Drs office charging monthly fee for "better service"??

[Anonymous]

Anonymous wrote:Actuary here again. PP who lost coverage is on the right track. Here's the thing, right now insurance companies can exclude pre-existing conditions because it's always been that way outside employer coverage, if one company tomorrow decided not to, all the people with high cost conditions flock to that company and it will go bankrupt which helps no one. All the companies need to be forced to start covering all people with pre-exisiting. Young people need to buy into the system (forced or else why would they) and support the older and sicker people in society. In the future those younger will subsidize them. If they get in a car wreck they won't go bankrupt. If you can afford a cell phone you should have health insurance.

Hello Obamacare, that's a good step and should happen. I don't think Obamacare is great and it's caused some increases in costs, but fundamentals of it are necessary or else we are talking rationing of care very soon. We are out of $$ as a country. It forces the healthy to pay in NOW and gets those exlcuded from coverage in at an appropriate price. Insurers want more people covered. They especially want young people and even families like yours. Yes, COBRA is actually $2000, your employer is just no longer paying the majority of the cost. COBRA rates are maybe only 2% higher than what your employer is paying now for families. Believe me, insurance companies lose money on COBRA, and guess who decides to stay and pay $2000 a month, the already very sick and heavy utilizers. Average claims for a family of 4 can easily be $2000, people just don't realize how much the employer is covering beyond your copays and deductions.

I think I love you.
Thank you for being a voice of reason and facts.

[Anonymous]

Anonymous wrote:Concierge service. Definitely a result of insurance micro managing the doctor/patient relationship. I am 50 and healthy--see my doc 1 or 2 times a year so I don't think the extra money is justified. However, if I had a chronic illness and needed to see my dr frequently, I would probably pay the fee.

Bingo. that's the point of concierge services. Most health plans, including Medicare, do not reimburse doctors for any of the work they do to manage the care for patients with multiple chronic conditions and there are a lot of patients out there like that. So all the time spent trying to contact your patients' specialists and other providers gets expensive and isn't reimbursed. They're also not reimbursed for time spent after-hours emailing and otherwise communicating with high-need patients. I'm not trying to defend concierge-type practices (nor am I a doctor, just a health policy analyst), but just explaining why they are popping up. If I had multiple conditions and was seeing upwards of 3, 4, 10 doctors, I might be willing to pay for that kind of coordination. Of course, what would make a lot more sense, and be far more equitable, is if health plans would make care coordination a billable code.

[Anonymous]

Anonymous wrote:My Dr. (Taweel) Offers a similar program from a company called Privia. When I first got the packet I was pissed but after discussing with him figured it made sense. The treatment I get from him is no different but I do now have access to a nutritionist - fitness trainer - and nurse (24/7) whenever I need them. It's not my Drs. fault that my insurance (tricare) which i consider one of the best does not even cover those things that seem like no brainers to me. Think you folks may blaming the wrong people... but like I said before I looked Into it more I was pissed too.

The chances of you seeing this are slim, but are you still happy with the Privia thing? I'm not sure what I would do with access to a nutritionist or fitness trainer, and I can't think of any time I needed a nurse in the middle of the night. I'm trying to decide whether to dump Taweel and go to someone else, although he is a decent doctor. I suppose it would be a case of do I want to pay $60-80 a month for the privilege of seeing him.

[Anonymous]

Just try getting a doctor in Bethesda/Chevy Chase that has been insurance panel AND is accepting new patients.

Sometimes they tell you they will take you, but not your insurance.

I gave up and pay out of pocket and submit for reinbursement. Coincidentally, I never wait long for my doctor and she calls me personally to follow up on routine test results....but it's $550 for my phyiscal each year. Considering what I pay each month for healthcare coverage, it adds up....

My OB/GYN dumped me mid way through pregnancy, stopped taking insurance altogether. The only doctor I found on my panel that anyone spoke highly of is at Georgetown and has a 3 month waiting list for a rescheduled annual exam.

Welcome to the three tiered insurance world.

I guess I should be happy I don't have Kaiser.

[Anonymous]

Actually my mother has Kaiser, one of those MediGap-type things. It's really not too bad, one-stop shop for almost everything, which is is good for her. I always thought they sucked, but you could do worse based on what I've seen with her.

[Anonymous]

Just be glad you have insurance. We don't. And can't get private due to per-existing conditions. Sucks.