Correct. That is the deal with HMO’s.
Correct. MA plans tend to have smaller networks. That’s the deal for a lower monthly premium. You may have to to to a facility in theri network, even if its farther away.
Not surprising if the assisted living facility has an attached SNF. The MA plans don’t pay as much AND they require more paperwork. If I was a SNF manager, I would prefer Orginal Medicare too as its more profitable for the assisted living facility.
Our annual mammograms are booked 1 year in advance. If they cancel on you, or if you have to move it, it’s another 3-6 months. And rinse and repeat until you get in. Yearly is easily 2 years here. That’s normal insurance. So 6 months doesn’t sound so bad!
wow, my wife gets an appt in 2-3 weeks. Never been an issue.
It is interesting how health care varies across the country. In the day, there was no way you could get through a pediatric appointment in an hour. 2-3 was typical. Same with the ENT and the local orthopedist. I joked with my knee, I could drive 1:30 to my out of town doctor, be seen, and be back home, before I could have gotten out of the local place.
My husband has had an appointment scheduled for 6 months.
Office called, we need to move the appointment. Are you having issues? Yes. Nothing open until May.
Sometimes I am so annoyed with healthcare.
To be on topic. Another example with my mom
My sister suspected that my mom was misdiagnosed on an issue that she has knowledge of.
Sister was able to get mom an appointment at her major research hospital and mom’s supplement paid. No questions asked. Mom was billed at her normal Medicare rate. Out of state. No out of network problems.
Here are the magic words…Okay, I will take the May appointment which is an XXX amount of delay from the appointment I had and/or X amount of time from when I told you I was having problems. But in order to do so I will need an email/note/phone call from the Doctor stating they agree that this is within the acceptable standard of care and are stating that such a delay will not negatively affect the patient.
I’ve used that phrasing several times and it is miraculous how quickly appointments become available.
They called my husband while I wasn’t around and he said fine. He’s given up that there is anything this specialist is willing to do.
I think we will need to find a replacement.
This kind of thing happens regardless of the type of insurance you have. I’ve asked to be put on a cancellation list and usually, by some miracle, an appointment opens up the following day.
My Mom is on Medicare and Medicaid so the cost of the plans are not really a concern for her. So having a plan that saves her money isn’t her top priority. I totally get that for many dealing with the hassles that sometimes come with HMOs might be worth the cost savings. But at this point in her life she just needs something that is easy to navigate and where she can get the care she needs.
Her assisted living facility does not have an attached SNF. I think they were more referring to the frustrations they see their residents go through, especially if they need any type of rehab or therapy services.
The hospital/provider network I usually use has MyChart (as do two of the other major hospital/provider networks in NYC). There is an option, always, to request an earlier appointment if there’s a cancellation. The patient receives a text with a limited time period to accept or reject. I have very often received appointments sooner that way, most recently with a rheumatologist I saw on Monday of this week.
Haha. Nobody in town uses mychart. The hospital even has their own weird system. H’s PCP doesn’t even have an online payment system.
Now our out of town places - ortho, colonoscopy peeps and now the cancer hospital have mychart. I love mychart! But no. We aren’t that sophisticated here.
Can you call and at least leave a message? I did call the three rheumatologists I made the first available appointment (beginning a week before my actual appointment) when I had a flare right after I had Covid after my daughter’s wedding. I explained myself, said I was enrolled in the automatic cancellation thing, and that I really needed to see someone. An office staff member for each of the three said, sorry, we can’t cancel someone to fit you in, but a week later I got a call from the staff of the doctor with whom I had the second appointment (12/27). She said, can you come in on 12/18 and I said thank you so much, I’ll be there!
I think that if there were no electronic queue for cancellations, I would call every 2 weeks or so, not to waste time, happy to leave a voicemail. Several of my friends told me to keep calling but I didn’t want to be a nuisance.
My gyn is part of a big hospital system. You can no longer “call the office’. You call a centralized scheduling number and they try to schedule. They can call the office but rarely do/will they, or if they do, they say the office will get back with me through the portal and it doesn’t happen.
But this is all kinda off topic.
I actually got the central scheduling unit. In two out of three rheumatology practices, they put me through to the staff member who works with the doctor I tried to call. With the third, I just left a voicemail and that’s the one with whom I got an appointment. Maybe it was just that they had a cancellation, but usually when that happens, I get an automated offer of an appointment by text. But who knows? And the appointment was only two weeks before it was scheduled, after waiting a couple of months, during which time my symptoms got worse.
If you’d like any more info, we can take this to PMs,
Thanks, but its clear systems vary greatly from city to city.
I was able to get a same day CT scan because I have traditional Medicare plus a supplemental policy, but I would have had to wait for an approval with a MA policy.
United Healthcare’s (mis)treatment of it’s Medicare Advantage clients
My husband injured his hand badly a few weeks ago so I took him to the ER. He had X rays and they cleaned out his wound thoroughly. His OOP cost on his Advantage plan? $95. Even in the good old days on our Anthem plan, our copay would have been $250.
If this had been me rather than him, on my current Anthem plan I would have gotten a bill for over $2,000.
There are some decent MA plans. There are lots of bad ones. Glad yours is a decent one. Hope he is doing well.
Thanks, he’s good! It stayed swollen and purple for awhile so he went back in and they said it was good. If it had been me, I honestly wouldn’t have gone back in due to the cost. Ugh, so unacceptable.