Insurance problems

[maria garcia]

Anyone here with an Hmo Insurance plan? I want the best doctors, even if I need to travel but my Hmo insurance won't cover. I feel like Im not giving my daughter the correct care she needs even though her blood work is still inline except for the Anca's and MPO positive but its already attacking her eyes. So what next to attack is my worries :thumbdn: I feel like I need to make a plan for better doctors for her future. What to do? Her Rhematologist will get insulted If I ask him to consult another DR. He just has no bed side manners. iM so depressed and anxious Im getting chest pains all the time.( it normal with me when Im very stressed. Im already taking anti deppresants. Honestly I think she is taking this better than me. Or she is still in denial on how serious this illness is.

[mama2005]

Maria I would push for your daughters Rhematologist to consault with a WG specialist or get a refferal to one from him. I have no insurance so I pay out of pocket and most places will decrease the bill by income.

[Trudy]

Anyone here with an Hmo Insurance plan? I want the best doctors, even if I need to travel but my Hmo insurance won't cover. I feel like Im not giving my daughter the correct care she needs even though her blood work is still inline except for the Anca's and MPO positive but its already attacking her eyes. So what next to attack is my worries :thumbdn: I feel like I need to make a plan for better doctors for her future. What to do? Her Rhematologist will get insulted If I ask him to consult another DR. He just has no bed side manners. iM so depressed and anxious Im getting chest pains all the time.( it normal with me when Im very stressed. Im already taking anti deppresants. Honestly I think she is taking this better than me. Or she is still in denial on how serious this illness is.

I suggest you look into your state HMO laws. In Illinois - "If the HMO network doesn't include a specialist qualified to treat your condition, your PCP must give you a referral to a provider outside the network." We had to do this for my daughter for a surgery and it was covered as in network. It took some doing and we had a very caring PCP who wrote letters on my daughter's behalf, but it worked. Using our PCP bypassed the rheumatologist in our case.

Hope this helps, Trudy

[KimH]

I have no insurance. It is stressful. I am so lucky that my rhuemy will consult with the Weggie specialist. The consult did not cost me a penny. Can you find another doctor who will do a consult and be willing to send your daughter's records to a Weggie dr . That's what I did. All of my records have been sent, my dr has emailed the Weggie doc and we are waiting to hear back . Also as mama 2005 says dr's and hosp do give breaks for the uninsured. It is not fair that you would have to pay since you have ins and this is all due to a dr with a big ego. And I too am a Mom of a very sick daughter so i can feel your frustration, fear and anger is wanting to get the best care possible.

[me2]

Helllo. I'm sorry you are having problems with your doc and with insurance. I know what its like. I would like to suggest a book that helped me tremendously to deal with my insurance company. It is written by a woman who has been through the wringer herself and has used her experience to help others get the treatment they need. You might find her book at the library or be able to order it from the library out of system if they don't have it. Here is her web site

health insurance help (http://www.theinsurancewarrior.com/)

Her information is very empowering. For me, it taught me how my insurance company thinks.

[Dryhill]

Maria as a parent (a dad in my case) my heart goes out to you and it is when I hear stories like yours that I am thankful that I was born in the UK. I know our National Health Service has some serious problems but at least I do n ot have the stress of how to pay for treatment or for the meds.

I know it can be difficult and somewhat upsetting, but if you are not happy with your doctor you must get a second opinion.

[Al]

Anyone here with an Hmo Insurance plan? I want the best doctors, even if I need to travel but my Hmo insurance won't cover. I feel like Im not giving my daughter the correct care she needs even though her blood work is still inline except for the Anca's and MPO positive but its already attacking her eyes. So what next to attack is my worries :thumbdn: I feel like I need to make a plan for better doctors for her future. What to do? Her Rhematologist will get insulted If I ask him to consult another DR. He just has no bed side manners. iM so depressed and anxious Im getting chest pains all the time.( it normal with me when Im very stressed. Im already taking anti deppresants. Honestly I think she is taking this better than me. Or she is still in denial on how serious this illness is.

Maria--This gets my hackles up. You and your daughter deserve and need the best care you can get. And you deserve and need a doctor you can communicate with. If your rheumy isn't playing ball in this regard, I would go to a good internist (who is, by definition, a generalist rather than a specialist), explain your situation and problem, and ask for a better referral. Since the eyes are involved, this is not an ambiguous situation. If the medics are not going to take this seriously, you must, even if you have to beat them up a bit!

Al

[drz]

Anyone here with an Hmo Insurance plan? I want the best doctors, even if I need to travel but my Hmo insurance won't cover. I feel like Im not giving my daughter the correct care she needs even though her blood work is still inline except for the Anca's and MPO positive but its already attacking her eyes. So what next to attack is my worries :thumbdn: I feel like I need to make a plan for better doctors for her future. What to do? Her Rhematologist will get insulted If I ask him to consult another DR. He just has no bed side manners. iM so depressed and anxious Im getting chest pains all the time.( it normal with me when Im very stressed. Im already taking anti deppresants. Honestly I think she is taking this better than me. Or she is still in denial on how serious this illness is.

I don't know how your HMO works but when I was stuck in a PPO I found the specialists I saw were most likely to referral me to another specialist outside the clinic. I would push the eye doctors to see what they can do to help you.