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PostPosted: Sat Jun 11, 2011 4:25 pm 
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I'm going to try to make this short b/c it's a long story.

Ive been on Suboxone for about 2 1/2 months. My first Dr. I had many problems. He took my Ins. so I was trying to hang in there. Then I get a call that all his pts. appt. would be pushed back a week b/c he had to leave town. I was told to do my best to make my meds stretch....RU Kidding me? This was after MANY problems with his office.

I go to another Dr. of which I had to pay. After I get there he tells me I have to come back every week at 200.00 a pop for 6 weeks.

I called and got another appt. for this Tues. with a Dr. that actually called me back and spoke to me. I have to pay cash. Then she tells me that she does not have a Medicare number. I have Humana/Medicare. She said she was not sure if my Ins. would pay for the script since she does not have a Medicare number.

I've been approved for my Suboxone after I went thru a Appeal.

So,my question is...Does anyone have any idea if this will have any effect on my meds being paid for? I'm sure this means I will not be able to put a claim in for me to receive the money back from the office visit. But,there is no way I can pay for both.

I got to thinking,that if I had say,Eatna Ins. and the Dr. didn't have a number for that Ins. then surely that wouldn't make a difference. However,when it comes to Humana and this whole ordeal with Suboxone there seems to always be problem that continues to pop up.

I do not want to have to keep changing Dr.'s. This is very stressful. I feel like I'm Dr. Shopping and that's just I want to be free of. It's terribly difficult to move forward in my recovery when I keep running up against one problem after the next.

Also,I called my Ins. Co. and they said they didn't know what I was talking about and didn't know anything about it. That gives me no comfort b/c that could mean "she" didn't know anything about it.

If anyone has any advice or suggestions PLEASE share them with me.

Thank you.
Marie


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PostPosted: Sat Jun 11, 2011 7:15 pm 
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Are you saying that this new doctor isn't a participating doctor in like an HMO or PPO-type plan and you're worried that the insurance company then won't pay for the meds because of that? If that's indeed your situation and question, I can give you my opinion. I highly doubt that it would make a difference at all in them continuing to pay for your suboxone. They are covering the medication, not the office visit. I don't see how it would be a problem. That's only how I see it though and I have nothing concrete to back up my opinion. It just seems logical to me - she's the non-participating provider while the medication is a covered item/product, often falling under a separate rider attached to your medical insurance. I see them as totally different things. If it were me I wouldn't let it stop me from seeing her. Good luck! :)

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PostPosted: Sat Jun 11, 2011 7:36 pm 
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I ran up against the same story with Blue Cross/Blue Shield doctors. First I made a list of all the doctors who are in the Suboxone program, then I crossed referenced them with the PPO list of BC/BS doctors.

Then I started the phone calls to see who would take my insurance. Most said "cash only". I called my insurer and they said that Sub is covered but needs prior approval. They even called one of the doctors for me who refused to take my insurance and he agreed to take me. I won't go to him of course.

My current doctor explained that the program costs way more than insurance will pay and I signed a waiver stating I'd pay the difference.

I think you need to talk to someone else at your insurance company who will go to bat for you. Mine did. Most doctors are charging cash now and could care less if we can afford it or not.

This sh** pisses me off to no end. They first get me hooked on the pain pills, then when I need help getting off them with an approved drug treatment method, they tell me to pay cash or get lost. I went to war instead. Now I have several that will take my insurance, but it took a lot of phone calls.

PM me if you want to get more into this.

Tom


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PostPosted: Sat Jun 11, 2011 8:42 pm 
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Thanks Tom and Hatmaker,

I have spent most of the last week on the phone trying to get someone that sounds half way competent that will take my Ins. Like I said earlier the one that did is a quack. I could forsee him being on the news anyday for all the illegal activity that goes there. He starts his appts. at 5:30am. He or his staff would do nothing to help me with the Ins. Told me I'd have to find a way to pay for my meds. Luckily,I fought and I do mean fought for them to approve it.
The final straw was when they pushed ALL the pts. back a week and left without meds. Yea,he really cares...

I'm just praying and STRESSING over this 3rd. Dr. I see Tues. I'm hoping there will be no problem with the meds like Hatmaker said,hopefully that will not interere with it. It just concerned me b/c the Dr. told me I might have a problem with it. She said I'd know when I went to fill it......Great.

Tom,I'm so ready to do something,anything with this crap with these Dr.'s. It's not in my nature to just accept that this is the way it is BS.
However,at this moment and time I'm stuck to have to play there game....For a short time. First I need to get stabulized. Ive been so stressed over this that it's been days since I've eaten a real meal.

I'm just totally unable to understand how the same office of many of these Dr.'s will hand out pain pills and take the Ins. but to get of the pain pills they want cash. If only someone could make me understand this other than greed.

I appreciate the help.

Marie


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PostPosted: Mon Jun 13, 2011 10:44 am 
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Hey Marie, I feel for you, and I can certainly understand why you are stressed. I went through something similar, though not as bad. My doctor is pretty sketchy, too. He has disappeared for weeks at a time, his office staff never lasts more than a couple of months, and he almost lost his liscence a while back. But, he does take my insurance. One time he left me high and dry, with no refill, and I made a firm decision to get a new doc. Like you, I scoured the lists made calls, and even went to another doctor. But in the end I couldn't find anyone who I found acceptable that would take my insurance. And I wasn't willing to expand my radius to doctors an hour away.

So, long story short, I'm back with my original doc, and I have mixed feelings about him. Unlike so many doctors I've read about here who are clueless, everything he has ever said about Sub has been spot on. Also, my insurance has been horrible about paying him, and yet he continues to see me (he's been a lot more reliable lately). But yet, I still fell that something is really wrong there. He told me he is starting group therapy because "the DEA is on my back", but every month it's next month.
I guess it all comes down to what you can live with. If the doc is unreliable about appointments, you might be able to ask for a higher dose and save up the extra. But if he's so bad he is about to be shut down, that's a different story.

It really burns me that there are these shady cash only Sub docs out there. Isn't there enough stigma about Sub without people having to go to places that are just like the pill mills that addicts go to? It's really sad. I hope you find a doc that will work for you. People who have insurance shouldn't have to pay cash (no one should, really).
Hope it works out,
Lilly


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PostPosted: Mon Jun 13, 2011 11:36 am 
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Lilly-I think the group therapy thing might be some new requirement for Sub doctors. I just saw my doctor las week and he mentioned that I (and all of his Sub pts) hafta attend a 1hr group therapy session at his office in the next month or so. He gave me the impression that this was not his idea, but rather something REQUIRED now. My doctor also makes statements frequently like......the DEA this and that. I've only had one UA in almost two yrs of seeing him, and this is the only time he's said anything about therapy......so, not too bad.

MeMe-Im sorry your still going through this crap. If you want, I can give you the name of my doctor (though Im planning on trying to find a new one soon). He's located in Slidell. You live in Slidell too right? Im not sure what his initial fee/monthly ofc fees are, as he's raised the prices a little since I began treatment. I just paid $400 for a three month visit. I think thats on the low end......i've read so many horror stories about docs charging OUTRAGIOUS prices! Good Luck.......pm me if you want that info, K?


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