[golfing eagles]

Originally Posted by OrangeBlossomBaby

It's not about that. When you go to your regular physician for a problem, and the physician says you need a specialist, you need to know if you can afford to go to the specialist. Knowing whether your insurance covers specialists in your area, especially if your regular physician refers you to a specific one or group - is incredibly important.

Getting a PCP is a no-brainer. There are dozens and dozens of them, and you just have to pick one that accepts your insurance. There aren't dozens and dozens of specialists in each specialty, and many of them don't accept medicare at all.

For instance - I know I need a hip replacement. My PCP doesn't do those. I need a specialist for that. So when it was time for me to select my health insurance plan, I had to consider the cost of the hip replacement in mind. They run around $25,000 for people who don't have any insurance and aren't in a poverty level to get a break on the price. My insurance has super low premiums - only $17/month. No deductible. But an out of pocket expense max of $9700. That means - if I need a hip replacement THIS year, I'll pay $9700, instead of $25,000, and other medical expenses for the year won't cost anything at all.

If I don't need the hip replacement this year, then I'll pay my co-pays throughout the year when I go to the doctor, UNTIL I've paid out $9700, and then I'll pay no more til next year. Right now I'm racking up $85/DAY in expenses because I'm undergoing radiation treatments for skin cancer. My PCP doesn't provide that service, a specialist is handling that. That's the co-pay for specialist services on my plan.

I'm not on medicare yet, not old enough yet. But the explanation of "why" people are concerned about specialist access is the same no matter which type of health insurance you have.

Just one question: How did you get insurance for $17/month and no deductible when I've been paying $1600/month with a $7200 deductible (no health problems that would cause it to rated up)