How much is too much?

Roadwarrior

Roadwarrior

Member
After getting Medicare, then a 'Vantage' plan, I discovered a quirk in their system. I go to my PCP every six months have been for 8 years now. I have an approx 30 minute session with him then I do labs. I have a CBC every year, less in between, my counts are used to determine where I stand. My numbers have always been in normal ranges, BMI below 25. He tells me I'm doing great, keep up whatever I've been doing. Exercise, eating proper, abstaining from the normal vices,,,etc.

About every 3 months I get a call from my 'Vantage' plan, asking for a question & answer period. At first I was okay with them, until I realized I was giving more information than they were asking for. Our PCP office has all my medical records online, I hadn't been too concerned until the last 2 years. Reading the information that they (Vantage) posted on my records is all the answers to the questions they had asked. Reading it was an eye opener, a couple of years ago I fell 3 times over a 2 year period, getting used to newer walking shoes, kicking my walking stick out from under me (accidentally) & stumbling over an embedded rock in the asphalt. No details, just I fell.

It was vague incidents but made me look like an accident looking for someplace to happen. The next call I question the caller about her credentials. She claimed she was a registered nurse & the information would never be used against me. But in my mind I was not coming off looking like a competent senior, who could take care of myself. Could it be used to deny my a driver's license? Who knows, I refused to give her an interview & told her she can converse with my PCP for more details if she needs it.
 

I had a similar interview with a pharmacist from a group that was hired by my PPO plan.

I stuck to the facts and thought that it was interesting that she was nudging me towards a couple of different medications. I'm not sure if it was for my benefit or for Medicare's benefit perhaps due to a lower negotiated cost on certain medications.

So far my PCP continues to prescribe my usual meds without any interference from the PPO plan.
 

Roadwarrior said:
After getting Medicare, then a 'Vantage' plan, I discovered a quirk in their system. I go to my PCP every six months have been for 8 years now. I have an approx 30 minute session with him then I do labs. I have a CBC every year, less in between, my counts are used to determine where I stand. My numbers have always been in normal ranges, BMI below 25. He tells me I'm doing great, keep up whatever I've been doing. Exercise, eating proper, abstaining from the normal vices,,,etc.

About every 3 months I get a call from my 'Vantage' plan, asking for a question & answer period. At first I was okay with them, until I realized I was giving more information than they were asking for. Our PCP office has all my medical records online, I hadn't been too concerned until the last 2 years. Reading the information that they (Vantage) posted on my records is all the answers to the questions they had asked. Reading it was an eye opener, a couple of years ago I fell 3 times over a 2 year period, getting used to newer walking shoes, kicking my walking stick out from under me (accidentally) & stumbling over an embedded rock in the asphalt. No details, just I fell.

It was vague incidents but made me look like an accident looking for someplace to happen. The next call I question the caller about her credentials. She claimed she was a registered nurse & the information would never be used against me. But in my mind I was not coming off looking like a competent senior, who could take care of myself. Could it be used to deny my a driver's license? Who knows, I refused to give her an interview & told her she can converse with my PCP for more details if she needs it.
Click to expand...

If those answers are in your online medical file, they might factor in if you ever wanted to go to another plan with another carrier.

I just refuse to talk to anyone but my physicians about my medical stuff. If they need to know something they can contact my treating physicians. I resent the hell out of those allegedly helpful people from insurance carriers who so cheerfully feel they can violate my HIPAA rights.
 
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