Has anyone noticed that your appointments for medical procedures have been months away. I went to my regular doctor in

[debm55]

July, and complained about numbness in my spine and left leg. He sends me for a test Electo procedure--two months away. I get the results back. The tests showed the results as being abnormal. My Doctor says I need to see a neurologist. I saw a NP and not a doctor. I was told that I have to have scans done on my spine and pelvic nerves---in January. Mean while , I am falling, and find it difficult to walk. I asked the woman if I could get it done sooner, She told me that it was BCBS and Medicare that are delaying the tests. Does anyone know if this is true? Is anyone experiencing a delay in medical procedures? Thanks, Debbie.

[elleng]

1. Not mine, Deb. Sorry yours are.

(Eye doc next week, Dentist 11/22)

[debm55]

4. Thanks elleng. Yes, dentist is pretty good. Eye doctor, I see every 6 months,

[Polly Hennessey]

23. Same as Elleng. Saw dentist yesterday and

see eye doc tomorrow. Any procedures I need done have so far been in a timely manner. No hold up because of Medicare or other insurers.

[leftstreet]

2. It's for-profit healthcare

Meeting the hallowed shareholder expectations means things like cutting staff and delaying/denying procedures

[EllieBC]

24. We have plenty of wait times here and it's not for profit.

Wait times for surgeries, MRIs, CTs, ultrasound.

Wait times aren’t just in the for profit system. I’m fairly certain you haven’t had to wait 24 months for an autism evaluation for a kid there.

[former9thward]

67. The OP said it was Medicare.

[leftstreet]

68. No, BCBS and Medicare

You realize Medicare is actively cutting costs just like BCBS.

The profit generating healthcare industry is infecting everything

[Elessar Zappa]

69. Not just for profit.

Britain is experiencing the same (actually much worse) problems and they have the NHS.

[leftstreet]

71. Right

Because they keep under/unfunding it. All social programs are the chopping blocks, in many countries.

Then people will point and say "look the system doesn't work!"

So rather than properly fund and administrate programs for the public good...

[CrispyQ]

3. A procedure I need is scheduling in February!!

This is the "greatest health care system in the world." : eyes:

[debm55]

6. Wow, that;s shitty. I pay extra for the BCBS, and have Medicare.

[elleng]

27. I too have BC/BS and Medicare, Deb,

and feel vey fortunate. (Did wait for neurology procedure.)

[vapor2]

9. HA!

Plz let me respond........got a one page letter from my husband's retirement benefits and they have given us less than 2 months notice in ending our supplemental health care costs PLUS an end to our dental. REASON: increasing health care costs. Will do more research and find out how much the CEO makes annually. We are in our 70's so not working to absorb these additional costs.

[cilla4progress]

37. How can they do this??

Is this your gap policy?

[Delmette2.0]

5. Not at all.

Medicare and BCBS have never in my experience required preapproval or delayed medical services.
It sounds like they are short on doctors and they are all booked well in advance.

[debm55]

11. I have Federal Employes BCBS. My husband picked up the muscle relaxers they gave me---11 refills of 30 pills each. They

scheduled for a spinal tap. When I got there, they said they had the wrong patient.

[woodsprite]

52. Since our BCBS Highmark partnered with

Evicore for third party reviews, I have had procedures denied even with specialist’s justification. Before Evicore, that hadn’t been the case.

I have insurance through a state employee group. They had planned to move everybody to a Medicare advantage plan on retirement, but the Governor got push back on that, so they’re “reevaluating” the recommendation.

[Basic LA]

7. So sorry to hear this

Medicare only pays after the fact. It can't delay anything as far as I know. I'm covered by the VA, where all things are months away, but that shouldn't happen to you.

[debm55]

12. Medicare is our primary and BCBS is the secondary. Do you have another insurance in addition to the VA ?

[Basic LA]

15. I do, yes

I have Medicare.

[cachukis]

8. We are spending billions on health care, a profit center.

We are also a large group of old people.
Think about it, the corporations have always chased our dollars.

What do you fight back with when you are slow?

Relentlessness.

Insurance companies need to make money or they go out of business.

If you cannot advocate, find one.

[debm55]

13. But my husband worked for the Federal Government for 46 years.The BCBS is for retired Federal Employees and it's shit.

[cachukis]

20. My sister is in that system. She pays for Medicare.

It is underfunded. They are all underfunded.
We are the only advanced nation that cannot simplify health care.
Our age group is putting a lot of stress on the system. Nurses are done.
I have to search for cancellations or wait.
We are becoming an emergency nation. I taught students who lived in emergency. I know that world and we are letting it happen.
We live in the world we accept.

[TwilightZone]

10. I doubt it's really insurance that's causing the delays.

I've had a zillion medical appointments and tests in the past few years and the vast majority of delays have been staffing and availability-related. I've also had a lot of stuff that required pre-authorization and that's rarely added more than a few days to the process.

You could try calling BCBS directly and see if they're really delaying the process and, if so, why. They might be able to shed some light on it.

[debm55]

17. My husband made an appointment in July for a colonoscopy, He has polyps. His appointment is in January. Mine( I also

polyps was for March. However, I got a letter stating it was cancelled as the doctor will be out of town.

[TwilightZone]

31. I ran into that a lot - I often had to switch doctors or hospitals just to get seen.

I had to see a series of specialists for a serious medical condition. I'd be told that one specialist or another wasn't available for several months, but other locations or hospitals in the same network were able to get me in sooner.

That only worked because our health provider system is huge. It sometimes meant I had to drive 80 miles round-trip for an appointment, and it often meant I couldn't see my preferred specialist or one I'd seen before, but the size of the organization meant that I could at least see *someone*.

I usually called scheduling for the department and asked them to check availability for other doctors at that or related locations. They don't always have access to scheduling for the other locations, but they can provide contact info and you can contact them yourself. We did that a lot. You may not have the same kind of options, of course, but probably worth checking into.

Bring on universal healthcare, eh?

[debm55]

36. I will look into that, TY

[TwilightZone]

39. Best of luck.

Scheduling important follow-ups months out has never made any sense to me, but it seems to happen all too frequently. I hope that you're able to find alternatives.

[multigraincracker]

14. I'm real happy with my GP, Urologist, Dermatologist and

Orthopedics. All female DOs.
Best thing is they all do what I need without sending me to other doctors. They all listen to me and are knowledgeable.

[woodsprite]

54. My regular gyn retired, and I currently have a gyn onco now

For the next 3 years due to a cancer diagnosis and follow-up protocol. I made an appt with the gyn who took over my regular guy’s practice. She asked why I even scheduled an appt with her since I’m seeing a gyn/onco. I told her if I needed to see her for something outside of my cancer diagnosis, I needed to establish myself as a patient now or I may have a difficult time getting in when I need her. She looked at me like I had horns on my head.

[GP6971]

16. I think it's hit and miss.

My wife's clinic closed in June. In late August she requested a first available appt for her yearly checkup at the next closest clinic...earliest was March. She decided to change providers and got an appointment for early October. So it wasn't too bad of a wait.

[Silent Type]

18. Called ophthalmologist's office today for annual eye exam, not available until May.

So took the first available appointment with another doc in group, early January. Didn’t really like the first doc, anyway.

There are docs in most specialties available, but it’s tough finding them. I’m fine with Physician Assistants and Nurse Practitioners. They communicate better.

[brooklynite]

19. No. I just booked a dermatologist visit for next week.

Pretty much the same for my last annual physical.

One things about posts like this is a lack of geographic context. If you're in a rural area, there may be fewer resources available.

[debm55]

21. I live in Pittsburgh, UPMC is here, I am not allowed to use them as I have BCBS which UPMC will not accept. At one time

they did. But BCBS has it's own hospitals.--Allegheny General Hospital.

[debm55]

25. UPMC is one of the best hospitals in the country. We have a lot of hospitals around here but UPMC ate them up. It used

be you could use any of them. No more.

[Staph]

22. I despise Blue Cross. (Beware - TMI!)

Back in 2017, when I had BCBS insurance through my work, I became anemic, with signs pointing to bleeding somewhere in the gastro-intestinal tract. I had both a colonoscopy and endoscopy, but nothing was found. The assumption was that the problem was somewhere that couldn't be reached from either end, somewhere in the middle. The doctor wanted to use a camera pill, swallow it and it takes pictures all the way down. BCBS refused to pay. Because of the foolish money-saving decision, they ended paying for two weeklong hospital stays and an ambulance, called when I passed out due to hemoglobin so low that the ER folks said I was lucky to be alive. They eventually did another endoscopy using an extra long instrument, which discovered the bleeding ulcer and the return of my cancer.

I hate BCBS with the fiery passion of a thousand suns.

[debm55]

26. Staph, I am so sorry to hear that. I hope you are better now and hope you have found a better provider.

[Staph]

29. Much better!

My cancer returned one more time, but I started immunotherapy and it works like a charm for me!

And I now have Medicare and United Healthcare. They haven't turned down any medical requests!

[OldBaldy1701E]

28. I don't have Medicare and I am finding this is true as well.

I am thinking it is because they are quietly prioritizing patients because rea$on$. (People in general cannot afford proper healthcare anymore and they are trying to make up the differences any way they can. Again, just my theory.)

[debm55]

38. Old Baldy, I think you are very right. TY

[marybourg]

30. No, not seeing this. My Internist saw me that very afternoon

when I wanted to change an antibiotic she had prescribed which I didn’t want to take. (Cipro, Warpy) and I got an appointment with a Urologist in two weeks, and a procedure two weeks later. Also saw an Endodontist in two weeks for a non-urgent eval., but that’s not Medicare, of course. I live in a heavily senior area, rich in medical and dental practices. Purposely.

[enid602]

32. GP

I have almost the opposite problem. I’ve had a new GP for about one year. He orders a blood test every 3 months! And then tells me each time how perfect the results are. No chronic conditions. 70 years old.

[Trailrider1951]

47. My doctor does the same thing. She is monitoring certain items in my blood that are related to kidney function

because I'm taking a prescribed diuretic for HBP. Also, I have a history of anemia, so hemoglobin and hemocrit are monitored as well. I am glad she is so serious about getting these tests done. Ask your doctor what exactly he's concerned about next time you see him.

[summer_in_TX]

33. I don't think it's the insurance.

Sounds like you and I may have the same kind: Medicare is primary (parts A and B) and Blue Cross Blue Shield Federal Employees Program?

It may be the specialty. I get most of my medical specialists scheduled within a few weeks (I'm in Central Texas), unless I can't get it paid for because I'm limited to once a year. Sometimes I have to wait because of that rule. Some of the specialists are new to me, some not.

Or it may be the region you are in and the availability of specialists there, the contract they have with a particular network of doctors.

[debm55]

42. Thank you, I in Pittsburgh-tons of hospitals TY

[cilla4progress]

34. Yes.

5 months off. Unless urgent.

[I_UndergroundPanther]

35. I have medical assistance

And bcbs

Every appointment is pretty quick. My doctor isnt corporate. He has his own practice. He has a little in house lab for bloodwork. No nurse practitioner I see him.He has seen me the same day once when I was losing my mind with nausea,and unable to eat.
When he orders tests it happens pretty fast too.

He is a friggin unicorn when it comes to doctors these days . I am hellova thankful he's my doc.

[debm55]

44. You are lucky. Ty

[Desert grandma]

40. Are you in a Medicare Advantage plan?

If so, that might be possible if due to limited providers and networks. If you are in a regular original Medicare plan with a supplemental, ask your primary to recommend a different provider specialist, or research one yourself. With symptoms like that, call around to different providers. I have never known my Medicare plan (original) to put any limits on care. Original Medicare does not require pre-authorizations for tests or specialists. Even check with different cities near you. Good luck to you. Remember, you are a consumer here. You pay for that insurance. You might have to be your own advocate.

[debm55]

46. Oh on numerous ocassion, we had them fight over who was going to pay.

[Desert grandma]

60. My mom has Medicare part A and B

as well as Federal Employee retiree insurance as a supplemental. She did have BCBS which offers several plans in our area. The one she had used Medicare as Primary. When I called the federal employee insurance hotline for her, the plan she chose operated as a supplemental only, secondary yo Medicare. She was NOT limited to the networks in the BCBS plan because Medicare was primary. The less expensive of the BCBS plans were limited to networks in the BCBS plan. This past year my mom went with Mailhandlers as a secondary and has had no limits to networks or specialists. Mailhandlers, if it was primary, would definitely limit networks. Maybe now that we are in open season, you could change the supplemental coverage, or at least research alternatives?

[sakabatou]

41. Not that I know of

Then again, I'm under guardianship due to my disability.

[debm55]

45. Thank you and take care of yourself.

[sakabatou]

50. I try

[Zeitghost]

43. We are still seeing the effects of the pandemic

Routine healthcare was put off by many for a year or two. We are still chewing through that back log of appointments.

[Maru Kitteh]

48. In my area it's the growth coupled with the lack of providers and facilities, so yes

a coworker of mine's husband recently had a melanoma lesion and positive lymph nodes removed from his thigh and was told to come back a month later for imaging because hey, cancer spreads and looking to make sure you don't have mets landing in the lungs/bones/brain etcetera is a good idea.

Melanoma. Wait. A month. Those things do NOT belong in the same neighborhood.

I told her you call every hospital and imaging center in a 500mi radius and get him in, melanoma doesn't wait. We had just seen a friend of my husband go from finding a spot on his leg --> waited 4 weeks for an appointment with his doc ---> dermatologist the next week --> surgery and finding of positive nodes the week after that and ---> about 3 weeks later dead.

[LiberalLoner]

58. Wow. Just wow. I live in NoVa and thought my six month wait for

Breast cancer surgery was outrageous. Melanoma is infinitely more aggressive and deadly than my breast cancer. Wishing your friend good health and the best outcome. The advice you gave was excellent.

[Maru Kitteh]

61. So far he's doing really well from a medical standpoint but he signed up for medicare only

so there's a very good chance they will have to sell their business and/or their house. The medical system in this country is heartbreaking.

[LiberalLoner]

62. Oh I hate that we don't have universal health care in this country. 😢

[marybourg]

66. I agree with you. A six month wait for cancer surgery *is* outrageous.

I’m sure there’s a good reason why you weren’t able to circumvent such a roadblock. Continued good health!

[W_HAMILTON]

49. I've always found this to be the case...

...which is why it was always laughable to me when conservatives would try to say that we'd be waiting months for various procedures if we implemented universal healthcare. I always thought, "have you ever actually tried to have a specialized procedure done? It takes months here anyway."

[woodsprite]

51. I have BCBS, and haven't had that issue

for the most part if something was a problem or I needed a procedure or scan. There are long delays for regular check-up appts or physicals which seem to come from the drs offices. Sick appts for things like sore throats, etc, they will usually see you within a day or two.

I have a harder time getting callbacks or questions answered by the nursing staff. I felt like I was coming down with a uti awhile back. Something a diabetic and a permanent ureteral stent patient are told to look out for. I called the nurse to see if I could get a script called in either for an antibiotic or urinalysis. She didn’t call back within 24 hrs so I went down and walked in their office. Told them I never received a call back, was in the building and was wondering if I could pee in a cup for them. The receptionist said the message hadn’t been picked up yet. She took me back and handed me a cup for the test. Said she’d print off my message and hand it to the nurse along with my sample. Turns out I had a Klebsiella infection and needed a course of strong antibiotics.

For my cancer diagnosis, the first time in 2006, it was 3 months from diagnosis to surgery. With my recent recurrence it was 4 months from first seeing an abnormal reading on a scan for kidney stones to my port placement and first chemo round. With my hernia it’s been 11 months from first issue to permanent repair, but they wanted me to lose some weight before attempting repair.

One thing I’ve learned over the years is for the most part is how to advocate for myself. The one thing that has been an issue for me is despite an original diagnosis and recurrence of endometrial cancer, BCBS’s third party review company (Evicore) has turned down requests for a PET scan from my onco. They say I’ve had surgery, rads, and chemo, therefore I have no more cancer. My onco is working with my uro to get copies of ultrasounds that I have to have every time I get a stent replacement. It’s not as thorough of an image, but my onco said it’s the best he could finagle with BSBS’s review company issuing a denial every time, even after he interviewed with them.

Wishing you the best.

[raccoon]

53. Are you living in an area that has grown tremendously in recently? Upstate SC, I've heard others mention this.

There are lots more residents and not enough medical staff to keep up with the population increase.

[dembotoz]

55. having heart procedure done mid december. i think its a combo.

heart thing not an emergency currently under control with medication but not a long term fix.

preauth took 3 weeks then a month out to schedule......

This is not a rare experimental procedure, it is the standard thing....

Wife had a car accident. went to urgent care and er.....follow up supposed to be done with primary. Primary had nothing available for 2 months....follow up from a car accident. Thinking her knee needs some surgery or at least a scan...2 months.

[lanlady]

56. Not in my area (deep blue No. Virginia)

We have loads of good docs, PAs, and hospitals. Sure, you'll wait months to see a particularly good specialist but overall wait times are reasonable, based on my experience. A friend of mine has heart issues and raves about the excellent, timely care he gets at Virginia Heart in Loudoun Co. I often wonder why some areas are better served with medical care than others. I wish every part of the country was as fortunate as we are in No. VA.

I'm sorry that you're going thru these issues, Debbie. It sounds awful. Phooey on BCBS. I hope you're able to get the spinal care you need and make a full recovery.

[LiberalLoner]

59. I live in your area. Took me six months from first suspicious mammogram to the surgery I had four weeks ago. I have

Excellent primary and secondary insurance and went to the best facilities and doctors.

[LiberalLoner]

57. Hugs to you for what you are going through, and wishes for your good health.

I have multiple sclerosis and had an episode of Transverse Myelitis 12 years ago so if you need someone to talk to, I’m here for you, just DM me. ❤️

I have a different primary and secondary insurance from you, and still it took almost six months from my first mammogram showing cancer, to get the partial mastectomies to remove the cancer. This type of cancer generally doubles every six months and spreads to the lymph nodes at 2 cm in size so that delay was significant and even though my lymph nodes were clear, lowered my chances of five year survival by quite a bit.

On-line cancer support boards show delays like that all over the US and actually in other nations as well.

Research shows increasing delays and wait times with every passing decade. The UK even passed a law, not sure of the details, but it was to try to ensure cancer patients were treated in a timely manner.

My best guess is, we are all sicker with serious illnesses now (chemicals, pollution, lifestyle changes, who knows?) and the medical system is overwhelmed. Worldwide.

So it doesn’t surprise me that you are encountering delays as well.

I remember I was pretty anxious to get a firm diagnosis…they took a bunch of tests to rule out a lot of other diseases I might have had instead of MS…it took time for the results to come back, time to get an appointment to start on the disease modifying drugs, and I was just sure I was going to be blind and totally paralyzed before I could get medicine. I discussed my fears with my neuro at the time and she said, whatever disease you have, you have had it for many years, and most likely decades. A month or two wait won’t make a big difference.

Hearing that helped me be less anxious.

Good luck to you and I wish you all the best. 🙏🌹❤️

[csziggy]

63. I know that before I went on Medicare BCBS depayed MRI for my heart problem

This was a few years back. I saw my GP in October, the cardiologist in January. The cardiologist wanted a MRI to diagnose a problem with my aortic valve. BCBS kept delaying approval. Finally it was given provisional - but not full - approval for the MRI to be done June 20. The imaging company wanted a guarantee that I could/would pay the full cost if BCBS reneged. Apparently they had had problems with BCBS backing out, so they wouldn't rely on a provisional approval from them.

I realized that I would start on Medicare July 1, so rescheduled the MRI for July 7. When I told the imaging company my supplemental insurance, they were pleased - said they'd never had them back out. So I got the MRI that diagnosed my severely stenotic aortic valve. The day after, I got a letter from BCBS giving full approval of the MRI.

I am sure that BCBS looked at my age and situation, said - "Oh, she'll be on Medicare before we will give approval and we'll be off the hook." and delayed it.

In a way, that delay saved my life. Along the way to getting the aortic valve replaced, they found cancer in my left kidney. The timing was perfect. If the MRI had been done sooner, the cancer may have been too small to detect. As it was, it was just large enough to detect, but small enough that it had not spread and I did not have to have chemo or other treatments.

So in October of that year - a year after my GP had sent me for testing - I had my aortic valve replaced with the non-invasive TAVR procedure. A month later they took out my left kidney.

I still hold a grudge against BCBS for playing around with a needed procedure and playing doctor against the wishes of an actual doctor.

[ExWhoDoesntCare]

64. It could be a lot of things

I don't have long waits for most things, but I live in a large city and have the right insurance for my locale.

Waits can depend not only on your insurance provider (networks and the like) but also on where you are, the schedule of your surgeon, available slots at a hospital or testing center, and even new developments in surgical techniques/procedures.

When I reported to the ER about the condition which turned out to be uterine cancer, I was able to get in with a GYN specializing in high risk conditions within a week. Could have been the next day, but I had *another* medical appointment that I couldn't miss, a post-op checkup. Once my results turned up positive for cancer, the GYN referral doctor got me in with a specialist in gynecological oncology the next day.

The hysterectomy was the only thing I waited for, and only because my oncologist was the only person in a 250-mile radius qualified on a robotic surgical machine at the only hospital in a 250 mile radius that could afford that piece of equipment back then. I was among the first run of patients to get surgery via that method--in the entire country. It was that cutting edge at the time, but its newness and how few doctors could perform that procedure added to the wait. I could have gone with the traditional surgery, but my doctor recommended this one. I was stage I, so waiting wasn't a huge deal, plus, this procedure offered a chance for a much easier recovery. I'd been there when my mum and my ex-MIL got a hysterectomy in the old days. Being up and about in a few days versus six weeks? I'll wait for the one that has me up and about faster, thanks.

Anyway...

Fast forward four years later, and my DIL needed a hysterectomy. She got slotted within a week at the same hospital for the same robot-assisted surgery. She got in faster because more facilities had the machine (or more of them at that hospital), and more doctors were qualified on the procedure.

So it wasn't one thing that went into why we got the care we did at the pace we did, but several different factors at work. I would say that I got fast access to care, thanks to where I was and the sheer number of care providers I can see. My particular insurance really didn't factor into it much, although I'm sure it helped that they were fast with approvals of everything I needed to get better.

[milestogo]

65. Yes, especially some specialists.

[Elessar Zappa]

70. Just dermatology appointments.

For some reason, appointments are hard to get. My next available time is March 7th.