[Peazoup]

I had the occasion to visit the Urgent Care facility next to Sweetbay the other day and thought I'd pass on some information that was told to me by a doctor practicing there. I've been diagnosed with arthritis and am on borrowed time before a knee replacement will be necessary. As I'm trying to delay that day, I went in for a little relief via a cortizone shot.
The doctor told me that I probably shouldn't wait much longer as when the new Health Care Reform becomes effective in 2014, joint replacement surgery will be viewed as elective surgery and, therefore, not covered. Do you believe that after paying into our system all our working lives, this will happen to us? Is it really true? Does anyone have anymore info?

[Xavier]

Originally Posted by Peazoup

I had the occasion to visit the Urgent Care facility next to Sweetbay the other day and thought I'd pass on some information that was told to me by a doctor practicing there. I've been diagnosed with arthritis and am on borrowed time before a knee replacement will be necessary. As I'm trying to delay that day, I went in for a little relief via a cortizone shot.
The doctor told me that I probably shouldn't wait much longer as when the new Health Care Reform becomes effective in 2014, joint replacement surgery will be viewed as elective surgery and, therefore, not covered. Do you believe that after paying into our system all our working lives, this will happen to us? Is it really true? Does anyone have anymore info?

If it turns out NOT to be true, as I suspect, I'd find me a doctor with more integrity and report him to the state medical regulatory agency.

[actor]

Originally Posted by Peazoup

I had the occasion to visit the Urgent Care facility next to Sweetbay the other day and thought I'd pass on some information that was told to me by a doctor practicing there. I've been diagnosed with arthritis and am on borrowed time before a knee replacement will be necessary. As I'm trying to delay that day, I went in for a little relief via a cortizone shot.
The doctor told me that I probably shouldn't wait much longer as when the new Health Care Reform becomes effective in 2014, joint replacement surgery will be viewed as elective surgery and, therefore, not covered. Do you believe that after paying into our system all our working lives, this will happen to us? Is it really true? Does anyone have anymore info?

That's nonsense.

[mac9]

Joint replacement surgery is CURRENTLY considered elective surgery which is why pre-authorization is required. Was is actually a doctor who told you that or a physician's assistant or someone else who works in the office? They should be chastised for starting/passing on such nonsense.
How do I know this? I have had two knee replacements and it was carefully explained to me by both my physician and my insurance company as I did not believe that it was elective.

[Russ_Boston]

Originally Posted by mac9

Joint replacement surgery is CURRENTLY considered elective surgery which is why pre-authorization is required. Was is actually a doctor who told you that or a physician's assistant or someone else who works in the office? They should be chastised for starting/passing on such nonsense.
How do I know this? I have had two knee replacements and it was carefully explained to me by both my physician and my insurance company as I did not believe that it was elective.

Not sure how you view it as nonsense. If elective surgery wouldn't be covered under the new plan then knee replacement wouldn't be. Right? If that's the case (I'm not sure about the new rules) then the only thing to chastise the doc or PA for would be that they didn't emphasize that knee replacements are currently elective.

I guess the real thing to find out: was the doc right? Will elective surgery not be covered? If that's not the case then chastise away!

I have been to this Urgent care a couple of times as has my wife. They are by far the best in The Villages and to dismiss them when they tried to alert the patient is outrages. They were trying to help. The patient has options one of which is to go to another Dr. or do research on their own.
Since the Dr at the Urgent Care does not do knee surgery the only motive would be to help the patient.
Who has read the Health Care Reform act? Who understands what it states?
My guess is that very very very few in The Villages understands it and the patient should be grateful that the Dr. took the time to mention it. My only concern is that this type of negative behavior by "knocking the Dr" may lead them to not help with additional advise in the future. Fortunately I know the Dr.'s at this Urgent Care and they will always continue to do what is best and professional for the patient and not be influenced by those that make it entertainment to try to harm the good reputation of a Doctor.

[l2ridehd]

Please read the bill that has been passed. Today knee replacement is elective and when approved is paid for by insurance. Under the bill as currently passed. elective surgery is not covered and would require some type of a supplemental policy to have elective surgery covered. I doubt anyone knows what the cost of that policy will be as they have not yet been required. My guess would be that this is still a place where insurance companies could still make a profit so probably not cheap. The doctor at the urgent care was accurate in what he told you. Maybe didn't go as far as he should have by telling you today you need approval.

The difference is today you need approval, usually fairly easy to get, tomorrow you will either pay for out of pocket or buy supplemental insurance at some currently unknown cost. Based on that, if you know for sure your going to require it, I would do it sooner vs later. I am getting every test, check up, physical, that I think I may need in the next 5 years done now where I know the rules. May be better or worse in the future, but at least now I know what to expect and don't need to deal with a government run system.

12ridehd..Thanks for taking the time and opening yourself up to naysayers in order to pass on education. As the guy said in the movies to the naysayer, "you can't take truth"..Denial is a terrible attribute.

[Xavier]

Originally Posted by l2ridehd

Please read the bill that has been passed. Today knee replacement is elective and when approved is paid for by insurance. Under the bill as currently passed. elective surgery is not covered and would require some type of a supplemental policy to have elective surgery covered. I doubt anyone knows what the cost of that policy will be as they have not yet been required. My guess would be that this is still a place where insurance companies could still make a profit so probably not cheap. The doctor at the urgent care was accurate in what he told you. Maybe didn't go as far as he should have by telling you today you need approval.

The difference is today you need approval, usually fairly easy to get, tomorrow you will either pay for out of pocket or buy supplemental insurance at some currently unknown cost. Based on that, if you know for sure your going to require it, I would do it sooner vs later. I am getting every test, check up, physical, that I think I may need in the next 5 years done now where I know the rules. May be better or worse in the future, but at least now I know what to expect and don't need to deal with a government run system.

What pages of the bill will I find this information? My primary becomes my secondary when I turn 65. I think, just maybe, your brush is a bit broad.

Lou Card hit the nail on the head again. We'll all have to wear hard hats just in case the sky really is falling! I think not. I've got too much to do than sit around and worry about this story book stuff. Hey did ya hear about the world coming to a stand still when the new millennium starts? (Sorry - couldn't help myself)

X

[chachacha]

in the sand is not the same as looking on the bright side of life!

[chachacha]

the complete post was "burying your head in the sand is not the same as looking on the bright side of life" in fact it must be pretty dark down there!
baa daa boom!

[Peazoup]

Thank you RussBoston, REH7380, 12ridehd and others who took this information as something perhaps to look into more deeply and not to negatively pass judgement. As mentioned, the doctors at Urgent Care have no incentive to advise patients on issues relating to the new health care reform other than to try and protect them against rising costs in the future. In my experience, these doctors are thorough and caring professionals and we should be thankful for such advice.

[Lou Card]

[Autoshow]

Originally Posted by Xavier

If it turns out NOT to be true, as I suspect, I'd find me a doctor with more integrity and report him to the state medical regulatory agency.

I think that Dr. is looking for more business,immediatly

[Russ_Boston]

Originally Posted by autoshow

I think that Dr. is looking for more business,immediatly

With the shortage of physicians - not likely. No physician I know (I'm an RN) is looking for any more business. Our practice has all the patients we need thank you.