Health insurance help?

Question

I began a new job last August (teacher) with a new heath insurance company which meant new doctors and lots of appointments to establish care (I'm an insulin dep. diabetic).

Today, I received a letter from an RN who works for my health insurance company encouraging me to participate in a diabetes care program at no cost to me. The letter said, "These programs are designed to support you and your doctor." My doctor is with Emory in GA and I have a very good care system.

However, I'd love to get involved in another program, but I wonder if this is a cover program set up more so my insurance company can "keep up with me" and second guess or even dispute my doctor's care.

What do you think? Please indicate if you've participated in such a program.

Answer 1

~~These programs are designed to give you all the current information to keep you the healthiest you can be. They want you informed and educated on your disease. Keeping you in optimum health is not only great for you, but saves them money. Definitly take the program. You can learn so much information that your doctor may not have time to teach you or talk to you about!~~

Answer 2

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Answer 3

We are entering a new of era of preventative care & health management. The thinking is that if they can educate the patient about controlling, mitigating and managing their condition or illness, it will save the insurance company money in the long run.  As long as you're not with an HMO the decision is still between you and your doctor, but I would expect that they educate you about less expensive and/or alternative treatments. The program is voluntary, so if you don't like the direction it's taking -stop. I have participated in a smoking cessation program, which was successful, and attended several seminars (sales training really) about similar programs.  

Don

http://mtnhealthinsurance.com

Answer 4

Dawn,

No this is not a way for the health insurance company to dispute or second guess your doctor's care.  Many health insurance plans offer these care programs for things like diabetes, high blood pressure, high cholesterol, etc, as a way for them to help insure that patients are getting comprehensive care.  Making sure that patients are getting the right care for their chronic conditions is a way to not only help the patients but also help to keep costs in check.  Think of it this way, if you didn't take care of your diabetes, and ended up in the hospital for a day or two, that would be much more expensive than if your were regularly visiting your physician, taking the proper medication and having your condition monitored.  

That's my take on these types of programs.

I wish you good luck and good health!

Kathy K

www.premiumwatchdog.com

Answer 5

I work for a heath insurance company and we offer programs like this as well. We would never set up a program just to keep up with a patient or dispute provider care.  The programs are designed to help you manage your condition so that it does not get worse (and yes if your condition gets worse it will cost your insurer more money in claims).  They would rather offer these programs than pay thousands of dollars in claims from complications because the disease got worse and caused more health issues.

Answer 6

Yep, we've participated in a program like that.    Cigna does this, with us, because the data shows that actively managing chronic conditions like that, ultiimately means a healthier patient, which means less cost to them.  

In other words, recruiting you to this program, actually SAVES them money in the long run.