How did you "get better"? - what 'route' worked for your thyroid treatment?

[LazyMoose]

As modern western medicine is slowly becoming corrupt by greed and control over actual health, I believe it is about to change, and I'm not talking about the US 'health overhaul" , (another joke!).

Most economical 'bubbles' eventually fail after their highest peak. Sometime failure is good, its a restart. Our heath system is failing. Its no longer affordable, inaccurate Dxing is the commonplace, greed has taken over. Even if a doctor has insight on what to do, what is covered by insurance, not by what works for you, and clinic time allowances is how your  treatment plan is decided.

So called 'good' insurance offered by large corporate employers this year now has high deductibles, $500 to $2500 is common. What does that mean? The 'smart consumers' will hopefully be more health informed (I must be dreaming right?), and shop for their services since its coming out of there pocket - like 'informed' self employed folks have already learned to do.

The monopolizing of health care hopefully will have less power once the people start to make their own decisions. Maybe new alternatives will open up.  Example: a few local pharmacies near me now have people that can draw blood for basic screening, one even does TSH for $19, but not the 'free T3 /4' Lack of overhead and red tape make this price possible, its lower than insurance co-pays.

Many people spend thousands on western medicine and don't get much better until they learn on their own from researching or go to a holistic type of doctor and pay a lot. Personally I dont like paying a lot for anything (who does). But if I must pay a lot, I want results - which standard medicine failed in my opinion to treat my Hashimoto correctly. Without researching and help from people on health boards, many including myself would still be sick from under-treatment of thyroid disease - because our over priced health care system failed us.

We are lucky that people with  "experienced thyroid wisdom" on health boards abroad continue to inform others on their thyroid health choices.

[LazyMoose]

Lets hear it from some of the readers that don't comment to often, or never do.......this poll is for you!

[goolarra]

The other code you're talking about is a "diagnosis code".  It's a bit of a misnomer.  In the case of thyroid labs, it would be the code for "hypothyroidism", for example.  However, it can also be something that they are TRYING to diagnose, e.g. "stomach pain".  It has a number, just like the procedure code.

The codes are universal.  They're like UPCs on goods you buy.  They're the same for every doctor, every lab, every provider, every insurance company.  I'm pretty sure you can get a list online, but it's better to get it from your provider since this is what they're reporting to our insurance company.

Your doctor's office shouldn't have to be too involved.  If you know what your doctor ordered for tests, you should be able to call the labs and get the codes from them.

Sorry, I can't provide you with a website...I've just figured this out on my own out of necessity.  I'm just not about to go in for a procedure without knowing ahead of time what it's costing me.  After doing this a few times and finding HOW different prices are, I have to demand answers.

[alfonsina]

Thanks for your input; you really know your stuff! :)

I know the code you are talking about and I think they also have a code, if I am not mistaken, for illnesses, I mean for the reason you are being tested.

Is there any other way to find out about the codes or it is something specific to each doctor's office?

People at my doctor's office are not really nice and I am not taking anything personal, I was told a lot of people have complained about those who work for him. They are not cooperative at all.

This deductible story is new to me. I had an insurance that I used for a good 5 year period which was perfect. I did not have a deductible, my copy per visit and specialist was $25 and ALL my tests were free, I mean covered by the insurance. The only but, was that it had a primary doctor and I had to see him before seeing a specialist, but I manage so well that I did not actually visit my primary as I should've, I got away with it I do not know even how.

Less than $80 was taken out of my paycheck every month and that was okay, because I went to the doctor a lot. With all my hypo symptoms I went to every specialist I could and never got well. Now I go only to one, because I know the majority of my problems are related to my thyroid. But it felt good to know you could go to any doctor and get tested without worrying about costs.

Anyway, as I was saying this deductible game is a total new story and I am paying the price of not going to one of the providers they already chose for me. I went to a hospital IN NETWORK for a bunch of tests and I owe my entire high deductible. Sad.

Any Website where I can do more research? Thanks!

[goolarra]

Your insurance company knows.  It's true that the provider can't tell you what your bottom line is going to be.  All they can tell you is their "unadjusted" charge for a procedure.  EACH insurance company negotiates with EACH provider as to what percentage of that unadjusted amount they will pay.  If your deductible is not satisfied, you pay out of pocket what your insurance company would reimburse the provider if your deductible had been met.

I find it really helpful to get the "procedure code" for what you are shopping.  Either the doctor who orders the tests or the lab can provide you with this.  If they say they can't, don't take that for an answer.  THEY need the procedure code in order to bill your insurance company (which they do whether or not your deductible has been met, so that it goes toward your deductible).  I find most doctor's offices keep a short list of their most frequently-ordered procedures very handy, and I'm sure labs do the same.  

With the procedure code in hand, you can call your insurance company and ask what procedure "999.9" costs at Provider A and Provider B.  They've always been able to tell me accurately within a few dollars (on an expensive procedure).  Once again, don't take "we don't know for an answer"...someone knows, otherwise they wouldn't know how to pay providers.

It used to be much more of an exercise in frustration.  However, with more and more people with higher deductibles, it seems to be getting easier.  Once doctors, providers and insurance companies hear that this will be coming out of your pocket, they seem to get more cooperative pretty quickly.  And they SHOULD.  Suddenly, you are once again the consumer.

If providers expect to get paid for their services, they'd better be able to provide you with cost ahead of time.  After all, you just might not be able to afford it...  

I think we are getting some transparency...it's still pretty opaque, but I do see things loosening up.  

If you have any specific points providers or your insurance have used to make it difficult or impossible to find out cost, I'd be happy to make suggestions on how to answer specific run-around tactics.  

One thing I've found very helpful is to state loud and clear that "I'm paying for this myself; I have a very high deductible, and I'm not even close to meeting it."

Best of luck, I hope you keep at it and get some answers.  If there's anything I can do to help, just ask...  I think this is where "health care reform" is really going to start.

[alfonsina]

I have had read some of the posts where you suggest to shop for better prices. I think you are totally right. My insurance is one of those with high deductible and probably has two labs where I can go and get a very good price for THS and frees per example. But they usually have "their" place if you know where I mean.

What I have encountered is that sometimes I do not get to know how much I will pay out of the pocket. Per example my doctor forgot to test my vitamin A and I’ll go for it only if I know I won't have to pay my entire deductible while trying.

But, the insurance does not know, the lab does not know when I call to inquiry, so who the heck knows?
If I knew how to shop around or how much exactly I am going to end up paying it would be a different story, but every time I receive the mail I wonder what's coming now. Not even my insurance website’s is helpful.

So how I am supposed to know if everybody says it depends on the type of insurance I have.

I went once to the hospital for labs I asked in advanced how much it would cost and guest what :they did not know and just refereed me to someone else who said I would know after they entered my tests in the system, which means I had to do the tests there.

Maybe I am not asking the right questions, I do not know, I wish the system was more transparent.

[goolarra]

I had a hypo dog, too!

My vet says, "Vets are doctors who know how to treat more than one species."  

[Barb135]

Deductible has nothing to do with labs in my case. The insurance company we have through my work, has only one lab chain "in network"; when we go to that lab chain, our blood work costs "us" nothing (except the cost of the insurance); if we don't go to that lab chain, our insurance doesn't cover the cost, so even if I found a less expensive lab, I'd not be able to use it..

[LazyMoose]

You mean if you have not met your deductible you still cannot choose even if several places are in network?

Health insurance guidelines and laws differ state to state.

The agent for my high deductable insurance encouraged us at our company to 'shop' pricing before our deductable was met. We have 'in network' options, but yes, online labs are not covered. (?#$!!*)

The $19 TSH at the pharmacy would be even cheaper once deductible was met.  

[Barb135]

I kept the circle orange........ I have a high deductible ($1500)

My pcp kept me ill; I "accidentally" got sent to an ENT, who ended up being my "best advocate" and sent me on from there....

I do agree that we need to search out the best options, but for some of us, with "company" provided insurance, our options are limited -. my insurance company tells me where I "have" to go for labs or they won't be covered - healthcheckusa does the same labs for a fraction of the cost, but isn't covered; why is this?  

I recently had CT scan (not for thyroid), but had only one place to go for it, in order for insurance to pay........ we all know what's going on here.

[goolarra]

Okay, I'm the one who turned that whole circle orange (for the moment anyway)!

I couldn't agree more.  Higher deductibles could be a blessing in disguise.

"The 'smart consumers' will hopefully be more health informed (I must be dreaming right?), and shop for their services since its coming out of there pocket - like 'informed' self employed folks have already learned to do."  

No, I don't think you're dreaming...hit people in their pocketbooks, and they get real smart and real informed real quick!  I'm in the investment advisory business, and I have to say that people would not put up with our handling their money like they put up with how the heath care industry handles their health.  

[LazyMoose]

{"We wouldnt put up with this from our car mechanic, why should we have to put up with it for something as important as our health?"}

- point well said. With other services, payment is 'results orientated', as we are the customer. Unfortunately Dxing people is a little more difficult than cars , but the troubleshooting skills are very similar.

A friend of mine is a veterinarian. He says: 'Since "Ed the Talking Horse" (60's TV) died years ago, veterinarians are presented with more difficult Dxing skills than common Medical Doctors.'  -but they do it, LOL

Funny, my dog (r.i.p.) was Dxed with hypothyroid before I was, while I had symptoms too. He got heavy, stared at walls, hair was dull and falling out, and looked sore when moving. I should have brought myself back into the vet back then.

[Deelited]

Hi & thanks for adding the poll research question, great idea. Unfortunately I am one of the many, many people desperately searching for answers so dont have anything to add to the poll. I just wanted to say I totally agree with you with regard to our health system, corrupted by greed! I also agree that bubbles burst after their peak and lets hope this is the case with this farce too, the finish line is always a great place to start again!

We pay these 'professionals' outrageous money for their 'services' so why cant we have an active say in our treatments. We wouldnt put up with this from our car mechanic, why should we have to put up with it for something as important as our health?

Thanks for the poll, I will be curious to see the outcome but I know the answer already too :)

[LazyMoose]

Opps!

Above the choices:

{ -Standard US insurance covered medical practice
-Holistic, naturo path type docs (not covered)
-You researched, and partially told docs what to do! }

I meant to ask just what route led to your proper thyroid treatment. Given the nature of this forum, I think the answers will be obvious. Consider this an 'official' research question.