Diabetes Talking

Question:

Anyone with Pacificare? My company is switching over next month. Unfortunately, I have been ecstatic with my current RX plan and have heard not-so-good reports about Pacificare. I can choose HMO or PPO. (I always go with PPO.) Thanks for the input! Nancy/AZ

Response:

Nancy … Anyone with Pacificare? My company is switching over next month. Unfortunately, I have been ecstatic with my current RX plan and have heard not-so-good reports about Pacificare. I can choose HMO or PPO. (I always go with PPO.) Thanks for the input! Nancy/AZ

My experiences have all been positive with Pacificare; I have been with Pacificare since Nov 1992 (currently with their "Age 65+" subsidiary, Secure Horizons); I have a plethora of IPAs and providers to choose from, and Pacificare has only balked once at authorizing a treatment (a custom orthopaedic shoe), and I got that approved in the first round of the appeals process.  I should also say that I’ve seen a long list of specialists (never a problem), and had any number of expensive tests and procedures (including three surgeries). One caveat … I live in Southern California, and there well could be signifigant differences between geographical regions. Also, with any "managed care" plan, an absolutely critical element is your primary physician (the gatekeeper); I had to try three different ones before I found a "keeper." Good luck, Ted Rodrick T2; Insulin and Glucophage

Response:

I’m with Pacificare (the HMO plan) in Texas, and have had fairly good results. (I’m type 2, 2.5 yrs.). I’m on Glucophage and Glucotrol. My doctor wrote a prescription for a three-month supply of Glucophage with two refills, but Pacificare will only cover a one month supply, so I use up my prescription and two refills in the three months between doctor appointments. For some reason, Pacificare will not pay for the Glucotrol. I got tired of trying to get that straightened out, so I just figure that’s about $150 every three months. As far as annual trips to the Opthamologist, and some trips to a Neurologist, etc., and the initial diabetes control class my doctor recommended, Pacificare has been quite responsive. I would prefer to be on the PPO plan, but it was a real nightmare just getting anyone to cover me for a "reasonable" rate (I’m self-employed). Most of the problems I’ve had with Pacificare are the same type of problems I’ve had in general with health insurance companies.

– Hide quoted text — Show quoted text – Anyone with Pacificare? My company is switching over next month. Unfortunately, I have been ecstatic with my current RX plan and have heard not-so-good reports about Pacificare. I can choose HMO or PPO. (I always go with PPO.) Thanks for the input! Nancy/AZ

Response: