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Thread: "Affordable" Care Act??

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    Thumbs down "Affordable" Care Act??

    I see a dermatologist every six months for exam & follow up on actinic keratosis (aka "pre-cancers") as well as several moles. Been doing this for about 4 years now, both as active duty and now as a retiree.

    Every six months I call my PCM (or email) to get a new referral. The referrals always included three exam appointments, labs (if there are any biopsy) and treatments (freezing, ointment, etc.) In fact six months ago I had 21 pre-cancers frozen with liquid nitrogen.

    Just made/had my first session under guidelines from the Affordable Care Act. No longer can a PCM give a "blanket referral" that includes multiple exams, labs, and treatments (even if pre-existing and "standard" procedure). Each referral must be specific, and cannot give out multiple referrals.

    My exam on Monday was clean, no new pre-cancers, no changes in any moles. If they had found anything, I would have to go back to my PCM, request a new referral (for that specific finding), make a new appointment, take more time off work (sick leave), and pay another co-pay.

    Can anyone explain how this is 1: Affordable (my costs double), and 2: Care (rather than receive treatment same day, at least 2 weeks till treatment is received).
    "Never force a fart in Djibouti"..."Always marry your second wife first"..."If anyone says that you're not a team player, maybe they're on the wrong team"..."You can gold plate a turd and it's still a turd"

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    Default Re: "Affordable" Care Act??

    Quote Originally Posted by Chief_KO View Post
    I see a dermatologist every six months for exam & follow up on actinic keratosis (aka "pre-cancers") as well as several moles. Been doing this for about 4 years now, both as active duty and now as a retiree.

    Every six months I call my PCM (or email) to get a new referral. The referrals always included three exam appointments, labs (if there are any biopsy) and treatments (freezing, ointment, etc.) In fact six months ago I had 21 pre-cancers frozen with liquid nitrogen.

    Just made/had my first session under guidelines from the Affordable Care Act. No longer can a PCM give a "blanket referral" that includes multiple exams, labs, and treatments (even if pre-existing and "standard" procedure). Each referral must be specific, and cannot give out multiple referrals.

    My exam on Monday was clean, no new pre-cancers, no changes in any moles. If they had found anything, I would have to go back to my PCM, request a new referral (for that specific finding), make a new appointment, take more time off work (sick leave), and pay another co-pay.

    Can anyone explain how this is 1: Affordable (my costs double), and 2: Care (rather than receive treatment same day, at least 2 weeks till treatment is received).
    And because of the increased workload on the PCM the wait to see him will grow longer, driving more people to the Emergency Room for otherwise benign, non-emergency issues. I saw it all the time at my last duty location, to include my own visit because I refused to wait 27 days to see the PCM for something that MIGHT have gotten serious had I waited.

    One of the biggest defenses of the so-called "affordable" care act was the assumption fewer people would go to the costly emergency rooms, but that won't be the case with medical care rationing.

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    Default Re: "Affordable" Care Act??

    Quote Originally Posted by Chief_KO View Post
    I see a dermatologist every six months for exam & follow up on actinic keratosis (aka "pre-cancers") as well as several moles. Been doing this for about 4 years now, both as active duty and now as a retiree.

    Every six months I call my PCM (or email) to get a new referral. The referrals always included three exam appointments, labs (if there are any biopsy) and treatments (freezing, ointment, etc.) In fact six months ago I had 21 pre-cancers frozen with liquid nitrogen.

    Just made/had my first session under guidelines from the Affordable Care Act. No longer can a PCM give a "blanket referral" that includes multiple exams, labs, and treatments (even if pre-existing and "standard" procedure). Each referral must be specific, and cannot give out multiple referrals.

    My exam on Monday was clean, no new pre-cancers, no changes in any moles. If they had found anything, I would have to go back to my PCM, request a new referral (for that specific finding), make a new appointment, take more time off work (sick leave), and pay another co-pay.

    Can anyone explain how this is 1: Affordable (my costs double), and 2: Care (rather than receive treatment same day, at least 2 weeks till treatment is received).
    Is your PCM on or off base? Are you using Tricare for Retirees?

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    Default Re: "Affordable" Care Act??

    Quote Originally Posted by Chief_KO View Post
    I see a dermatologist every six months for exam & follow up on actinic keratosis (aka "pre-cancers") as well as several moles. Been doing this for about 4 years now, both as active duty and now as a retiree.
    Not exactly....they are POTENTIALLY pre-cancerous as around 20% become cancerous...
    “I say, imagine in your private life, if you decided that I’m not going to pay my mortgage for a month or two—first of all you’re not saving money by not paying your mortgage. You’re just a dead beat. “

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    Default Re: "Affordable" Care Act??

    Quote Originally Posted by 71Fish View Post
    Is your PCM on or off base? Are you using Tricare for Retirees?
    On base PCM and yes, TRICARE-Retired. From what my dermo staff said it is part of the ACA that there are no more "blanket" referrals due to the potential for abuse...
    "Never force a fart in Djibouti"..."Always marry your second wife first"..."If anyone says that you're not a team player, maybe they're on the wrong team"..."You can gold plate a turd and it's still a turd"

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    Default Re: "Affordable" Care Act??

    Quote Originally Posted by Pullinteeth View Post
    Not exactly....they are POTENTIALLY pre-cancerous as around 20% become cancerous...
    True statement...when I was first told "pre-cancers" it was a little scary, but my doctor explained the 20% and emphasized what to do to take care and be preventative. The ones on my face and top of the head were by far the most painful to freeze.
    "Never force a fart in Djibouti"..."Always marry your second wife first"..."If anyone says that you're not a team player, maybe they're on the wrong team"..."You can gold plate a turd and it's still a turd"

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    Default Re: "Affordable" Care Act??

    Quote Originally Posted by Chief_KO View Post
    On base PCM and yes, TRICARE-Retired. From what my dermo staff said it is part of the ACA that there are no more "blanket" referrals due to the potential for abuse...
    I haven't had any ACA issues so far, but I haven't had a referral in a while. My wife has an appt next week to get a referral to a dermatologist so we'll see how that goes.

    I just noticed you were in RC, SD. I was stationed there 02-06. I really enjoyed it and wouldn't mind going back, but my wife hates the cold weather.

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    Default Re: "Affordable" Care Act??

    Quote Originally Posted by Chief_KO View Post
    True statement...when I was first told "pre-cancers" it was a little scary, but my doctor explained the 20% and emphasized what to do to take care and be preventative. The ones on my face and top of the head were by far the most painful to freeze.
    Amen!! Got my "pre-pre-cancerous" cells cut out...took two times but they are gone...
    “I say, imagine in your private life, if you decided that I’m not going to pay my mortgage for a month or two—first of all you’re not saving money by not paying your mortgage. You’re just a dead beat. “

    --Barak Obama


    You may say I'm a dreamer But I'm not
    --John Lennon

    Lord of the Pings

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    Default Re: "Affordable" Care Act??

    It will only be affordable if you have nothing and do nothing. If you are a hard working contributor to society, it's much more expensive than it was previously.

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    Default Re: "Affordable" Care Act??

    Quote Originally Posted by sandsjames View Post
    It will only be affordable if you have nothing and do nothing. If you are a hard working contributor to society, it's much more expensive than it was previously.
    True statement.

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