Yikes | ADHD Information

We do have this opportunity.  I never thought of this possiblity in detail.  I guess when I heard you lose money if still in the plan at the end of the year, I just shrugged it off this past year.   I'm definitely going to reconsider next year when open enrollment comes back around.  Thanks for the reminder.  Does your company offer that Medical Savings Plan where you put aside so much money out of each check to use to pay for health stuff (I believe even stuff like OTC drugs) and it's taken out of your pay BEFORE taxes so it actually lowers your tax bracket.  It fairly easy to figure out how much you spend year to year if you keep all your receipts.  It's going to always be about the same for co-pays at the doctors and pharmacy.  I understand that it's really easy to use, though I haven't been able to convince my husband of the benefit of reducing our tax bracket.  BUT the one drawback is is that it's a use it or lose it account.  If you have 0 in your account at the end of the year and no doctor's appointments or prescriptions coming up, then you need to use that 0 before Dec. 31 or you forfeit it.  But that could be a good time to get your teeth whitened (dental expenses are obviously included, too) or an extra set of glasses or contacts, for example.  Just a thought.

I'm so glad you worked it out with the Doctor.

It is maddening having to pay out of pocket and you have high insurance premiums.

I don't know how long my insurance will cover office visits. 

 

Thanks everyone!  I was able to get the doctor's office to make some adjustments.  Quite honestly I think she finally came around to seeing my point that they should of alerted me of the change back in October.  I was going to have pay in the hundreds and I got it down to .  I can live with that. 

I still have to find a doc though on my plan or otherwise it will be a visit.  I just can't justify that when I have insurance.  If I had child support coming in on a regular basis from my hopefully soon to be  ex I probably wouldn't worry so.  Plus I have lawyer fees getting ready to hit me for my divorce.  I make a decent salary but by the time you pay all of these items and then on top of that your house payment, car payment,  school/daycare, soccer etc  the  money seems to disappear fast.  At least next year I get a raise.  I'm only going  to pay for after school care. 

Now that I think about it... the money I save is just about what I might need for ds doc if I don't find another doc on my insurance plan.  Hmmmm  something for me to think about.  I however, would rather the money so I can put back into college saving plan for ds.  I'm so confused! I know health comes first... but my weakness is that I am a planner and the future just makes me nervous sometimes. 

I so appreciate all of your kind words and suggestions.  It makes me feel good to have an outlet such as this site.  Lots of great advice is out there and I get so much from sharing here on the site. 

Keep your chin up . The most important thing is that you care about your ds. Having a parent in corner ready to come out and champion issues is so encouraging to a child. Were on your  side Too! Sammo39176.1661689815

first of all, I am sorry that you are having to shop for a new doctor, I know that if my son's ped suddenly was not available to us, I would freak out.  I don't have to worry about insurance coverage, because we cannot afford insurance that would allow us a copay, and we are self employed and provide our own...and we pay over 0 a visit, but she is well worth it.

Secondly, I think that I would fight paying those visits (the ones since October) That doctor's office did business with you, knowing that they had stopped working with your insurance plan.  That is deceitful and you should have had the opportunity to choose for yourself whether or not to continue with him on self pay, not be forced into it for 3 months.

Good luck finding a good doctor that fits your ideas and treatment plans, I know that feeling comfortable with the doctor is half the battle!

I feel so badly for you.  I know how frustrating insurance can be.  I had to switch to a more expensive plan because every Dr. I wanted to go to for my son wasn't on my old plan!

I agree with Chasemom, you should not just give in to your old Dr's office.  Ofcourse, the most important thing is your son's health. 

I think you should write a nice letter to the old insurance plan explaining that you were deceived and that you were paying co-payments to the Dr.s' office all along but apparently, you weren't being covered.  HMMMM - did the Dr''s office bill the insurance company and get reimbursed?  HMMM - I'd also write to the insurance plan you are currently with.  Perhaps the office is double billing and playing games.

Unfortunately, it seems that the medical profession is ruled by insurance companies.  Health is an afterthought.  I remember one pshychologist I went to spent 45 minutes having me and my husband fill out insurance forms!!!!  we had 15 min. left to speak about my son.  We never went back.

How expensive would office visits be if you continued with the current doctor?  You may want to consider that until you find a doctor on your plan.  

Hey - I have to pay 0.00 to have an office visit with my pediatrician if my son is not present!  Last year I did this and I found out that submitted the bill to the insurance comany and got paid!!  They did give me my money back but only after I had shown up for a well visit and they saw it on the computer.

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HI... I am not a lawyer... but just a thought.

If you have paid for the 3 doctor visits your copay and they accepted that payment... then your contract for those services are paid in full... they can't not change the contract on you after the fact.  If they cashed your check for payment or have a receipt for cash that doesn't state that your were only paying a part of a payment... then they don't have a leg to stand on.  Or even if you paid by credit card you are accepting terms that you are paying for services rendered....

Sorry for the rant... but insurance companies are horrible.

I'm so sorry that you have to deal with this.  Finding a doctor is hard enough and then to have to worry about insurance coverage.  Here's a big  for you. 

 

Get ready for a long post... I NEED TO VENT

Today I took my ds to his med check and they tell me that his doc is not on my insurance plan any longer. Hasn't been since last year.  My detective brain starts thinking, "How can this be?".  We've gone to him since last March/April.  We've paid our co-pay of !5.00.  We've spent several  hundred out of our pocket after insurance on expensive QEEG test. And we haven't had to pay anything since last November or so,  because they owed me money for over payment for QEEG test.  My mind starts trying to figure this one out.  I knew that I was going to have pay my co-pay today because the credit had run out.  The office manager tells me I owe them for three visits!    What, I say?   She repeats herself and I said, how?  You can see where this is going. 

Then I proceed to remember that I spoke with both my insurance company and the doc in January as my insurance is in different management hands (school district insurance uses company to handle claims etc.) starting in January.  Same plan, same coverage, just different people handling paper work.  The only real differnce is that my mental health coverage is still on old companies paper work chain as the district didn't want us to have to change mental health providers. 

I get home at 6:30 after office visit and proceed to call my mental health group.  The nice gentleman tells me that yes the doc is off my plan and has been since Oct. 1st.  Hmmmmm... I ask him who should of told me this and he said the doc's office.  Hmmm..... I said who stopped, my mental health group or the doc.  He said I'm not at liberty to tell you, but you can read between the lines. 

YES, you guessed it!  My doc's office stopped working with my plan.  Yet, the office manager never told me this.  She acted as if it were my fault or the insurance companies.  She said how about calling the business office and see what they can tell you.  I think she knew I had something on them.  Seriously, how can I be told I don't owe anything since last year and then all of a sudden, I owe them for three office visits.  And at a visit to boot!!!! We go every other month now but did go monthly.  Can you imagine the money out of pocket.?  Oh, by the way I was given two prescriptions tonight so that I wouldn't have to come back to pick up my ds's prescription next month (our off month from visit).  Now, I'm wondering if they did this on purpose because they know they messed up royally.  I've always been told in the past that I had to pick up the prescription in person.  They would never allow me to have two prescriptions in the past even post dated.  Hmmmm.... do they honestly think I'm that dumb?  To think I trusted this group. 

Now I have to find a new doc.  My insurance plan doesn't have too many child psyhchiatrists  close by.  I can go downtown but who wants to fight traffic.  So I pray that the doc I call tomorrow that is close by is someone that I like and feel will be in the best interest of my ds. 

I'm just sick!  We have been doing so well.  I just pray I can find someone that believes in the whole picture.  Not just meds.  I chose to medicate my son but I believe in other things to.  Therapy, diet, environment, etc... I don't want to mess up what we have going good.  He deserves better. 

Thanks for being my shoulder this evening.