HMO wants my check up to be every 3 months

[Villages PL]

The last time I went for my yearly check-up, the doctor told me everyhting on my blood-work checked out perfectly (and I don't take any drugs). So I thought it was strange that he wanted me to come back in 6 months. But since he said there wouldn't be any charge for it, I agreed to it. Although, I don't look forward to fasting before getting a blood test.

Today I received an automated call from my HMO telling me that it's been 3 months since I last visited my doctor. They now recommend once every 3 months even if you feel well. And the fact that I don't take medication doesn't seem to matter. It's getting a bit mindless, in my opinion.

So much for thinking and feeling positive about my health. It seems they want me to think negatively now, that my health can fall apart at any moment or any day, and they want to catch it early.

The assumption must be that, as an American, I'm eating the standard American diet and at age 71 my health is teetering toward a slippery slope to decrepitude. This is where I draw the line.

[gomoho]

Or - lets get this guy in as many times as we can so we get paid for it. I would definitely report this to the "fraud squad" at Medicare. Think through this - you aren't paying, but the money for these services is coming of Medicare which we are all trying to protect. We need to be proactive and stop these guys from collecting when they shouldn't be. Another good reason to have a salaried doctor. He gets paid no matter how many patients he sees.

[pooh]

Once one reaches a particular age, the three month recheck seems to be the time interval health care providers do rechecks. Remember, you don't have to go that often if you don't want to. It's sort of like preventative maintenance on their part...there may be changes taking place in your body that you are unaware of. Kidney function may be a bit different, liver changes could occur, who knows. Some of these changes only show up in blood work and suggestions to help restore norms or prevent more damage can be discussed by doctor and patient when results are slightly changed, really changed or not good at all. OR the doctor can remark how well the patient is and tell them to continue on with whatever they're doing.

It was an automated call....the computer just selected members of a certain age and beyond, made calls. The decision to go or not go is up to each member.

[lightworker888]

VPL This is a good example of taking personal responsibility for your health. How do you feel about getting a notice. How do you feel about saying no to a request from an HMO. If you do not go, and something turns up later is that OK with you. If you go and nothing turns up later, how does that feel . Your belief system and your ease with all these situations will all have am impact on your decision.

For me the big thing is to own my responses and not to feel victimized by the system. It is what it is and you are choosing to interact with it, so you might as well be at peace with it and then decide how much you want to interact with it and then be at peace with your choice.

Before we moved, I was getting all kinds of reminders to get tested, vaccinated or screened for all kinds of things but since we have moved I seem to have been lost in the shuffle either because of location or because I didn't respond over the years.

They changed our health card many years ago to a picture ID that needs renewing every 5 years but I still carry around the old red and white one that is duct taped together but is still valid. Have to use it at the optometrist. That's the only claims I have had on it since my last daughter was born 38 yrs ago.

Good luck with your choicemaking. It is very empowering and liberating to own your life, when others around you are blaming things outside themselves for any negativity in their life.

LW888

[Virtual Geezer]

It's all about the benjamins. Just like the oil changes on your car. Owners manual says every 5,000, 6000 or even 10,000 for some cars using synthetic oils but the quickie change shops say every 3,000. It's all about the benjamins.

VG

[zcaveman]

Just cancel the appointment and make another one three months down the road. And cancel that one and make and make another one three months down the road. And cancel that one and make and make another one three months down the road.

And go to that one and you will have your one a year.

But make sure that if you do this your HMO will not penalize you if - God forbid - you ACTUALLY get sick and the problem was not picked up but the three checkups that you missed..

[asianthree]

i would have to be out of town on that three month checkup

[blueash]

Contrary to some postings, I believe that the doctor is paid for the visit, not the HMO. It is the HMO which has to pay the doctor. I would like to see more information from the OP, specifically the name of the HMO. Is this a Medicare advantage plan or a private insurance carrier? I am not aware of any national organization that has recommended 4 times a year routine check-ups. Perhaps the OP could call the insurance company and ask if this call really came from them. Four times a year "annual" exams would overwhelm the already overworked primary care doctors. Only explanation I can come up with is that somehow the HMO has you coded as having an illness that should require more frequent visits like diabetes. It is possible the doctor's office entered a wrong diagnostic code on a charge they submitted to the insurance carrier which triggered this call.

[jblum315]

opposite. My GP has switched me from every 3 months to every 4 months

[Mimivillager]

I am healthy. My new dr wanted to see me every 3 months. I told her 1 yr which is what I was accustomed to. We compromised on 6 mos. She said she could not be responsible for 1 yr.
I do need 1 prescription so have to see her periodically.

[2BNTV]

Medicare Complete in CT only pays for an annual physical so I go once per year. Anything more and I would feel like I'm getting ripped off.

I thought you were only suppose to go to a doctor when you had symptons or something wasn't right.

Am I misssing something?

[zcaveman]

Medicare Complete in CT only pays for an annual physical so I go once per year. Anything more and I would feel like I'm getting ripped off.

I thought you were only suppose to go to a doctor when you had symptons or something wasn't right.

Am I misssing something?

In my case we are on meds and we get three check-ups a year with blood tests to make sure everything is okay.

[ilovetv]

Since it was an automated call, it seems like it's possible that the electronic medical records program/software might have detected a "red flag", correct or put there by human error. Remember GIGO being at the crux of computing? Come to think of it, I haven't heard anyone mention GIGO in about 20 years.

Whether or not it is the case, we should be careful what we wish for with those.

[2BNTV]

In my case we are on meds and we get three check-ups a year with blood tests to make sure everything is okay.

To clarify, I meant that unless there was a known medical condition, frequent check-ups shouldn't be mandatory.

Being a type 2 diabetic, I go for blood work every six months although it is not mandatory in my case as I have a very mild case. In fact, I make an appointment even though my doctor doesn't follow-up as he should.

[Villages PL]

Or - lets get this guy in as many times as we can so we get paid for it. I would definitely report this to the "fraud squad" at Medicare. Think through this - you aren't paying, but the money for these services is coming of Medicare which we are all trying to protect. We need to be proactive and stop these guys from collecting when they shouldn't be. Another good reason to have a salaried doctor. He gets paid no matter how many patients he sees.

That's a lot to think about. I have always thought that the Medicare HMO gets a set amount of money to take care of each member-patient. In that case, what would they have to gain by offering 3 month check-ups unless they really think they are going to catch some medical problem early? Also, it's my understanding that the HMO pays my doctor a certain amount for each office visit. And it's usually not a large amount of money.

[Villages PL]

The decision to go or not go is up to each member.

I think you're right about that; what could they possibly do about it if I don't agree to it? Maybe I'll call the HMO to see what they have to say about it.

[Villages PL]

Good luck with your choicemaking. It is very empowering and liberating to own your life, when others around you are blaming things outside themselves for any negativity in their life.

Thank you. I want to ease into old age and I don't feel old yet. Just a few months ago I agreed to the 6 month check up. I believe I will just let it stay that way for a few years and see how things go. My motto will be: "If it ain't broke, don't fix it." :)

[Villages PL]

But make sure that if you do this your HMO will not penalize you if - God forbid - you ACTUALLY get sick and the problem was not picked up but the three checkups that you missed..

OMG! On top of being sick they'll give me a penalty?

:)

[Villages PL]

Contrary to some postings, I believe that the doctor is paid for the visit, not the HMO. It is the HMO which has to pay the doctor. I would like to see more information from the OP, specifically the name of the HMO. Is this a Medicare advantage plan or a private insurance carrier?

This is a Medicare advantage plan: Optimum Health Care, Inc.

I am not aware of any national organization that has recommended 4 times a year routine check-ups. Perhaps the OP could call the insurance company and ask if this call really came from them.

That's a good idea. The literature I read before joining never said there would be 4 "free" check-ups per year. Not even 2 per year.


Four times a year "annual" exams would overwhelm the already overworked primary care doctors. Only explanation I can come up with is that somehow the HMO has you coded as having an illness that should require more frequent visits like diabetes. It is possible the doctor's office entered a wrong diagnostic code on a charge they submitted to the insurance carrier which triggered this call.

Wow, it's getting more interesting all the time. I never thought about the possibility of a wrong diagnostic code. I certainly will call to find out.

Thanks!

[Villages PL]

I thought you were only suppose to go to a doctor when you had symptons or something wasn't right.

Am I misssing something?

What's coming next is a gadget we will all wear on our wrist which will provide constant 24 hour monitoring, even if we are healthy. If something goes wrong a signal will be sent to our doctor's office and we will be notified that we need an appointment. In the event of a heart attack, 911 will be alerted.

:)

[Villages PL]

Since it was an automated call, it seems like it's possible that the electronic medical records program/software might have detected a "red flag", correct or put there by human error. Remember GIGO being at the crux of computing? Come to think of it, I haven't heard anyone mention GIGO in about 20 years.

Whether or not it is the case, we should be careful what we wish for with those.

How about a "red flag" put there by a computer error?

[graciegirl]

Something isn't right here. Either your doctor is wrong in wanting to see you more frequently or you are ignoring something he wants to see you about.

[Villages PL]

Something isn't right here. Either your doctor is wrong in wanting to see you more frequently or you are ignoring something he wants to see you about.

I'm glad you asked. This should wrap things up with this thread. When I went in to get the results of my blood test, I just happened to mention to my doctor that I had decided to take a larger B12 supplement. I told him I had been taking only 100mcg per day. So he must have wondered about it and decided to require another B12 blood test. Then he must have looked over my records and saw a few other items that hadn't been checked for a long time, like urine analysis. So he combined three different items. I'm not sure what the third one was; I couldn't understand it.

Anyway, for those who might be wondering, I made an assumption that my exams would be every 6 months in the future. No! I shouldn't have made that assumption! When I called Optimum Health Care, they told me that there would be no such requirement for someone who doesn't have any health issues. As a matter of fact, they offered to cancel the appointment for me. But I told them I would prefer to keep the appointment and they said okay to it. And there would be no charge to me.

Anymore questions? :) Did I leave anything out?

[graciegirl]

I'm glad you asked. This should wrap things up with this thread. When I went in to get the results of my blood test, I just happened to mention to my doctor that I had decided to take a larger B12 supplement. I told him I had been taking only 100mcg per day. So he must have wondered about it and decided to require another B12 blood test. Then he must have looked over my records and saw a few other items that hadn't been checked for a long time, like urine analysis. So he combined three different items. I'm not sure what the third one was; I couldn't understand it.

Anyway, for those who might be wondering, I made an assumption that my exams would be every 6 months in the future. No! I shouldn't have made that assumption! When I called Optimum Health Care, they told me that there would be no such requirement for someone who doesn't have any health issues. As a matter of fact, they offered to cancel the appointment for me. But I told them I would prefer to keep the appointment and they said okay to it. And there would be no charge to me.

Anymore questions? :) Did I leave anything out?

I didn't ask a question. I just made a summary statement.

Urine tests, blood tests for cholesterol, sugar, vitamin D levels in blood, liver function, and thyroid function and procedures such as endoscopy and colonoscopy can all alert for illnesses that have not presented themselves blatantly.

An ounce of early diagnosis is worth a pound of heavy medicine is my feelings. Seeing your doctor once too often is better in my mind than once too few.

[Villages PL]

I didn't ask a question. I just made a summary statement.

Urine tests, blood tests for cholesterol, sugar, vitamin D levels in blood, liver function, and thyroid function and procedures such as endoscopy and colonoscopy can all alert for illnesses that have not presented themselves blatantly.

An ounce of early diagnosis is worth a pound of heavy medicine is my feelings. Seeing your doctor once too often is better in my mind than once too few.

I'm trusting my doctor to decide which tests are needed.

Even more frequent visits and tests don't guarantee anything. I was just reading a book from the library and it told about a woman who went to the emergency room with some complaint and the doctor told her she was okay and not to worry. As she left the hospital to go to her car in the parking lot, she collapsed and died.

[graciegirl]

I'm trusting my doctor to decide which tests are needed.

Even more frequent visits and tests don't guarantee anything. I was just reading a book from the library and it told about a woman who went to the emergency room with some complaint and the doctor told her she was okay and not to worry. As she left the hospital to go to her car in the parking lot, she collapsed and died.

I missed the point you just made. An emergency visit is not the same at all as being monitored by a physician routinely. An emergency visit cannot detect all health issues that may be sickening a patient.

People frequently take medication for conditions that do NOT cause them to feel ill or be ill. Those people feel healthy but they have conditions that if left untreated will blossom into dangerous health issues.

My response to you a few posts back about the issue that you stated at the beginning of this thread that you started is that your doctor/service/office wanted to see you every three months. I responded by saying either your doctor is wrong or you are ignoring his advice.

[Villages PL]

I missed the point you just made. An emergency visit is not the same at all as being monitored by a physician routinely. An emergency visit cannot detect all health issues that may be sickening a patient.

People frequently take medication for conditions that do NOT cause them to feel ill or be ill. Those people feel healthy but they have conditions that if left untreated will blossom into dangerous health issues.

My response to you a few posts back about the issue that you stated at the beginning of this thread that you started is that your doctor/service/office wanted to see you every three months. I responded by saying either your doctor is wrong or you are ignoring his advice.

I hope this clears it up: Yes, I received an automated call from my HMO stating that it had been 3 months since my last visit and that I should contact my doctor to make an appointment. When I called my HMO, after starting this thread, they said the automated message goes out to everyone. It was not specific to me.

About the hospital patient: She thought she might have been having a heart attack but the doctor said otherwise. So it wasn't that she came in for one thing and died of another.

[graciegirl]

Now that I reread your initial post on this thead I do get your point. You wanted to point out that you are eating a healthy diet.

[Villages PL]

Now that I reread your initial post on this thead I do get your point. You wanted to point out that you are eating a healthy diet.

boy howdy