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Wednesday, September 14, 2016

Health Insurance Companies...BOO !!

So there I was, cruising along down the Parkinson's Disease Highway in my very own Happy Parkie bus.



The weather was sunny, there wasn't much traffic and the road was well-maintained. I was enjoying the ride as well as the scenery, just relaxing and listening to my humorous song parodies on the radio. 

All of a sudden, up ahead, I saw a huge barricade across the road. "ROAD CLOSED!" the sign said.



Well, not really. It was my computer screen shouting at me. Or was it me shouting at my computer screen? Does it even matter? I was getting upset and everyone knows stress is bad for Parkies. So, WHY was I upset?

I was on my Medicare Advantage Plan website, checking to make sure all of my Doctors were still in-network before calling to make my regular October appointments. Dermatologist, yes. Primary Care Doctor, yes. Gynecologist, yes. Nearby laboratory, yes. All my appointments are made. Smooth roads ahead.

Hmm, while I am on here, I better double check and make sure Dr. Sherman; my Movement Disorder Specialist is on the list. After all, I already have an appointment with him in November, right after I speak to his class of medical school students

Warning! Warning! ROAD CLOSED ahead! 



My Happy Parkie bus came to a screeching stop, sliding sideways and kicking up a cloud of dirt. 

Dr. Sherman's name wasn't popping up like the others. I re-entered the Tucson zip code and carefully typed S-h-e-r-m-a-n. Nothing! I tried a different Tucson zip code, still no Sherman. No matter what I tried, Sherman was no longer on my insurance company list of Doctors THEY think I should see.

I don't need this right now. I am leaving tomorrow morning for Portland. I sent Dr. Sherman a quick email, and tried to calm down and finish packing for our trip. As I went to sleep, the words "Continuity of Care" kept bouncing around in my head. I know how important it is to have an established team of health care professionals, especially with a chronic disease like Parkinson's. 

"Continuity of Care is concerned with quality of care over time. It is the process by which the patient and his/her physician-led care team are cooperatively involved in ongoing health care management toward the shared goal of high quality, cost-effective medical care."

My Continuity of Care just evaporated. I will need to find another Movement Disorder Specialist. IF I can find one accepting new patients, it will likely mean a six-month wait for an appointmentThis means pages of paperwork for my Wonderful Husband to fill out, again. Plus I will need to educate my new Doctor about me and my DBS settings; what they have tried in the past; what worked and what didn't. In other words, this will be a huge pain in the neck. 

Morning comes and I have decided to deal with it when I get back home from Portland.

I check my email and there is a reply from Dr. Sherman. He knew nothing about the insurance change, and says he will try to work something out for my upcoming visit.

I asked a doctor friend how they decide what insurance they will take and was told they have little choice in the matter. The insurance companies decide how many providers they need in an area, and then they pick the ones they want and sign them up. 

Don't our insurance companies realize how difficult it is to change doctors? Do they even care? It's not like I can just call one and get an appointment for next week.

I don't WANT to find a new Parkinson's specialist. I like the one I have. 
       
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3 comments:

  1. Wow, sorry U got handed the Road Block blues, I would 2 if it happened to me. Scary thought to have something so important to ones well being to be taken so nonchalantly by the insurance companies. Hoping this works out for U soon. Good luck.
    What's your take on ACA, has it helped or made it worse do you think?
    logan

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  3. Hey,
    Thank you for sharing such an amazing and informative post. Really enjoyed reading it. :)

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