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  • insurance and treatment options

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    Old 06-14-2021, 04:22 PM   #1
    JWPMP
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    insurance and treatment options

    Do any of you all think Drs / Hospitals like UCSF let what insurance you have influence their treatment of you?
    I'm not talking whether it's approved or not. I'm talking will they be more aggressive in their approach with a private insurance that pays almost 80% more than Medicare? Even though both insurances cover the particular procedure? Jim's Blue Cross paid way more for an MRI than Medicare did. Wondering if that's why they decided to be less aggressive with Jim's treatment. Insurance changed in February.
    Just thoughts rolling around.

     
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    Old 06-14-2021, 11:02 PM   #2
    Prostatefree
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    Re: insurance and treatment options

    No. Beware of conspiracy theories in your head and in those around you.

    As another example, you will hear many men believe a radiologist prescribes radiation and a surgeon prescribes surgery because they make money from their procedures and have no professional interest in what's best for the patient.

    https://www.psychologytoday.com/us/blog/talking-apes/201801/why-do-people-believe-in-conspiracy-theories

     
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    Old 06-15-2021, 03:49 AM   #3
    Insanus
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    Re: insurance and treatment options

    Walk into you doctors office and ask him what insurance you have or ask him what your policy will cover. They won’t know, nor could they.

    There are far too many variables between private insurance polices within the same company and certainly far to many options in Medicare Advantage Plans.

    What is quite a hardship is private plans that are basically what ever your employer wants to pay for. That includes some very high deductibles and out of pockets expenses and a very limited selection of providers in many cases.

    Likewise Medicare Advantage Plans can also be restrictive in providers and can require you to try a less expensive treatment first.

     
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    Old 06-15-2021, 04:21 PM   #4
    JWPMP
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    Re: insurance and treatment options

    Quote:
    Originally Posted by Prostatefree View Post
    No. Beware of conspiracy theories in your head and in those around you.

    As another example, you will hear many men believe a radiologist prescribes radiation and a surgeon prescribes surgery because they make money from their procedures and have no professional interest in what's best for the patient.

    https://www.psychologytoday.com/us/blog/talking-apes/201801/why-do-people-believe-in-conspiracy-theories
    Thank you for that PF. I've been really over thinking this change of treatment plan...

     
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    Old 06-15-2021, 04:26 PM   #5
    JWPMP
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    Re: insurance and treatment options

    Quote:
    Originally Posted by Insanus View Post
    Walk into you doctors office and ask him what insurance you have or ask him what your policy will cover. They won’t know, nor could they.

    There are far too many variables between private insurance polices within the same company and certainly far to many options in Medicare Advantage Plans.

    What is quite a hardship is private plans that are basically what ever your employer wants to pay for. That includes some very high deductibles and out of pockets expenses and a very limited selection of providers in many cases.

    Likewise Medicare Advantage Plans can also be restrictive in providers and can require you to try a less expensive treatment first.
    That's a good point.
    I was just so shocked how much less Original Medicare (which we have now and our Anthem Blue Cross has moved to secondary) paid than what our BC paid when it was primary.
    I got to thinking that's why UCSF doesn't want to be as aggressive with Jim's treatment. Do as little as possible until it becomes absolutely necessary to step it up a notch.
    But after reading your post, it's probably only the Billing department that actually knows who what where and how much, not the doctors themselves.
    Thanks for the perspective, my mind has been working overtime.

     
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