Hello Ezine readers. So as many of you know, I am a Type 1 Diabetic. Last fall I was with PPO health insurance with Aetna and through an extraordinary amount of circumstances, was faced with almost $7,000 in deductibles alone. It was a nightmare.
After some calling around because I've only ever heard nightmares about HMO's, I was convinced to make the switch and give it a shot. Folks, if you have the choice between PPO or HMO and have ongoing health issues, I do NOT recommend HMO.
Here is what I've learned: From the start you must first pick a primary care physician from a list of approved doctors on your HMO website. I did my best to Google them and find out through their reviews and credentials who felt like the best match. That takes about two weeks for insurance to process. Once you have your approval you may then get yourself an appointment- another 1-3 weeks of waiting. Upon visiting my primary care physician I explained I needed regular visits with an endocrinologist to help manage diabetes with me. It was another three weeks before I was referred to Dr. Sawson Barakat in Tarzana and another week before I could see her and she was awful to me. I saw her and she refused to write a prescription for my insulin, handing me a bunch of free insulin that is not the kind I usually take. I told her the only problem was when I ran out I couldn't just go to the pharmacy, I'd have to get approval all over again, wait for an appt with her, then come in to get it and this was not a viable solution. She assured me I could just drop in for insulin any time.
So, six weeks later I was having a hard day, my insulin was not working and I was down to my last vial. The pharmacy, for legal reasons, could not call the doctor unless they had already had a prescription from her prior. Since she refused me a prescription when I first saw her, I called her begging her to call one in. Mind you my blood sugar was 490 and I had been taking shots all day. She said it was an office policy NOT to call the pharmacy, that they had to call her. 490 blood sugar by most standards is considered a medical emergency where you are in no condition to drive yourself to see your doctor who is 45 minutes away. But alas, she still refused. It was 36 hours of high blood sugar before I could convince a pharmacist to please call her.
Well that was six weeks ago and I've since requested another endocrinologist and have YET to receive approval thorugh insurance. So this entire time I've no reliable person I can go to for my insulin, test strips, or otherwise. All I can tell myself is I must be doing something wrong. But no, I've spoken with my Regal group representative who assures me this is the only way, that I myself cannot request another endocrinologist that my primary care physician must do it and that the delay is his fault.
If anyone has better resources let me know, but otherwise it's time to switch to PPO where I am treated like a human being and whose health comes before some ridiculous, power-struggle motivated policy that is against calling in prescriptions to a pharmacy in the case of a medical emergency.
My name is Dani Kelly. I work in Web Development, online marketing, Social Networking, Social Media, SEO, and more. But first and foremost, I am a writer; a journalist. I love to review our Los Angeles teams and am impassioned about finding the next artist to make it in our highly-critical pool of music fans. Check out my articles and get the latest reviews on how our teams have been doing, are doing, will be doing, etc.
Sometimes I play devils advocate, just to pose the questions. Sometimes I share with you my own, deeply personal view, and sometimes my work is entirely objective. My various writing styles will keep you guessing as to which ones. Have fun and I hope you enjoy some of my literary musings!
Article Source: http://EzineArticles.com/?expert=Dani_Kelly
Tidak ada komentar:
Posting Komentar