My medication was changed to generic. It doesn’t seem to work as well What should I do?

Posted March 6th, 2010 by
Categories: Questions

Generics are supposed to be the same formulation as the brand name.  Sometimes  different filler(chemicals for binding the drug,color) may be used.  This may cause you to feel the medication is not working as well.  There are several options.  You can ask to get the brand name. Your doctor will have to write on the prescription “No substitution” The insurance will probably label it a third tier drug which means , you will have pay most of the cost.  You can ask the pharmacist if there is the same generic medication manufactured from a different company.

I have asthma and can’t seem to get it controlled. Who should I see?

Posted March 4th, 2010 by
Categories: Uncategorized

I would recommend you ask your primary care doctor to see a pulmonologist.

These doctors specialize in the lungs and respiratory system.  They will be able to help with your asthma.

Will my insurance pay for plastic surgery?

Posted March 3rd, 2010 by
Categories: Questions

Generally, no.  The exceptions are for some reconstructive surgeries. For instance, breast reconstruction from a mastectomy. Burns or animal bites will fall in this category Most plastic surgeries are considered elective and not medically necessary. Surgeries for cosmetic reasons are not reimbursed.  Check with your insurance company before proceeding.

I just got dropped from my insurance, what can I do?

Posted March 2nd, 2010 by
Categories: Questions

First, I am sorry  to hear this has happened to you.

I would start by calling your state department of insurance.  I would file a complaint.

Next, I would ask if your state has a high risk insurance pool.  This pool, although it maybe higher premiums, will cover you with any pre existing conditions.  There may be other state insurance plans that are not Medicaid.

Write your senator and congress people to get a healthcare law that eliminates pre existing conditions and dropping people from insurance plans.

My Sister has been diagnosed with gestational diabetes, and has been told that she may not attempt a vaginal birth or have a midwife and must schedule a C -section now , even though she is months away from birth and the complications that would require a c-section ( i. e. huge baby )have not yet appeared. Is there a legal requirement for hospitals to schedule a C- section from day one? Is there a patients’ rights component to this question?

Posted March 1st, 2010 by
Categories: Questions
I would start by advising a second opinion or even a third opinion outside the existing medical system she is in.  This may be a conservative approach of the OB/GYN she is seeing.  I would also suggest she request from the doctor a copy of the standard of care for this issue and exact medical reasons as to why it is necessary to have a date set so far in advance.   It is my understanding that a cesarean is a possibility given the risks of gestational diabetes to the baby.  It is not a given.   In fact,here are some web sites that speak to these issues.
http://www.diabeticmommy.com/index.html
http://diabetes.niddk.nih.gov/dm/pubs/gestational/
www.patientslikeme.com
A good resource may be the American Diabetes Association.
You are correct that there are patient’s rights involved.  Your sister does have every right to have more information  to make an informed decision.  I encourage her and the family to get all information.  I have not heard of hospitals demanding C-sections be scheduled immediately for gestational Diabetes.  I don’t believe this is a legal issue.

How do I locate a doctor for a second opinion?

Posted February 24th, 2010 by Hari Khalsa
Categories: Uncategorized

First, always look for a doctor outside the practice or hospital clinic system which you are currently using.. Ask colleagues, family and friends if they have they can recommend someone. If you are internet savvy or have a friend who can help, do a search. You can search by the medical specialty in your area, or disease and treatment. You should be able to view credentials and any publications or research papers. I sometimes will call to get a feel of the office and possible treatment.

Do I have a coinsurance? Please Leave a Comment Below

Posted February 24th, 2010 by Hari Khalsa
Categories: Questions

Check your insurance policy. Some policies have a coinsurance anywhere from 10-30% with out of network from 40-60%. It means you will owe the percentage amount of the bill until the out of pocket limit is met. If your insurance is through a business, contact either the HR Department or the designated person.

Should I take someone with me to my visit? Please Read Below and Leave Comment

Posted February 22nd, 2010 by Hari Khalsa
Categories: Questions

Yes! I always advise taking someone with you to take notes and be another set of ears. It is easy to forget what your doctor told you. I highly recommend a person with you, if you are going to receive tests results or are planning a surgery. Having support is important if you receive a new diagnosis or need to plan a surgery.

A specialist gave me a new medication. Will it cause any problems with my other medications?

Posted February 12th, 2010 by
Categories: Questions

If you have concerns about a new medication, here are some things you can do to get answers.  Call the doctor’s office who prescribed the medication and ask for clarification.  You can ask to speak with a nurse.  You can call your primary care office and ask the doctor or nurse to clarify.  You can ask your pharmacist to do a review of your medications and if there are any interactions.  You can go on line to sites like

http://www.drugs.com/drug_interactions.php

www.drugstore.com

http://www.healthline.com/druginteractions

What is insurance out of pocket limit mean?

Posted February 11th, 2010 by
Categories: Questions

Out of pocket limit is the top amount you pay from your pocket per year.  Insurance policies designate the top limit. The insurance company decides what is included in the out of pocket limit.  It may include deductible and coinsurance  or it may designate the coinsurance only and the deductible separate.  Copays are not included in the out of pocket limit.  It is important when deciding on an insurance policy to know what the out of pocket limit is.