I have had the same health insurance since 1981, they were very generous with me when Thyroid Carcinoma was diagnosed in 1986, paid 100% of partial thyroidectomy, and follow-up with my endocrinologist appointment/labs for 5 years without contest.
Then, in 1991 they gently advised me that my Primary Care Physician could take care of monitoring the lab tests. Funny thing though, while the HMO sounded agreeable to me, they apparently told my primary care doctor that it wasn’t necessary to take the Tg (Thyroglobulin) or TgAb (Antibodies), only the lab work for T3, T4 and TSH needed to be run, as a 5 year survival means "cure".
When finally checked by the original endo, my Thyroglobulin test was 600. Off to emergency high dose Radioactive Iodine ablation I went. Since WBS was not helpful, the Thyroglobulin tests will determine whether I need to have a PET scan to locate any metastases.
Now, after less than a year after ablation and two Tg blood tests, the HMO says I don’t need to be followed by my endocrinologist anymore, and is denying appointment (with only 3 days notice before my appointment date).
What gives? How many of you have had your HMO deny your appointment to your endocrinologist when you are being followed for Follicular Carcinoma recurrence? How did you deal with it? Well, I do know avenues for recourse, but they all take time; any thoughts on a fast solution?
Needless to say, I'm upset about this. Yes, I can go pay my endo out of my own pocket, that's not the point; What if I do need a PET scan to find where the metastases is? Plus the posibility even more medical attention to resolve? This HMO interference is out of line. Am I being overly anxious?