As a former social worker and current insurance advisor, I encourage you to advocate for yourself or bring a relative or trusted friend who can help you.
A. This starts with the plan you choose.
Even if your 2 doctors are 'in-network,' if they're in different medical groups, you may
not be able to see your current primary care provider AND specialist.
2 in-network pharmacies may have different prescription costs, as 1 is preferred, where
the other is standard.
If out-of-network care is covered, your financial responsibility could be significantly higher
when you use out-of-network providers.
B. Also, doctors don't always know what a medication costs, may not know Medicare solely covers lab tests as frequently as a medical specialty board, Health and Human Services, etc. may advise, and may benefit from being reminded of other appointments you have. This can lead to having -one- lab visit to address multiple doctor's lab orders, saving you time and money.
C. When a medication is prescribed, ask if there's a comparable alternative that's less expensive (i.e. Why the newest brand name medication is necessary for you, instead of a generic.) On the other hand, ask why an older anti-nausea or psychotropic medication is being ordered versus a newer, yet affordable alternative.
D. Even if you receive a referral for a specialist, lab or x-ray services, call that provider's office to ensure your insurance is accepted, the referral has been received, and that Medicare will cover the service. Also, ask what documentation you need to bring (i.e. health plan card, referral, or lab/x-ray order, etc.)
E. Because some specialists see lots of severe cases, their first impression of your signs, symptoms, or concerns may be that 'its nothing to be concerned about.' Ask about potential outcomes, the impact of other conditions you have, and what to expect should these signs and symptoms not go away.
For example, for those with certain conditions or who are on certain medications, a rash or sporadic bleeding may not be 'routine or normal.'
There's a difference between occasional stomach upset and what may be gastro-esophogeal reflux, especially given your prior history and family history.
In summary, advocate for yourself or go with someone who may be better at it. For example, a spouse, adult child, trusted friend, etc. Note: even healthcare professionals need another set of ears when they're the patient. If something doesn't sound right, sufficient, or similar, speak up.
