STYLETHREAD -- LET'S TALK SHOP!

Aurora · Marc Jacobs

Question - medical insurance?

laken1 · Hermes

I think most insurance companies allow your well woman visit without a referral. I've been on United forever through different companies & that is always the case with them. When you make your appt you can ask the person that sets it up - they should know.

monica · Kenneth Cole

hi -- i'm on aetna too -- you can change PCPs as often as you like, but you do need to contact them b/f you go to your first visit or aetna will charge you an out-of-network fee. (depending on what plan you are on)

regarding the gyno.. my plan allows me one annual checkup; no referral needed and i can go to whoever in in-network. (or again, you can go out of network and pay the out-of fee)

Aurora · Marc Jacobs

Thanks monica. that was what i was wondering. I asked a co-worker and they said since the doctor is "in" network its no big deal but I think before I have a physical I'll call aetna and let them know what I'm doing. I don't want hidden fees!! I just went ahead and scheduled my well woman's exam with the new doctor since she does both gp and gyn and I want to meet her. I figure that is the safest way to do this meet her and see if I like her and how bad the location from my apt is and then call aetna and change to her as my pcp.

relrel · Marc Jacobs

monica wrote:

hi -- i'm on aetna too -- you can change PCPs as often as you like,

just a cautionary note...every body was correct in saying that you can visit for your annual without a referral. this is actually a state law in many places. however, be careful about changing pcps too often. while most health care insurance companies *claim* that you are allowed to change pcps, they are tracking this and will evantually stop you from changing too often. switching pcps is often a red flag in thier computer records and two things could happen, they will start charging you more when they do thier annual rate reviews or two, they could completly drop you from coverage. generally before they do either of the two things they will send out very nicely worded letters to knock it off and just settle on a pcp. the major health insurance companies all have a different cutoff level at the number of changes they will tolerate, but i do know that aetna's threshold is five changes per year before they take some sort of action. just a note of warning.

Aurora · Marc Jacobs

Thanks relrel for the info. I just need to find a new doctor in my state and I'm hoping this lady will be good. My friend recommended her so I'm crossing my fingers since she's been seeing her for 10 years or something. I try not to be a doctor hopper. That sucks.