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Old 01-21-2017, 08:49 PM
 
Location: Planet Woof
3,139 posts, read 3,510,190 times
Reputation: 9889

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He probably had a ''Medicare Managed Care Plan'' of some sort which limits providers and has networks. Most seniors I ever worked with don't understand all this and that it limits who they can see, what services, and where. Sounds like he might have had some dementia re the belligerence or he was ''chemically altered'' or he was just a rude jerk.
There is a huge turnover in these medical office jobs and no surprise, eh? LOL
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Old 01-21-2017, 09:07 PM
 
Location: Ft. Myers
17,628 posts, read 11,185,645 times
Reputation: 37672
I deal with sour people like this from time to time, and generally ignore them and let it go. But every so often one gets to me and won't let up.

Just last week I was helping a guy and he kept saying "That is what I'm trying to tell you, don't you understand ?" Finally, I looked him square in the eyes and said "Look, in case you didn't notice, I was trying to help you out here. Now, if you don't want my help, just let me know !" He finally took the info I was giving him and left, and I fumed for a little while before I calmed down.

There are just some very bitter people in the world, and we have to live with them.
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Old 01-22-2017, 05:48 AM
 
16,019 posts, read 19,693,299 times
Reputation: 26200
OP, I guess you would have to be there.

Sometimes after you have had years of run around, and snarky youngsters who mistake frustration and fear for rudeness, you get one that pushes you over the edge.

Like you said, We don't know the back story. Maybe he had to ride 3 buses to get to his Doctor. My brother used to, because he was in Calif. and I have lived in the upper Midwest for 35 years....He no longer drove, he had a terrible time with mobility sometimes and would have to transfer buses twice.

Then if he had to get meds, he had to take a different bus, which dropped him off further from home, and he had to walk home. We never know what type of events others are going through....That is why it behooves us to always be kind.

I know that I'd be wanting some sort of explanation if my Doctor abruptly said He couldn't see me as a patient anymore. This is not a "Next in line please" moment IMO

But honestly, my experience working with some pretty grouchy seniors is that behind that façade is someone that needs a person to set down with them and explain, even just take a moment to explain at the desk.....not just tell them "Your Doctor can't see you anymore"

There are resources in many communities that assist elderly with so many of these changes. I would have had a list of referral numbers for the gentleman and some reassurance that someone would help him. I think even a business manager could have come out and taken him to an office and talked to him.....I'm sure part of his angst was being on display to all the disproving looks if what you say is the general feeling. That was disrespectful IMO.

Next time you see someone in this kind of stress. Tell them about this number, 211 2-1-1.org

It is a 24/7 resource info hotline, manned by trained volunteers. They are there so our citizens, any age, any issues.... do not have to feel that confusion and aloneness when they do not know where to start even looking for help ....repeat with any issue.

The caller explains what is going on with them.... and the trained volunteer will look up and provide a list of agencies and their contact information within moments. It is that port in a storm.

ETA.....Thank goodness for this forum where we can express our frustrations, share our experiences and commiserate with each other....occasionally get into a semi heated discussion, regroup and show each other respect and wisdom and many times simply kindnesses. I so appreciate this forum.

Last edited by JanND; 01-22-2017 at 06:04 AM..
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Old 01-22-2017, 06:17 AM
 
Location: RVA
2,167 posts, read 1,267,777 times
Reputation: 4465
Based on my location and where we were, he drove there or maybe took uber. The receptionist had been there for many years. She handled him fairly well, but her constant repeating, word for word, that he no longer had Medicare and he needed to call his Drs to see if he was still covered was confusing and a bit wrong, based on what you all are saying. The Dr would have been glad to treat him, but as an out of network/pocket cost. So in reality he did still have Medicare, but only Part A, hospitalization. I did not realize that you don't HAVE to take Part B from Medicare? I thought Medigap and Advantage plans were in addition to part B. Or is something like an orthopedic Dr. is not covered under Part B? I guess I have to get my "Parts" straight before DW & I am off my employers insurance.

BTW, IMHO, the guy was way out of line, and had he gotten really out of hand, I would have stepped in. That was why I stuck around. I "know" the rather small women that work there, and if he became a real problem, myself, and I think the other guy there would have stopped it. We were the only 3 patients in the room. She even started to tell him that another Dr wil only accept records as valid sent directly from another Drs office, but he cut her off there. He was quite self absorbed. He called someone on his cell (sounded like his wife) and gave a distorted version of what was happening and how now he would have to go home without being treated, etc that revealed a lot about his personality. Once on the phone, it was apparent he was leaving shortly, so I saw no reason to stick around. Unpleasant people abound. He is a heart attack waiting to happen.
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Old 01-22-2017, 09:11 AM
 
4,069 posts, read 1,559,260 times
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Okay.
MEDICARE - you are covered with Part A starting at age 65 at no cost to you. This covers about 80% of Hospital expenses. Note that the Medicare has negotiated lower fees for almost all hospital services, so your share of the expenses are based on that fee, not the "retail" fee. Part B covers the doctors fees, such as your checkups and other office visits, etc. You pay for Part B (normally around $110 a month) and it is not mandatory. Drugs are not covered.

If you wish, you can enroll in a "Medigap" Plan. These are also know as Medicare Supplements. They cover what Medicare doesn't, although some do have co-pays and/or deductibles. And you must be enrolled in Part B. These Plans (Plan A, etc) have standardized coverages, so that my BCBS Plan F is exactly like United HealthCare's Plan F. Premiums may vary but coverage doesn't and virtually any health care provider that accepts Medicare will accept the Medigap Plans. Drugs are not covered. That's Part D and a whole 'nother topic.

"Parts" are what the Government does, "Plans" are what the insurance companies do.

ADVANTAGE Plans are effectively a replacement for Medicare. You no longer use your medicare card, and they do not pay anything to the healthcare provider. Instead, Medicare pays the insurance company to insure you. You are now insured by whoever sold you the Advantage Plan. They can be HMOs or some other set up. Coverage is regional and the healthcare providers are part of a network. You may, or may not, still have the Part B premium taken out of your SS check, but that is really just part of your premium. You are not covered by Part B.

Advantage Plans can add other coverages, such as drug coverage, vision, dental, etc. These plans are allowed to vary widely. As does the cost.

If you are currently covered by traditional Medicare, but wish to move to an Advantage Plan you may almost always do so, but once you do that you may or may not be able to switch back to traditional Medicare.

Confused yet?

As for the older fella in the doctor's office, well, we've all had bad days, but it almost never helps in getting the end result you wanted. And Lord knows the receptionist that took the heat is not the root of his problem.
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Old 01-22-2017, 09:56 AM
 
Location: Saint Johns, FL
1,193 posts, read 943,275 times
Reputation: 1267
Annie... I am retired military and we have a 'supplement' plan designed for us (Tricare for Life), so I never had to really investigate the supplements and plans. But your explanation was the clearest I've read and I just forwarded it to a 64 year old non-military friend I have.
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Old 01-22-2017, 09:59 AM
 
20,593 posts, read 16,645,141 times
Reputation: 38682
Quote:
Originally Posted by Perryinva View Post
I had to get a cortisone shot in my foot to shrink a Mortons neuroma. I have a high deductible health plan, and paid the $56 with a credit card. After me, in line was an Ed Asner look alike, so maybe late 70s? Age doesn't really matter except that he was not foreign and well over 65. He was one of the rudest, most belligerent seniors I have seen in action to date. He literally walked in to the office a few minutes before his 9:00 appt. and started complaining at 9:05 as to why he had to wait when he had an appointment!

Then, while the receptionist was going over the usual "Identification and Insurance card, please", she told the man that they don't accept his insurance at this office. He had some United Healthcare version. The man went insane. He did not drop to expletives but kept insisting, very very loudly, that he was told his insurance was good everywhere, and they HAD to take it. She replied, no, they didn't and that many doctors don't take many types of insurance, including Medicare. She told him that they had treated him in the past when he had Medicare, but could only now, if he wanted to pay out of pocket. I listened while she patiently explained the same things over and over and he kept insisting she "Get on the phone, and make this right!" She even called a similar orthopedic surgeon/dr thta DID take his insurance and they offered him a later same day appointment. He would have none of it! He only wanted a Dr that he knew, and actually said "for all I know, this guy is a veterinarian!" Then he told the receptionist he wanted all his medical records "RIGHT NOW". He wasn't leaving his records at a Drs office that was no good and worthless. I left before it was totally resolved, but wow.

Anyway, my question is, are there actually cheaper alternatives to Medicare, with less coverage that one can get instead? This was news to me. She specifically told him to call all his doctors and tell them he does not have Medicare, but has the United Healthcare plan he specified. I thought everyone after 65 and not under an employers plan had Medicare. I thought maybe it was possible he WAS retired, and on Medicare, then went back to work and this was his work plan? But Medicare would still be cheaper, so that is unlikely.
YES, there are, and I wish more seniors would realize it. Medicare Advantage Plans, which are heavily marketed, seem cheaper and are upfront. My mom had zero premium. However these plans are sort of privatized Medicare, run by Blue Cross, Aetna and others, versus traditional Government-only Medicare. As such, there are high co-insurances and more importantly, gatekeepers. Many places including rehabs (I work in geriatric rehab) won't even take people with Advantage plans, because they don't pay as much, and because unlike traditional Medicare, which allows doctors to decide how long you need to be there, we have to write letters and beg the insurer to let the person stay. Two people with severe strokes, the one with traditional Medicare will be able to stay until the team, he and his family feel he's ready, the other guy might be forced out in 8 days and never fully recover because of it.


When my mom was in subacute rehab for 3 weeks, she owed $5,000 in co-insurance! Aside from the co-pay, I too had to fight to get her to be able to be covered until she was able to function again. My mom was living alone, driving, independent, got a leg infection (cellilitis) and due to being bed-bound, couldn't walk. So after 3 days, her insurer tries to discharge her, saying "we think it's unlikely your mom will be able to walk again" despite the fact she was walking fine 2 weeks ago! Luckily I fought and won, but she still had that giant co-pay, and that doesn't include the $500 her insurer wouldn't pay for the ambulance. Yes, under her Advantage Plan she had to pay $500 for using an ambulance. As soon as I was able, had POA and open enrollment came, I got her traditional Medicare, which is more because you need a supplemental policy for full benefit (my mom's is $300+ a month).


Many seniors can't afford this. I do not know if you've ever looked at the Medicare book (it's the size of an old phone book) but it is hard for even me to understand, seniors doing it alone, I can't even imagine. Then you put in insurance agents who get commission from selling these plans convincing them they're the bomb, and you end up with desperate, angry people like that man.


It is HARD to get old in this country, and if you have to navigate it by yourself, I can see how easy it could be to reach a breaking point. That man was probably promised the world by an insurer or some phone operator, and now finds no on takes his plan and it doesn't pay as much, and he can no longer choose his doctors...and he is stuck with it until open enrollment next year.

I hope more people will come to understand just how good traditonal Medicare is. If they end up privatizing it all like many want, many seniors are going to end up going without medical care due to the high costs they will face.
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Old 01-22-2017, 10:57 AM
 
Location: Phoenix, AZ > Raleigh, NC
15,079 posts, read 19,024,811 times
Reputation: 24192
Quote:
Originally Posted by LoriNJ View Post
Yes, it is most likely that he had switched to a Medicare Advantage plan; United Healthcare has a number of them. What many people don't realize when they switch to those cheaper plans is that although it is Medicare, you are in an HMO that has a network. You have to see those network doctors or else you will pay out of your pocket. There are some non-HMO Medicare Advantage plans, but they are more expensive and less common.

Even though the guy was belligerent, I do feel a teensy bit sorry for him. The Medicare Advantage plans are aggressively marketed as a cheaper alternative to "Original Medicare" (+ a Supplemental/MediGap plan). People happily sign up for the cheaper alternative and only when they try to see a doc who isn't in that insurance company's HMO network does it sink in that the cheaper "Advantage" translates into "less doctors to choose from". Fortunately, people can switch back to Original Medicare during the next open enrollment period that runs from mid-October through early December.
THIS!
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Old 01-22-2017, 11:12 AM
 
2,952 posts, read 1,640,257 times
Reputation: 5292
Quote:
Originally Posted by LoriNJ View Post
Yes, it is most likely that he had switched to a Medicare Advantage plan; United Healthcare has a number of them. What many people don't realize when they switch to those cheaper plans is that although it is Medicare, you are in an HMO that has a network. You have to see those network doctors or else you will pay out of your pocket. There are some non-HMO Medicare Advantage plans, but they are more expensive and less common.

Even though the guy was belligerent, I do feel a teensy bit sorry for him. The Medicare Advantage plans are aggressively marketed as a cheaper alternative to "Original Medicare" (+ a Supplemental/MediGap plan). People happily sign up for the cheaper alternative and only when they try to see a doc who isn't in that insurance company's HMO network does it sink in that the cheaper "Advantage" translates into "less doctors to choose from". Fortunately, people can switch back to Original Medicare during the next open enrollment period that runs from mid-October through early December.
RIGHT HERE^^^

United Heath care has the worst medicare coverage plan. He fell for the marketing ploy.

He might of been suffering from some brain issues too. Who knows
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Old 01-22-2017, 11:27 AM
 
997 posts, read 579,544 times
Reputation: 2290
I bet he was mislead. He had a reason to be upset. He also had a reason to request his medical records from a place who refused to treat him. He also had an appointment at a specific time. The expectation that an appointment really means 20 minutes in the waiting room is common, yet very wrong. An appointment is an appointment and there is a time set for that appointment. Why is the appointment time 9am when they really mean 9:20?

When he made the appointment shouldn't the insurance have been discussed at that time? I am sure this problem has come up in the past.

I am not saying that the man was not being a jerk, but he had some valid points. He shouldn't beat up the receptionist but she wanted him to go away quietly. This is true. She wanted to say that he had to leave and find another doctor on his own without help. His 'fit' at least got him an appointment with someone who could treat him. He still threw a fit hoping to get what he thought he was entitled to. His fit only got him what he was entitled to, which was more then he would have gotten if he politely waited for 20 minutes to be excused.

I used to work in customer service and I was supposed to be polite. Another person who is not employed could say something to the problem person. When I encounter that as a bystander, then I will say something to the rude person because I can be direct and stick up for the employee who's hands are tied. I know they can't say what they want, but I can speak my mind.
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