Re: In Diabetes, Get Glucose Control 'Just Right'




"Ozgirl" <are_we_there_yet@xxxxxxxxxx> wrote in message
news:7srv52FbmdU1@xxxxxxxxxxxxxxxxxxxxx

"Peppermint Patootie" <Peppermint_Patootie@xxxxxxxxx> wrote in message
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In article <7srjduFg7pU1@xxxxxxxxxxxxxxxxxx>,
"Ozgirl" <are_we_there_yet@xxxxxxxxxx> wrote:

I have a pretty straight forward type of diabetes in my opinion but I
requested an endo referral from day one and got it.

Congratulations. You have options that not everyone has.


So, does that mean where you live (not necessarily the entire US) you have
no right to request a specialist referral (and get it) in the area of your
particular illness? (whether that be cardiac, neuro, endo etc?) No need to
congratulate me though. It makes it sound like I am being smug about the
fact I can get referrals by asking. Presumptuous perhaps because I truly
believed that in this day and age everyone in modern countries had the
right to do so. This is totally aside to whether one can afford or not
afford a specialist etc.

I think the term "referral" can mean a couple of different things. In terms
of insurance, it means you either have to have one or not. I chose a plan
where for most things I don't need one. Mental health is different. If I
want my insurance to pay for that, then I *do* need a Dr. to write a
referral and it has to be approved. There is more to the mental health
thing and I really don't know the particulars on that.

But if I want to see an Endo. or an ENT, I just call around to find one that
takes my insurance. I did call a kidney specialist but that Dr. himself
would not see a patient who called. I was told there, you *did* need to be
referred by a Dr.

However, there is another plan called an HMO. If you have that type of
plan, you are assigned or in some cases, pick a Dr. who basically manages
your care. If that Dr. doesn't want you to see a specialist, you either
don't go, or if you can, you go elsewhere and pay out of pocket. With this
plan you often have to go to only certain hospitals as well and can't go in
unless referred.

I used to work with a guy who chose such a plan. He had symptoms of kidney
stones. He had them before. His Dr. kept saying he was fine. Nothing
wrong with him. Would not allow him to see a specialist. He wound up in
the ER (not approved) where it was found he did have stones and they were
removed. That was something like 20 years ago and he is probably still
paying that bill.

No way could you get me to take such an insurance plan unless it was the
last available option. My in-laws had/have such a plan. My FIL went
repeatedly to the Dr. and was told nothing was wrong with him. My SIL who
is a nurse is the one who forced the Dr. to test him for thyroid. It was
low. Sadly, they never caught his cancer until it killed him. Sent him to
a chiropractor instead. MIL might not be as bad off as she is today had her
cancer (and some other things) been diagnosed and treated early on. That
plan just prefers to take your money and tell you that you are fine. Then
when something does go wrong, they pay you off. In my MIL's case, they gave
her a wheelchair.


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