Seeking Advice Regarding Second Opinions, HMOs, Etc.
Posted: Sat Mar 26, 2005 3:52 pm
My insurance company is an HMO, and because I am single and self-employed I am essentially locked into it. During the years that my MS wasn't progressing very rapidly, my Neurologist and I got along fine. Over the past year, however, my functioning has declined noticeably. I have been on CRABS consistently for about 6 years, then did 2 months of Tysabri before it was withdrawn. At this point I want to do one of the chemotherapy treatments, but my neuro does not agree. He thinks that I am over-reacting to "normal disease progression." I have not been able to work for several months, and I know that things are getting rapidly and progressively worse. I'm not sure if his conservative stance is due to personal philosophy or HMO directive, but I know my body and I need to move forward.
Here is my question. If I find a neurologist outside of my HMO who agrees to a more agressive treatment plan, will they treat me knowing that I have another "official" neurologist whom I go through for my CRAB drug?
I am aware that I will have to pay out of pocket, but will they even treat me? Malpractice insurance is such a big issue with doctors that "Dr. B" might not be willing to assume the liability.
Also, does anyone know the approximate cost factor of the chemo drugs?
If you have gone out of your insurance network for actual treatment (not just a 2nd opinion) I would appreciate your insight.
Here is my question. If I find a neurologist outside of my HMO who agrees to a more agressive treatment plan, will they treat me knowing that I have another "official" neurologist whom I go through for my CRAB drug?
I am aware that I will have to pay out of pocket, but will they even treat me? Malpractice insurance is such a big issue with doctors that "Dr. B" might not be willing to assume the liability.
Also, does anyone know the approximate cost factor of the chemo drugs?
If you have gone out of your insurance network for actual treatment (not just a 2nd opinion) I would appreciate your insight.