Vent about healthcare

[MomRN0913]

I have a certain insurance (I would say what it is on here, but I don't know if it is allowed) that really stinks. I was calling to see if my OB/GYN was in network. They told me if they were, it would be a specialist co-pay of $50. WHAT??? and OB/GYN is not a specialist. ANY health insurance I have ever had always excluded an OB/GYN form the specialist category. A woman MUST see their GYN. MUST. She went on to compare it to seeing a podiatrist! i wanted to jump into the phone and smack her silly.

No wonder why women are getting diagnosed with end-stage ovarian and cervical cancer.

This to me is completely discriminatory. Because I am a woman, I have to pay $20 more than a regular co-pay to get a regular check-up of something WOMEN MUST be checked for.

11 years ago I had a bout with precancerous lesions and had may appointments, procedures and the such. I wouldn't have been able to afford treatment and check-ups at 20 years old.

Unreal.

[itsmejuli]

Call back and speak to a different rep, this one could be wrong.

[OCNRN63, RN]

OB-GYN is considered a specialist with my ins. You could have your exam done by a FP physician or NP. Women get dx. with late stage ovarian CA because the symptoms are vague and difficult to detect. I had a normal exam by my long-time GYN. Five months later I found out I had metastatic ovarian cancer.

Instead of complaining about your co-pay, be thankful you have coverage and don't have cancer.

[canoehead, BSN, RN]

Yep, OBGYN is a specialist, if you don't want the copay go to a FP.

[MomRN0913]

I don't go to a FP or any other OB/GYN because mine is the one who kept me from cancer.

What isn't understood is that PREVENTION is the key to lowering healthcare costs. The truth is, at a $50 copay, women may not take care of themselves the way they should. Would it stop me? No, but it may stop the other single mother out there who could not imagine spending her minimum wage on her $50 specialized copay because she doesn't have enough money or her kid will go without. The how heavy is it on the system when cancer is discovered.

I feel it is discriminatory to women. And my family practitioner and many I know will not do OB/GYN exams.

It's not a complaint, it's a valid concern.

And please. I did not imply or say I am not thankful I don't have cancer. I have been through a lot with preventing it and am very thankful. SO thankful, that which is why I am passionate about regular gynecological care for a woman to not be considered a "specialty"

[OCNRN63, RN]

Many FP do provide GYN care. Women of decreased economic means can go to PP for GYN care if they can't afford the co-pay. Since other providers can safely provide GYN care, it's not really discriminatory for a policy to charge a higher rate to see a specialist.

You chose to use ovarian cancer as a jumping-off point for your argument. My point was that even with exams by GYNs, ovarian cancer usually isn't detected until it's in the later stages. There's no good screening mechanism for it.

What I do consider discriminatory is prescription plans that pay for Viagra/Cialis, but don't pay for contraceptives. That's an issue I can get behind.

[Altra, BSN, RN]

The 2011 implementation of the preventative care piece of the Affordable Care Act means that insurance plans can no longer charge copays for annual well visits and generally accepted screening diagnostics like mammograms, colonoscopies for those age 50 and older, etc.

Your insurance company may be attempting to circumvent this by (newly?) defining OB/GYNs as specialists. Ten states have enacted legislation which formally allows patients to designate certain specialists (including OB/GYNs) as their PCPs. Check this list:

Managed Care State Laws

[MN-Nurse, ASN, RN]

i have a certain insurance (i would say what it is on here, but i don't know if it is allowed) that really stinks.

go ahead and post the name of the insurance company.

we'll look up their financials and see how much money they made denying care.

http://www.nytimes.com/2011/05/14/business/14health.html

"the nation’s major health insurers are barreling into a third year of record profits, enriched in recent months by a lingering recessionary mind-set among americans who are postponing or forgoing medical care"

[MN-Nurse, ASN, RN]

i have a certain insurance (i would say what it is on here, but i don't know if it is allowed) that really stinks.

go ahead and post the name of the insurance company.

we'll look up their financials and see how much money they made denying care.

http://www.nytimes.com/2011/05/14/business/14health.html

"the nation's major health insurers are barreling into a third year of record profits, enriched in recent months by a lingering recessionary mind-set among americans who are postponing or forgoing medical care"

[dirtyhippiegirl, BSN, RN]

Dude, it's just $20 more than a regular copay. I get that $20 can be a lot -- but if your regular copay is $30, and you can afford that, than I bet an extra $20 isn't out of your reach.

[Nascar nurse, ASN, RN]

What I do consider discriminatory is prescription plans that pay for Viagra/Cialis, but don't pay for contraceptives. That's an issue I can get behind.

Yep - this one just burns me up!

[anotherone, BSN, RN]

Yes aN ob/gyn is a specialist. Have always paid the specialist price to see one when I have in the past. Some family doctors do routine gyn exams.