RVers and prescription refills

[Vladimir]

On 7/24/2019 at 12:23 PM, chirakawa said:

I think we can all agree and have experienced what you've written.  However, Vladimir says that his doctor told him " she was required by the government to ask the question" about guns in the house.  I don't believe that's true, but I'll gladly concede if you can show me otherwise.

She did say that. And the question was also asked when my wife had her physical. My wife, was more upset about it than I was. This was about six or seven years ago.

I did a search on doctors asking gun questions and couldn’t find any such requirement. However, when you do the search there is lots of discussion in the medical community about asking the question with support for asking the question.  Doing a internet search brings up lots of interesting discussion on the subject within the medical community.

I am more concerned about the medical data basis. I have TWO comments that I have been trying to purge from my medical record.  

The question was asked of me “do you smoke?”. My answer was “only a cigar, when I fly fish”.  That usually amounts to somewhere between zero and 10 cigars a year. This year.....THREE so far. That got the notation that I was a smoker on my medical history!!!  After almost a decade of asking to get it changed....it still sits there.

Then just today I get a letter in the mail from a government contractor that my local clinic is going to be sharing my clinic medical records with Medicare.  That I should call the government contractor to op out if so desired. That was an adventure....still on-going.

Did anybody else get the mailing??

Having looked closely at my medical records I am rapidly heading to taking the 5th when talking to a doctor or nurse!!!   Particularly any open ended questions that are easily subject to mis-interpretation in the future.

 

 

Edited July 26, 2019 by Vladimir

[Kirk W]

7 hours ago, Vladimir said:

The question was asked of me “do you smoke?”

Do you still have the same doctor? Prior to be begining of electronic medical record standardization, which began during the second Bush administration, there was almost no sharing of medical records between medical practices and services. When we went on the road in 2000 we carried a complete copy of our medical records with us and updated it each year when passing through to see our doctor. We also got a paper copy of the report from any doctors that we saw while traveling and yet not one time did any office show the lest interest in seeing those records so we eventually stopped offering them. The fact that we both smoked up until 1987, was never known by a doctor from our past histories. We changed doctors in 2005 and again in 2011 when returning to part time and each time we had to give a complete new medical history. 

7 hours ago, Vladimir said:

Then just today I get a letter in the mail from a government contractor that my local clinic is going to be sharing my clinic medical records with Medicare.

If you are to get Medicare to pay for your medical care they must have access to your records or they will not pay. Most doctor's offices have a stack of forms that patients must fill out and sign each year and while much of it is from HIPAA and some from Medicare and insurance benefits authorization. As for the letter, it is most likely from  Medicare & Medicaid Services(CMS) and that is the processing center for both Medicare and Medicade. 

 

[chirakawa]

Yeah, I hate those questionnaires.  Have you ever ???????  Of course, I've ever.  I'm 70 years old.  I've done most everything plus a few more.  But, I haven't in over 50 years.

The latest one to baffle me was when I went to the Dermatologist.  One of the questions on the form was "Are you sexually active?".  Now, I can see that being pertinent to my Urologist or my Primary Care, but not a skin doctor.  So, I asked him what was up with such a question.  He gave the typical answer, it's required.  BS

[chirakawa]

8 hours ago, Vladimir said:

She did say that. And the question was also asked when my wife had her physical. My wife, was more upset about it than I was. This was about six or seven years ago.

 

 

 

Oh, I believe you Vladimir, didn't mean to imply that I didn't.  I just don't believe the doctor was required to ask that question, in spite of Barb's attempt to justify it.  I would have responded to such a question with "nunya".

[justRich]

Hope it's not too off topic, but. . .

I checked with a pharmacist at CVS Target yesterday.  She will fill my prescription for 90 days (as it is prescribed) if I pay cash - no insurance.  
While at the Costco pharmacy, they will only fill for 30 days as prescribed by the insurance company. (Triple the billing and handling costs but I can get the drug cheaper).

Funny thing was, when the CVS pharmacist entered my information into her computer, the insurance popped up as the "payer".  The "payer" can be over-ridden so that billing is cash (and cost to me is much more).

How much more?  The pharmacist said she can apply any number of "coupons" via her computer so that I get the discount.  I'll go back today to pay for it - and see how much "coupon" discount I can get.

Why?  Cause' I want a 90 day prescription on upcoming international trips.

 

[Barbaraok]

1 hour ago, chirakawa said:

Yeah, I hate those questionnaires.  Have you ever ???????  Of course, I've ever.  I'm 70 years old.  I've done most everything plus a few more.  But, I haven't in over 50 years.

The latest one to baffle me was when I went to the Dermatologist.  One of the questions on the form was "Are you sexually active?".  Now, I can see that being pertinent to my Urologist or my Primary Care, but not a skin doctor.  So, I asked him what was up with such a question.  He gave the typical answer, it's required.  BS

STDs are on the rise among seniors.  

[chirakawa]

6 hours ago, Barbaraok said:

STDs are on the rise among seniors.  

What's your point?

[Barbaraok]

That’s why more physicians are asking about it.

[Vladimir]

10 hours ago, Kirk W said:

 

If you are to get Medicare to pay for your medical care they must have access to your records or they will not pay. Most doctor's offices have a stack of forms that patients must fill out and sign each year and while much of it is from HIPAA and some from Medicare and insurance benefits authorization. As for the letter, it is most likely from  Medicare & Medicaid Services(CMS) and that is the processing center for both Medicare and Medicade. 

 

The letter is from a government contractor with Medicare. I asked.

It is "Medicare Shared Savings Program Accountable Care Organizations (ACO)".

"Medicare evaluates how well each ACO meets these goals every year. Those ACOs that do a good job can earn a financial bonues. ACOs that earn a bonus a may use the payment to invest more in your care or share a portion directly with your providers. ACOs may owe a penalty if their care increases costs"

They are assuming that you want to share ALL your medical records with Medicare.  I believe, Medicare has access to my "treatments" for which they decide if they are going to pay....they don't have access to my medical records.

My problem is I have to OPT OUT.  I called to OPT OUT. "Oh we have no record of your medical provider, call back in a week". This after spending an hour on the phone with them.

I want to know more about the program before I authorize Medicare to have access to my medical records.

 

 

[Vladimir]

9 hours ago, chirakawa said:

Oh, I believe you Vladimir, didn't mean to imply that I didn't.  I just don't believe the doctor was required to ask that question, in spite of Barb's attempt to justify it.  I would have responded to such a question with "nunya".

Your's was a fair question. No offense taken.

Everybody makes mistakes, and after searching on the internet I believe she confused "medical advice, within the medical community" with a government mandate. Which is my comment later on down.

To Kirk, she was BY FAR the best GP Doctor is ever had.  On some of her analysis, I said...."yeah, right".  She was right!! And they were really difficult areas to come up with a answer. She decided to move onto a speciality and had to drop all her clients.

To Chirakwawa...I did respond that I was still looking for a lightweight 12 gauge shotgun. I did know her father-in-law, I suspect my views and hers did not match on LOTS of matters.

But she was/is an excellent doctor, AND I hope I never see her again since she is now in Pallative Care.

 

[sandsys]

1 hour ago, Vladimir said:

But she was/is an excellent doctor, AND I hope I never see her again since she is now in Pallative Care.

I would hope TO see her again if I was ever in need of her new specialty. Like one friend of mine says, "If I ever get to that point, drug me and unplug me." Although if they follow my healthcare directive, I would never be plugged in in the first place.

Linda

I decided to not be plugged in after a friend of mine committed suicide but was "rescued" before the drugs had taken full effect. He was plugged in for three days before he finally died. His family had huge medical bills as a result. I prefer not to go there.

Edited July 26, 2019 by sandsys

[chirakawa]

2 hours ago, Barbaraok said:

That’s why more physicians are asking about it.

The forms I filled out were the same given to every patient, young and old.  There was a stack of clipboards which they handed out as patients came in.  I even heard a young guy comment on the question to his wife.

I certainly understand why a doctor might ask about it, although my other half a dozen doctors don't see fit to ask it.  But it's a stupid question to put on a questionnaire.  So, if I go in to see the doctor with a rash, and he thinks it may be caused by an STD, he's not going to say "oh wait, while I go read through five pages of questionnaire".  He simply might ask "are you sexually active?".  That's common sense. 

On the other hand, there is absolutely no point to asking someone if they have a gun in the house.  If they answer "yes", is the doctor going to confiscate it?  If the answer is "no", is the doctor going to buy them one?  I still say, there is no way that doctor was telling the truth.  It is not a requirement of government to ask if I have a gun in the house.

[Kirk W]

2 hours ago, Vladimir said:

I want to know more about the program before I authorize Medicare to have access to my medical records.

About the Program

[Velos]

This discussion has branched out from my original post "RV'ers and Prescription Refills? and provided much food for thought.  Thank you.

I found this article that may answer some questions about seniors health  "Patients over 60? Screen for STIs"  (Disease and Infections are used interchangeably)

With the increased availability and use of the internet combined with the casualizing of social norms over the last century,  information now travels at the speed of light and some topics never dreamed of being discussed in a Dr's office let alone in public are now daily headlines.  A few years ago while taking mom to her dr in Florida he made the comment that he has a high volume of patients (retirees from all over the US)  that were products of the 60's having smoked pot and experimented with recreational drugs. 

[richfaa]

We have not had any problem with any of this. I have not smoked since 1980 but have done most everything else.Both medicare  and   our supplement  have paid every  bill submitted to them. We have our prescriptions filled at WAlmart both at home and on the road without a single problem

[justRich]

Okay. . .I got the 90-day script refill without insurance for $6.00
The 30-day script cost 75-cents going through insurance.

 

[Barbaraok]

1 hour ago, Rich&Sylvia said:

Okay. . .I got the 90-day script refill without insurance for $6.00
The 30-day script cost 75-cents going through insurance.

 

So is it worth the cost difference not to go in every 30 days?

[justRich]

No.  Not logically, mathematically or philosophically. . .it's not worth it.

But the moral satisfaction that I'm not letting the insurance company do a rip-off by triple billing is priceless.

Additionally, the insurance company now does not know what drugs I'm taking.  😊

 

 

[sandsys]

13 hours ago, Rich&Sylvia said:

Okay. . .I got the 90-day script refill without insurance for $6.00
The 30-day script cost 75-cents going through insurance.

Excelllent! Now you can travel internationally without worrying about running out of meds. 

Linda

[rnsmth]

I live in Mexico.  I just go to the pharmacy and buy my maintenance meds.

Opiods are difficult, sudafed is illegal, antibiotics and injectables require a prescription, as do other strong pain meds.

So, if you are camped near Mexico, it could be an option for some medications

Edited September 15, 2019 by rnsmth

[dirtyboots]

Question of gun ownership - just wanted to comment here.  About 6-7 years ago when I took my Mom to her Dr. appt (she was close to 90 and on blood thinner, so had to go quite often) the drill was to go into the lab first for blood, then wait to be called for Dr.  Got to know the lab gal and would visit....one day she asked in conversation if Mom had any guns.  Mom said, sure, my shotgun is always within reach.  The gal then wrote down on her form something, so I asked if that was about the weapon.  She said yes, that it was a required question for all patients.  

After that we were still friendly but did not offer up any personal information.  

[agesilaus]

One visit for a physical for me. I use mail order (Walmart) for almost everything and in theory I could have the order shipped anywhere in the country. I'd have to know I'm going to be in fixed location long enough to get it tho. They have express delivery for a fee but I haven't used it yet. The problem with that stuff is that some needs to be refrigerated.

I also have an old workman comp injury and take a minimal dose restricted medication at night. In my case that requires a office visit every 90 days the doc somehow got the 30 day limit waived. I haven't had to deal with that yet since we haven't been away quite that long but next year that would be possible. That insurance company can be a PITA sometimes. I'm going to talk to the doc about non medicine solutions, maybe electro stim.

[Sehc]

My part D has never refused 90 day refill on my maintenance drugs. After having problems last year i had many visits and procedures at a university hospital. The bills were long, many lines of code for each visit. I noticed that Medicare did not cover some items as "it was considered part of another procedure on the same day".

[Barbaraok]

10 hours ago, Sehc said:

My part D has never refused 90 day refill on my maintenance drugs. After having problems last year i had many visits and procedures at a university hospital. The bills were long, many lines of code for each visit. I noticed that Medicare did not cover some items as "it was considered part of another procedure on the same day".

And you noticed that you weren't asked to pay for it, because Medicare does a pretty good job of auditing and every hospital knows what will and won't be accepted, but they try on the off chance that it will get through!  

[Sehc]

Well, I wasn't trying to disparage medicare or accuse the hospital of over charging. . In fact the charge that caught my eye was due to the hospital billing department listing my Surgeon visit on the wrong date. Resulting in the refusal of payment. And yes. Medicare has been good to me along with the private insurance that covers plan F.    But.  Part D is a different argument as how good or bad it is.