health insurance coverage ?

[cannoli]

I'm wondering if the type of treatment for something would depend on the type of insurance one had or if it would be the same for all? I think I'll ask my doctor that question and hope he doesn't get insulted.

[Dixielee, BSN, RN]

Your doctor should not be insulted...this is a reasonable question, especially since health care is so expensive. Generally speaking, emergency care is given in the U.S. regardless of ability to pay. This does not mean the hospital will not try to collect, but federal laws do not allow discrimination based on ability to pay in emergencies, child birth, etc. BUT, elective procedures, most doctors office visits etc must be paid for up front. It varies widely, but some places will work out payment with a hefty down payment, good credit, etc.

If you come into the ER having a heart attack, you will get the same care with or without insurance. Of course, if you survive and you did not have insurance, you will surely have another heart attack when you get the bill!

[moonbunnie]

i think a lot of times, at least in a doctor's office, the doctor will try and treat you in ways that will be covered by your insurance if possible, to save you money, like prescribing medication that is covered instead of medication that is not. but otherwise, treatments should be the same regardless of what your insurance covers.

[Mimi2RN, ASN, RN]

Unfortunately, medical care is not controlled by the doctor, but by the insurance companies. If they don't like what he/she orders, you have to go through hoops to get it (if you are lucky). My doc gave me Bextra samples, as Ibuprofin, Relafen, Vioxx didn't work. Gave me an Rx, for when they ran out, if it worked. I went to the pharmacy, and was told that I couldn't get it until the doc contacted the ins co, telling them why I needed it. That took another week, at least I got 30 pills. Now I need a refill.......

Also, he ordered an MRI of my hip (he thinks it's osteoarthritis), that turned into a CT scan.

I pay extra for the PPO plan for my dh and myself, and we have still spent at least $4000 in copays, deductibles, etc. etc. And it's only September!

So, cannoli, your medical care is not necessarily your doctor's decision, but it's dependent on a peon following a plan formulated by the insurance company.

[Havin' A Party!, ASN, RN]

I believe that generally, in non-emergency situations, the better the plan the better the service you'll get... treatments, med's and procedures.