece, LOL. How

things have

> changed. Somewhat.

>

> It all comes down to who has the most powerful lobby ....

>

> I was riding with a friend in her car and we were driving through

the Cape two years

> ago and we were rear ended.

>

> I had acupuncture and was hugely improved. I know that

> I have a right in a car accident (her carrier was in NY) to chose

my own

> doctor, so I told the insurance company that I was getting only

acupuncture.

>

> The would call each month to find out if I had been to an M.D.

(which would have

> referred me to p.t. and would have taken a year longer) and I said

that the

> acupuncture was working, I was getting better, and that I didn't

need an M.D. for now.

>

> When I was done with treatment in about 3 months,

> I probably save them several thousands of dollars.

> They paid the acupunturist completely.

> She never had any trouble collecting her money.

>

> So I think eventually in 100 years or more, if they can save money

with alternative

> treatments, they might open up their policies (and their minds)

to include more holistic alternative medicines.

> But I won't hold my breath that it will happen during my lifetime,

so I'll have to limp

> along and pay outta my pocket.

>

> After paying bills this week, I had to move my acupuncture

appointment to next week.

> Burns my backside a bit. ;-) Maybe I will call that

acupuncturist who is an M.D. after all

> and find out how he handles it, as physical therapy or

what. . .. . .

>

> Cheers, Cat

>

> ^. .^ ~

>

> " Optimism is magic! "

March 27, 2004

I had one doctor I wanted to see (Rhumatoid)

> He was recommended by my husband's sleep clinic doc, and they

didn't take the ins. my husband had. Then he got a different job,

and different insurance and they are not enrolled in that program

either. It can become very discouraging at times.

Hi Cat,

Thanks for sharing. It is frustrating. When Dh was sick we found

him a doctor was so amazing. He spent time doing a thorough exam on

the first visit, actually listened, made several different

suggestions and even called me at home a couple of times until Dh

was improving. I asked him why there were not more doctors like him

on major insurance plans and he said that the insurance companies

batter them so much that it's just too difficult to balance

providing quality care and staying within their guidelines. Sure

enough, two years later, he retired early and just closed up shop.

Thanks for the positive vibes. Sending some to you too.

Hugs,

Star

March 28, 2004

Dear Star,

Am crossing my fingers and praying that you do find a doctor (or combo)

that can effectively treat you. Does your insurance policy have an

appeals department where you could request that this naturopath doc be

covered?? When is your open season to switch enrollments? I know most

companies are not until Jan. 1st.

In 1996, when open season rolled around, something told me to switch to

the HMO offered by the university, although I had sworn I would never do

this. But they had added a few doctors that I knew by reputation, and

something inside of me told me that Elwyn would be in the hospital

during 1997. Well, sure enough, theh gamble paid off. Elwyn was

hospitalized in Feb. 97 and ended up with a dx of lung cancer. Never in

my wildest dreams did I dream that the hospitalization would be so soon

or result in such a drastic diagnosis. In addition to surgery, he also

underwent 33 sessions of adjuvant radiation to the tumor site. So

instead of owing 20% co-pay on all of his bills, which would have been

the case if we had stuck with the Blue Cross policy that was the other

option offlered by the university, all we owed was the $100 inpatient

deductible. We also have a policy that pays on the hospital and doctor

bills above and beyond what any other insurance pays on charges related

to cancer, heart attack, and accidental injury,. All told, we got about

$6,000 in benefits paid directly to us for these services. I used this

money to pay off as many bills as possible so we could make it

financially while Elwyn was off work. As it turned out, Elwyn was not

able to return to work, and went on SSD after the 6 month waiting

period. Later, he was approved for 100% disability for a service

connected injury (lung cancer due to Agent Orange exposure).

But while the HMO was a blessing for Elwyn, it turned into my worst

nightmare. my PCP did not believe in rx'ing narcotic pain meds, and we

went round and rouind over that for quite some time. They only had one

pain specialist on this HMO, and he is the doctor who walked in with my

chart in hand and told me he couldn't help me, then had the nerve to

write my PCP and tell him that he had examined me, and that all that was

wrong was that I was sufferering from severe depression! Can you

believe that?? He didn't ask me a single question... just told me he

couldn't help me... and arrives at a dx. of depression. Excuse me?>?>?

I finally ended up paying for an office visit to see Dr. Finn, who is my

internist, and the next year I switched back to Blue Cross of TN.

I still can't explain these feelings that I get when something is

getting ready to go wrong. I don't know how I knew that Elwyn would be

hospitalized... I just knew it in my heart of hearts.. And had I not

made the switch to the HMO, we probably would have had to file

bankruptcy. I am having a really bad feeling about the scans that Elwyn

had last week... let's just pray that I am wrong this time.

hugs and prayers,

Sharon - Memphis, TN

Faith...with it, miracles *CAN* and *DO* happen!

March 28, 2004

Thronberry@... wrote:

>I still can't explain these feelings that I get when something is

>getting ready to go wrong. I don't know how I knew that Elwyn would be

>hospitalized... I just knew it in my heart of hearts.. And had I not

>made the switch to the HMO, we probably would have had to file

>bankruptcy. I am having a really bad feeling about the scans that Elwyn

>had last week... let's just pray that I am wrong this time.

Hang in there

((((((((((( Sharon ))))))))))

Be keeping you in my thoughts and prayers - Hugs, Cat

^. .^ ~

" Optimism is magic! "

March 28, 2004

mahtamoon wrote:

>

>Sorry I haven't written more, been feeling poorly and can't seem to

>keep up with the chats.

Hugs to you too (((((((((((( Mahta ))))))))))

Cat

^. .^ ~

" Optimism is magic! "

March 28, 2004

mystardance wrote:

> I asked him why there were not more doctors like him

>on major insurance plans and he said that the insurance companies

>batter them so much that it's just too difficult to balance

>providing quality care and staying within their guidelines. Sure

>enough, two years later, he retired early and just closed up shop.

Another sad tale of a good medical person doing something else other than

being a clinician. Sorry to hear that.

Thanks for the vibes. They mmusta helped :-)

I slept better last night. Actually got 8 hours of sleep

with just one interruption. First time in years.

Hugs, Cat

^. .^ ~

" Optimism is magic! "

March 28, 2004

They only had one pain specialist on this HMO, and he is the

doctor who walked in with my chart in hand and told me he couldn't

help me, then had the nerve to write my PCP and tell him that he had

examined me, and that all that was wrong was that I was sufferering

from severe depression! Can you believe that?? He didn't ask me a

single question... just told me he couldn't help me... and arrives

at a dx. of depression. Excuse me?>?>?

Hi Sharon,

Yes, I believe it. Women are more likely to be diagnosed with

depression and much more quickly than men are.

The way that I see it is rather simplistic. If a person is

chronically ill, watching their life slip away, being told the pain

is not real or as bad as one perceives (as if that matters), and

generally losing QUALITY OF LIFE, how else could they feel? I can

not imagine even one person going through some of the things I have

or you have or others have and NOT feeling sad, upset, angry,

frustrated and tired. How should we feel? That seems like a very

appropriate response and drugging it away doesn't help especially

since the cause often is not brain chemicals.

My sister has a saying that makes me laugh. It might be offensive

so I apologize beforehand. She says " No, I'm not suidical. I don't

hate myself. I hate all you a**holes. " LOL

Big, big hugs,

Star

P.S. I have to separate paragraphs out because I get sensory

overload when I start writing in response to everything. I

apologize if this is more difficult to follow.

March 28, 2004

Dear Star, Am crossing my fingers and praying that you do

find a doctor (or combo) that can effectively treat you. Does your

insurance policy have an appeals department where you could request

that this naturopath doc be covered?? When is your open season to

switch enrollments? I know most companies are not until Jan. 1st.

Hi Sharon,

Thanks for crossing your fingers for me. My open enrollment is in

November with changes effective January 1st.

They do have an appeals department and it would probably be helpful

eventually. The problem is they will suggest I switch back to the

Alternative Care side, but when I do that and my ND sends me to an

MD for testing or hospitalization, they refuse to even look at tests

and reports from the ND. They want to redo the exact same test from

the same labs and my insurance denies it so I have to pay the second

set or have the doctor refuse treatment since he doesn't have " real

reports. " I was getting better under my Alternative Care doctor,

but I was hitting road blocks for other things because of the

internal discrimination toward non MDs. It's frustrating to say the

least and either way the patient is the one who gets to suffer.

>>>>> But while the HMO was a blessing for Elwyn, it turned into my

worst nightmare.

This is almost always the case. I ask Dh how he feels when I want

to transfer and it doesn't matter to him because he never gets

sick. I am going through this problem too because I've been forced

to see a OB/GYNE because s/he has to be at the same place my

Internist is. The whole time I've been involved with her, I've been

denied a mammogram, bled for ten days after she failed to suture

correctly and was burned during a pap smear. It is a nightmare.

So, if it's a nightmare for one patient, it just doubles when there

are other family members under the same insurance. Again, it's the

patient who gets to suffer.

Hugs,

Star

March 28, 2004