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YeaYeaWendy

I am not your 'Yes (wo)-Man'

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Living with my new HMO

Posted by YeaYeaWendy Posted on: 01/23/09

Living with my new HMO

I wanted to give everyone an update on life with my new health insurance policy under Kaiser Permanente.  I was very hesitant about this "forced switch" to an HMO - but so far so good. 

I was able to keep both my general practictioner, endocronologist, and neurologist.  I won't be able to keep the same general surgeon, but hopefully I won't need one too often!

The reall great news is that my prescription coverage has gotten much much much better!  Back in November, I was prescribed Amatiza for IBS caused by central hypothyroidism.  At that time, I had Blue Cross/ Blue Shield.  I dropped the prescription off at Rite Aid and came back to pick it up later.  When I got to the drive-thru window, the lady told me that BC/BS only covered $20 and my portion of the bill was $225.  I simply could not afford it and had to drive away.

Now that I'm on Kaiser, all my doc has to do is write "medically necessary" on the script and the pills are only $35 for a whole month's dosage.  Now, here's the great part ----- if I do a mail order, its only $35 for THREE months!  That's $750 worth of medication for $35!!!   My Synthroid is the same, as long as it says "brand necessary" on the prescription, it is only $35 for 3 months.  With BC/BS, it was $48 for 3 months.  Not as great of a difference as with the Amatiza, but still a substantial savings when both are combined!

I have had to learn how to work with a referral system, but since I don't have to start over with a new general practioner, it wasn't hard at all to get my referrals.  I will be going to my neurologist with my referral soon.

So, thats my update!  I've started to lose a little bit of weight, feeling a little better and look forward to better days!


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