Conference 7.286::digital

    
    
    	Makes sense. A doctor can only have as many patients as he/she
    	can handl. Obviously all the other doctors belobging to that
    	particular HMO in your area are full-up.
    
    	Maybe you can try another nearby area ?
    
    
    						Mike
    						----
    

re: .1

I suspect what .0 is objecting to is what I would say is similar to "bait and
switch".

You are considering joining an HMO and the HMO provides a 'list' of doctors
that are in the HMO and you are told you can choose your primary care physician
from the list.  You join the HMO, but when you try to choose your primary care
physician, you find that most of the doctors are indeed at capacity, and
unavailable.  At this point, you are stuck.  You can't switch medical plans,
you can't have the primary care physician you want, and like .0 you are p*ssed.

Bob

    Am I to understand that "foreign" or "brand new" doctors are any less
    qualified than say, "old" or "American" doctors?
    
    My family have been with HCHP for over 8 years now and we have seen a
    variety of doctors, all of whom we have been pleased with (and some
    of whom were even "foreigners or brand new").
    
    Steve
    who has a foreigner (who is also a woman) for a dentist

    I faced the same problem. Almost all the doctors in the location, close
    to my home no longer accept any patients and those who accept there is
    a waiting line of 1 month for every appointment.
    
    My other choice under Harvard Helathnet is to drive for 40 - 50 miles
    each way..
    
    I wonder whether DEC folks anticipated this problem before offering
    Healthnet.
    
    Jay
    

    I was informed today that John Hancock Ins. covers most of the
    cost of ORTHOTICs but my Harvard HMO formerly, Southboro HMS 
    Doctor said it did not. Is the Doctor correct ? She should know,
    but I find it hard to believe that one insurance firm would cover
    this remedial correction (for foot spurs) and that the HMO would
    not. A cast of the foot goes for $ 85.00-90.00 and $ 285.00 for
    the ORTHOTIC. Since spurs are really injuries to the foot, although
    I understand the ageing process can cause it as well, my problem
    definetly was an injuring from playing lots of Tennis.
    
    Has anyone in an HMO gotten some help from the Insurance ?
    
    
    Thanks in advance - Lloyd

    When I chose the HealthNET option for HCHP it was specifically because
    the HMO itself didn't cover orthotics, I will be needing new ones
    within the next year, and the DIGITAL plan and that portion of
    HealthNET will cover them. So if you have HealthNET you can get 
    some help, if you don't you probably won't.
    
    Linda

    	When you select a primary physician at HCHP, you are not locked
    into that choice forever.  You can ask to be notified when a practice
    opens up, and you can switch then.  We had that happen when we couldn't
    sign up for the most popular pediatrician at our center.  By the time
    we heard, however, we decided we liked our "second choice" quite well.

    	Anyway, I've found (as a long-time member) that I deal more with
    the nurse-practitioner than the docs in the practice, which is good
    because the N-Ps have more time to really pay attention to you.  That's
    certainly the case with our kids' practice.

    	You get what you pay for.  Why do you think the total cost (to you
    and Digital) is more than double if you select straight insurance?  You
    pay a lot for the dubious privilege of getting to choose a physician. 
    (And, then, how often are the top private docs' practices also closed?)

    	HCHP not including orthotics is an oddity I encountered a couple
    of years ago.  (But, then, consider that you save >$20/week for high
    coverage, or $1K/year, and you can pay for a lot of orthotics
    yourself.)  They did, on the other hand, cover an operation for my
    bone spurs, which had to cost a lot more than orthotics.

    	The bottom line is, belonging to an HMO is different, not
    necessarily better or worse, than dealing with private medical
    practices.  Take the time to learn how it works.  

    			David

Speaking of HCHP: I hurt my knee running the New York Marathon.  The
standard Motrin cure didn't work.  I asked for a referral to the othopaedic
specialist who x-rayed it (Monday) and scheduled my for an MRI ("magnetic
resonance imaging") for tonight.  (This is a referral outside of HCHP.)

Total cost so far: $9.00 ($3.00 for the nurse-practitioner, $3.00 for the
bottle of Motrin, $3.00 for the ortho specialist).

Martin.

    I'm impressed.  I injured my knees (both of 'em) this summer.  My
    doctor ordered up an MRI for each of them.  I had to decline the
    treatment because I couldn't afford the (nearly) $1000 it would have
    cost me out of my own pocket.  
    
    I'm in the DMP-2.
    
    tony
    (who wishes he COULD get on one of hte HMOs)
    

re .9:

Are you saying that an MRI costs nearly $5000?

DMP should pay 80%.  The out-of-pocket maximum should protect you from
really major expenses.

re:  <<< Note 1331.10 by NOTIME::SACKS "Gerald Sacks ZKO2-3/N30 DTN:381-2085" >>>

>> Are you saying that an MRI costs nearly $5000?

E gadz...sounds funky to me, too. I had an MRI done on my knee last year.
Total payment including the 'specialist' that's supposedly required to
read the results was less than $200. I also have DMP2. 

Jenna

My wife recently had an MRI done at a facility in Newton, MA and the cost was 
between $800 and $1000

    My MRI on my back about June of last year cost $780.00 and DMP-2 paid
    80% with no questions asked.
    
    Regards
    Al Root
    

The "real" cost of the MRI was, as others have noted, in the $400-$600
range.  Note that it was ordered for a fairly minor complaint -- knee
pain while running.  Also, the doctor offered other diagnosis alternatives
(an x-ray series).

In general, I've had good results from HCHP for injuries and illnesses,
even if I grumble about the multi-week delay to see specialists for
non-acute problems.

By the way, MRI is stupendously boring -- you have to lie perfectly still
for 45 minutes. It helps if you have developed the skill of falling asleep
on airplanes.

Martin.

    re: .9
    The cost of the MRI was just under $1000.  For each knee.  I would have
    had to pay the following:
    
    deductible				$150.00
    20% of remaining 1850 MRI cost:	$370.00
    20% of radiologist (190 per knee):	$ 76.00
    		total cost to me:	$596.00
    plus my own doctors fees
    
    I was "going from memory" when I wrote .9  ... sorry about the
    innacuracy.
    
    any way you cut it... it was too expensive.
    
    tony