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Originally Posted by golfing eagles
Sorry, but I'm forced to disagree, and I probably know a bit more on the subject
The "insurance company" is NEVER "managing " your care under an advantage plan, it is primary care physician.
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While I had a 100% success rate, I'm sure overall that rate is over 95% as long as the proper effort is put in. Remember, while that medical director is "safeguarding" the insurance co. $$$, they want absolutely no part in any decision that might adversely affect outcomes. Simply not worth the hassle for them, and the primary care physician will usually get an approval in 2 minutes.
As far as the second choice---"direct you own medical care", I cannot emphasize how bad an idea that is----kind of like deciding to build your own home nuclear reactor for cheap energy. Most often, it will blow up in your face. That is unless anyone thinks they can match 11+ years of medical education and years of experience by "googling" something. And surprisingly, there is a whole cadre of idiots who think they can do just that.
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Quote:
Originally Posted by golfing eagles
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I'm not sure that anecdotal evidence, dispels anything. As with any business (& you surely know medicine has become a "business"), human nature and human competency, always trumps theory. In this case, the theory being that Advantage programs should be offering a level of medical care, consistent with other options. They all don't and at minimum, all depend on the competency, dedication and (your word)
effort, of one's PCP.
As for "directing one's healthcare", I agree that folks shouldn't be relying on Google, but on a trusted, competent physician ... unencumbered by the corporate policy of a profit-making conglomerate.
(& I understand that Medicare has it's own standards and "rules", but manipulating and navigating Medicare rules, when the government is the overseer, seems much simpler to do, than negotiating/arguing/challenging/maneuvering through a structure controlled by competent, corporate America professionals.)
We can agree to disagree.
(& I'll bet a dollar, that the $1700/Month you're paying for your health insurance, with that huge deductible, allows you to see any physician you want and bet another dollar, it's a BCBS program!)