Saturday, December 12, 2009

Shown The Bum's Rush

Vero Beach
NoLL

We still have a lot to learn about dealing with the Medicare health care system.
  • I was fearful of being able to find doctors who accept new Medicare patients. Since we travel so much, every time we need a doctor it is likely to be in a new city.

  • Our first experience with the "Welcome to Medicare" checkup went well.

  • I signed us up for AARP's Medicare Advantage system provided by Secure Horizons. My theory was that they have a nationwide network of doctors who would be required to accept in-network new patients.

  • Yesterday I showed up for a follow-up visit. I told the receptionist that since my first visit, we have new insurance from Secure Horizons. She abruptly told me that they don't accept that. Also, because we have Secure Horizons, Medicare won't pay for a doctor visit. She cancelled my remaining appointments, and told me to leave the building. That's called the bum's rush.

  • When Libby checked with her doctor about follow-up visits, they said the same thing.

  • I went to the Secure Horizons web site to find doctors who do accept their insurance. I asked for any doctor, any specialty within 100 miles. It came back saying "contact us." Uh oh, not a good sign.

  • I called Secure Horizons and asked for doctors in Vero who accept their plan. The man on the phone said, "Sorry none." I asked about Fort Pierce - "none", Stuart - "none", Marathon - "none", Melbourne - "none",Daytona Beach - "none."

  • I asked if we could go to a doctor not on their list and paid cash, would they reimburse me? "No."

  • Before giving up, I re-asked the question a different way. Are there any doctors who accept Secure Horizon even though they are not "in network." "Yes," came the answer. There are three, out several thousand in the area who do.

  • Libby called all three and on the third try, she scored. She now has new appointments and the first doctor will forward her records. "Whew," I was scared that I had ruined her chance to get medical help by signing up for the wrong thing.
I signed up for this AARP program to enhance our access to doctors. It actually had the opposite effect. It severely limited our access to doctors, almost to zero.

We never do well dealing with bureaucracy. Heaven help us in the coming years. If Obamacare passes it will be still worse, I'm sure.

p.s. Wish Libby Happy Birthday, Sunday December 13.

2 comments:

  1. Welcome to my new life. After the third heart attack and now with other problems relating to vascular disease I am a super resource for all the fun times dealing with the health care system. I have come to believe that its designed to cause a stroke from the stress dealing with this mess. Saves dollars! (tongue in cheek!) Ken

    ReplyDelete
  2. Dick and Libby,

    Thanks for that heads up. I was thinking of switching to Horizons. Maybe I'll stick with Blue Cross Blue Shield, I know they cover my docs.

    ReplyDelete

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