Unnecessary Medical Procedures: It Pays to Question your Doctor
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We don’t have health insurance. My family of five participates in a medical cost-sharing program called Christian Healthcare Ministries. We joined them to save money and because, quite frankly, traditional health insurance companies suck.out.loud.
When you have insurance, unnecessary medical procedures could be covered by your insurance company, but this is not always the case. This post is about to get really personal. So if you want to dip out now, I totally understand.
Oh, you’re still here? Awesome! Thanks for sticking with me! So I’m in my 30’s, and it’s been about 4 years since I’ve had an annual well-woman exam.
When you reach 30 years old, most doctors recommend them only once every three years, so I was a bit past due.
I scheduled an appointment with my general practitioner because they know as Christian Healthcare Ministries patients, we are considered “cash pay”.
First, I’ll tell you a bit about how CHM works and then I’ll explain how I almost got duped into unnecessary medical procedures (and how I talked my way out of it).
How Christian Healthcare Ministry Works
My family recently had a $40,000 hospital bill and CHM paid nearly all of it. Here’s a link to the post detailing it.
You choose a coverage amount, called “units”. CHM has three main programs from which you can choose: Gold, Silver, and Bronze.
One unit is one qualifying individual; two units are two qualifying individuals; and three units are three or more qualifying individuals.
Gold membership is $150 per unit, per month; Silver is $85 per unit, per month; Bronze is $45 per unit, per month.
CHM shares 100 percent of bills for any medical incident exceeding $500 as long as all other guidelines are met. (Total bills incurred per incident must exceed $500 in order to be eligible for sharing.) You can receive assistance up to $125,000 per illness.
At the Silver level, you have a $1,000 personal responsibility per incident. In other words, you need to pay $1,000 (or receive at least $1,000 worth of discounts on your medical bills) per incident before CHM helps share your expenses. You can receive assistance up to $125,000 per illness.
At the Bronze level, you have a $5,000 personal responsibility per incident. In other words, you need to pay $5,000 (or receive at least $5,000 worth of discounts on your medical bills) per incident before CHM helps share your expenses. You can receive assistance up to $125,000 per illness.
Christian Healthcare Ministries also offers catastrophic illness coverage called “Brother’s Keeper” which covers up to unlimited financial assistance depending on plan guidelines.
Unnecessary Medical Procedures: How to Question your Doctor
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So I went in for my annual exam, and the reason I chose my general practitioner is that they’re generally very “affordable” to visit. They charged $100 and were to bill me for the difference (it’s never cost us more than the initial $100).
My results came back, and my pap showed “atypical cells of unknown significance”. The nurse told me that my doctor was referring me to a gynecologist for further evaluation. Great…I was trying to avoid going to a “specialist” from the beginning, so I took to Google.
Now, I know that Google’s advice is not medical advice. But I figured if I could arm myself with some information about these “atypical cells”, I’d at least be prepared for what was to come.
To be honest, I was scared to death it was cancer. But I didn’t want to jump the gun, so upon my Googling, I stumbled upon the fact that the #1 cause for cervical cancer is HPV.
I knew this already from those Gardasil commercials a few years back. Before you get all grossed out and weird on me, let me drop a statistic bomb on you. According to the CDC, during 2013–2014, the prevalence of any and high-risk genital HPV for adults aged 18–59 was 45.2% and 25.1% in men and 39.9% and 20.4% in women, respectively.
So nearly half of all adults are infected with HPV. It doesn’t mean someone who is infected is bad or nasty or terrible or promiscuous. This article addresses the stigma around HPV and how it needs to “die already”. It’s a great read if you have a minute!
Now, I know my husband and I have been in a monogamous relationship our entire marriage, but I also know that HPV can lie dormant, undetected for years.
So, naturally, I freaked out a bit. I scheduled an appointment with an OB/GYN but wasn’t able to get in for a few weeks. In the meantime, I called the nurse back and asked her if my pap results showed an HPV positive or negative. HPV negative…whew!
That made me feel a lot better! Since HPV IS what causes cervical cancer, surely the OB/GYN wouldn’t want to do any additional procedures. But I kept my scheduled appointment in place and planned to go.
Then Came the Bills…to the Tune of About $600!
I am enrolled in the Silver plan above, so CHM doesn’t cover any part of this visit. We’ve had visits where we didn’t meet the minimum personal responsibility of $1000 but CHM negotiated a 70% discount on our behalf once!
So I just couldn’t believe when 1. the doctor’s office wouldn’t negotiate with me on this bill. and 2. I was STILL supposed to go back to the OB/GYN and pay cash out of pocket for the visit (potentially resulting in her telling me that I was fine and it was probably just a bacterial infection).
So I called the OB/GYN back. I explained to them that I’d already received $600+ in bills that I have to pay out of pocket, and I couldn’t afford to come in for an office visit only to have her tell me it was probably just an infection.
Now, if I’d have felt like I was really having major medical problems, I wouldn’t have questioned going in. I would have gladly shown up and paid the bill. But I truly felt that everything would be okay.
I received a call back from the nurse at the gynecologist’s office and she told me that I needed to have a colposcopy done, and my OB/GYN wasn’t the one to do that but that I needed to be referred to yet another doctor. Really?! Cue freak out moment…AGAIN.
This was when I questioned the doctors. I told the nurse to please consult with my gyno and confirm that my HPV test was in fact negative and to explain to me WHY I needed to have a colposcopy done. I just wanted answers before I shelled out any more money.
Two minutes later, I received a callback. The nurse told me that I don’t need to have a colposcopy and that since my HPV was negative, I didn’t need to be seen for another pap for three years. The OB/GYN literally hadn’t even looked over my results before she referred me to another doctor.
So here I am…avoiding unnecessary medical procedures all because I questioned my doc and didn’t stop until I received answers. If anything, this little scare has brought to light the fact that we should probably switch back to traditional health insurance.
As sucky as it is, apparently with the ACA (which hopefully goes away at some point), you can get some tax breaks, and I think (if nothing else) it would give us peace of mind.
Your Turn! Have you ever questioned a doctor? What was the result?
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