My husband finally had to get out the book of 'doctors'

[China_cat]

that take his insurance plan (that he's paying close to $800/mo just for him). Primary care doctors are limited to the intern clinics at the medical university, chiropracters and DO's. There were some MD's listed but when called, say they no longer take that plan.

Without a primary care doctor he has no access to specialists and the insurance will NOT pay for any emergency services (no ER, no EMS) without the pcp deciding that it's needed.

What the hell are we paying for?

[zonmoy]

1. its a con.

just like all politics and anything that is corporate and in any way associated with the powers that control our country.

[uppityperson]

2. What company is that? That sounds really bad.

[China_cat]

4. Blue Cross's 'BlueChoice' plan.

[uppityperson]

7. That is wild. They have to offer mds. Not questioning you but them.

Can I help? I do billing and deal with insurance co's all the time. We can pm. Would need a zip code, etc, or can give other ideas maybe?

Insurance companies are legalized gambling.

Edited to add this link.
http://www.bluechoicesc.com/visitors/resources/networkdirectory.aspx
pdf printable version:
http://www.bluechoicesc.com/UserFiles/File/Everybody/provider-directory.pdf

[China_cat]

10. Yeah, I have the book, and the website.

They list some MD's but you go to the website and find they are actually DO's or you call and they no longer belong to the program.

We've spent the last couple weeks trying to find a pcp for my husband.

The only ones we haven't tried are the pediatricians and the ones more than 35 miles from here.

[sandnsea]

11. I've had a few DO's

and I honestly think they're better than any of the MD's I've had. They just seem to be better diagnosticians and treat the person, not just the symptoms of a disease.

[China_cat]

13. Sorry, not my experience at all.

See downthread.

[selador]

8. that's a lame plan

imo.

i did some reading on it.

i have pacificare and while i have SOME issues with them, any plan that can decide not to cover ER visits based on their decision that it it didn't meet the criterium:

"could result in permanent damage to the member's health"

is RIDICULOUS. and that's the standard that this plan uses.

iow, you have to decide whether visiting the ER is necessary due to something that "could" result in "permanent damage" to your health. that's pretty frigging subjective.

my plan covers ALL ER visits, i just have a $50 copay instead of a $5 copay for a standard office visit. if i end up getting admitted, the $50 copay is refunded. i think this strikes a nice balance in that the $50 copay provides significant enough disincentive to not use ER for routine stuff, but not so burdensome as to deter you from going when you need it. and in the cases where it was REALLY necessary (you get admitted) they refund it.

i've actually been overall VERY happy with my coverage, and i can't imagine a plan that forces you to make that sort of decision before going to the ER and then having to wait for the lord's on high (tm) to tell you whether they are going to cover the visit!

an ER visit (especially with diagnostics like MRI etc.) can easily run over 10k. that's the kind of thing you don't want to have to worry about.

[Sarah Ibarruri]

3. We're paying so insurance corporation CEOs and stockholders can have castles in France as 2nd homes

That's what we're paying for.

[Mojorabbit]

5. What is wrong with DOs?

They have the same training as MD's and also can do manipulation. I will pick a DO over an MD anyday.
I worked in both hospitals as a nurse and the one run by DOs was a thousand times better. Nowadays though they both practice in the same hospitals. The DO philosophy is to treat the patient as a whole person and not as just a diagnosis.

[China_cat]

6. The problem is that the only choices given

do not include any MD's.

As for me, I don't trust DO's any more than I do chiropracters.

[Mojorabbit]

9. Why is that?

Any reason?

[China_cat]

12. Yes, having only a DO growing up.

Who dismissed everything me or my sisters had as 'hysteria'. Including the collapsed lung that almost killed my youngest sister.

While he didn't diagnose my mother's breast cancer as hysteria, he did discourage her from seeing an oncologist, did a radical mastectomy and sent her home to die with some herbal 'remedy'.

[sandnsea]

14. DO's don't do herbal remedies

I don't know who you saw, but DO's are exactly like doctors. They use the same medical tests and prescribe the same medications. The only herbal remedy that I've ever had recommended was by an MD, isn't that ironic.

[China_cat]

15. This one did.

My mother could have lived longer, if not beaten it altogether, if it hadn't been for that quack.

And I will not, nor will I let my family, take that same chance.

[Celebration]

17. I understand that this experience was terrible

DOs now are different--well, most of them. I would not in any way try to talk you into trying a DO, but for the fact that it seems like you are stuck with them. They don't go through that considerable amount of education that they go through now in order to diagnose everything as hysteria. You just had a bad apple.

But I hope you are able to find an MD that you like. This sounds ridiculous!!

[Mojorabbit]

16. I guess you got a dud

You will find them as either MD or DO. Bad apples in every profession.

[chicagomd]

18. MD/DO

Does not make that much of a difference anymore, imo. More important is where they did their training after medical school. MD schools are very consistent in their education and rotations, but DO schools still have a lot of variability in their training curriculum. Some DO programs are more rigorous than most MD schools, and some are very lacking. You can control for this variation by looking at the physicians residency training program, which is usually listed on their practice website/advertisement. Professionally, I really don't care MD vs. DO as long as post-graduate medical education was at a good institution. Also, allopathic Board certifications have been historically more difficult to get and maintain than the DO boards, and are open to both MDs and DOs.

I find it hard to believe they are paying for chiropractors as primary care providers, but that is probably just some professional bias coming out before my coffee starts to circulate.

Good luck.

[Celebration]

19. that boggles my mind too

I don't think a chiropractor has the qualifications to be a primary care provider. My daughter has an ND who is also a chiropractor as a primary care provider, and is very satisfied. But he went to Bastyr, which is probably the best in the country for getting an ND. He can write prescriptions...........I don't think chiropractors can write prescriptions in most states, can they?