What insurance allows patients to obtain treatment from different facilities? - 1248019

Jazz
Posts:279

Hi Gracers,

I thought I had this figured out last year, when I thought I declined Medicare Part B in favor of continuing on my current plan with Kaiser. Since that time I've continued to pay the Kaiser premium (very expensive) and there haven't been any blips in the road until now.

Some of us here have been fortunate to obtain care from different facilities. I've only been able to do this on a referral basis from Kaiser, for clinical trials only. I'm wondering how people have been able to get surgery at one facility, radiation from another, and have their oncologist at yet another facility? Is this Medicare, a PPO, both? I'm so confused. I'm just trying to ensure that I can receive coverage when things get really bumpy... and although individual coverage is costing me an arm and a leg, I wonder if a MediGap plan wouldn't cost the same?

Thanks a million for any enlightenment on this topic. I realize it's a bit personal and private but if anyone can give me a general idea, that would be great. I'm supposed to meet with a health insurance counselor on Monday but this is eating my brain!

Respectfully,

Jazz

Forums

double trouble
Posts: 573

Hi Jazz. I saw you asked me about this on another thread. I have Medicare A, B, and D (prescription coverage). I have heard from numerous people, including a Hospice nurse, that Mayo doesn't take Medicare, but they have been taking it from me for 3 years now. I started out with them as a liver transplant candidate, so maybe that had something to do with it. I don't know.

I also live on my social security and fall well below poverty guidelines, and am eligible for charity care, which mean they accept assignment of Medicare, then write off the rest. Mayo is also a not for profit hospital.

As far as Duke, I got a call at 7:30 at night a couple of days ago, asking me if I have anything other than Medicare, so I don't know if there will be a problem there or not. They also told me not to apply for charity care until I have a bill, so I will owe them mucho denero before I find out if I qualify for the charity care or not. The social worker there, however, told me that if I qualify at Mayo he didn't see why I wouldn't qualify at Duke.

I have had problems with private physicians not wanting to accept Medicare patients. I had to ask my Primary Physician for an exception. I guess because I'm such a mess she felt sorry for me and agreed. I'm glad she did because I love her and everyone in her office.

I hope this helps. I looked at your profile for an email addy to keep this private but didn't see one so perhaps the moderators can delete it after you comment.

Debra

Jazz
Posts: 279

Thank you, sweet Debra, I appreciate your reply. My email is jtacalcramer at gmail dot com. Maybe we can PM? Not just about this but in general :) I'm so glad you feel well. Have a great weekend!

(Moderators, please delete Debra's response above, thank you!)

Jazz