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Do all the doctors in your doctors practice rate the same with your insurance company.


 There are loads and loads of information available on the internet regarding health insurance. So I'm not going to get into that discussion. 

Here’s something that no home economics class will teach. I’ve had to find out through countless phone calls and time on the phone. Don’t get me started on the elevator music I’ve had to listen to.

And this is not limited to just one insurance company. I know of several that do this.

When you get your list of doctors that are approved for a specific copay and there are several doctors in that practice. You need to check to see that the doctor you want is a preferred physician. 

Never fall for the standard line: “ Doctor X is on the list, so everyone should be on the list”

I just had my health insurer tell me this is not true. I’m not blaming them because they just don’t know.

This insurer judges each individual according to what ever standards they set and decides if that Doctor is a preferred doc or not. 

Finally someone openly shared this little tidbit of info. 

I went three rounds with my primary cares office last year over the same thing. My primary doc, I got charged a 10 copay. But if I saw the PA in the office it was 40. At the time when I questioned this each party blamed the other. I just stopped see the PA altogether and made my primary see me for everything. Which was stupid because the PA was just as good.

I just went a round with the RA doc office because I got charged $40 the first time but the second time a different doctor I got charged $80. Same office different docs.

I choose this doctor because he was a preferred provider. Now I'm told he's stepping back his practice and that why I was assigned to another Doctor, a doctor who is not a preferred provider. 

Moral of the story, research each doctor in a practice, and never accept appointments with those that don't get that preferred status. I have no choice but to spend the $80 now but I'll make other arrangements after I see the doctor again. 

Yes , I am aware that I extremely lucky we have health insurance thru my husband work. He pays a hefty chunk out of each pay for me. That will change in 3 years when I draw medicare. But when you live paycheck to paycheck you need to know where all your money is going. 

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