I have a medicare PPO plan and that gives me a 15 copay to my regular physician and a 30 copay to a specialist. Most xrays and stuff are covered, but sometimes there is a small amount due for labs. The disgusting thing is that a doctor will tell me they take my insurance, then I go see them and pay the copay and then they will send me a bill for hundreds of dollars above the medicare approved amount. They know that the plan only pays the medicare approved amount and I pay extra for the plan to cover the difference between the 25% deductible for medicare and my smaller copay. I'm so disgusted. I'm starting to refuse to pay, but all my docs just started this illegal practice, except my rhuemie and primary care, thank God, because they are decent people. I am already having to switch endocrinologists, she was good, but a joke, demanding over 300 a visit and expecting all of it from me. I actually asked her office how they could get up in the morning and face themselves in the mirror. Isn't there some law that says that if they bill your insurance, they must abide by its terms? If they say they "take" my insurance, I'm assuming that they will abide by its terms. I'm planning on sending them explanations of benefits, showing that they are in the wrong, and I've called the insurance company, but they won't get involved, they keep saying that if I ever signed anything that says I will pay any remaining cost, that that includes these illegal costs. I would be better off just having straight medicare at this point. Unfortunately, I'm 70 dollars over the limit for medicaid to fill in where medicare leaves off and social security won't pay me less. I'm so disgusted. I'm also running out of providers who take this plan. I hate this country. I've called board of insurance, but in my state they are just an answering machine and they are really corrrupt. I don't know what to do.
--Doctors are men who prescribe medicines of which they know little, to cure diseases of which they know less in human beings of whom they know nothing.--Voltaire (1694-1778)
Ills--Sjogrens-Lupus-like AI Disease, Hashis, Vitiligo, spinal stenosis/fusion with plate, salivary/lymphectomies, Diabetes, NAFLD, COPD, RLS, neuropathy, trigonitis, hystero, diffuse brain atrophy
Meds--Plaquenil, Evoxac, Metformin, Synthroid, HCTZ, Estradiol patch, Prosed, Klonopin, Soma, Ultram, Vicodin, Restasis, Albuterol,steroid injections, Protopic & Triamcinolone Acetonide ointments