Health and Medical Insurance in Washington - Observations (buyer, incomes)

[DallasYankee]

Originally Posted by MechAndy

The people I know that have had sports medicine treatments were given this care by those that also worked with sport teams.
One friend of mine in particular is a provider and will travel with pro teams to align them up when needed.
She also does freelance work.
I’m not recommending anyone but rather a way for you to possibly find the help you need.
You might look up who is serving the local pro teams and ask them for advice.
There are lots of people in the San Francisco area that offer this, up here probably not so much.

Thank you for the tip, MechAndy.I don't know where to find this info, though.
When we first moved here in 2022 , I received two treatments from a highly skilled combo Chiropractor/Acupuncurist in Federal Way. (She was supposed to treat many pro athletes, but I think she didn't want to invest too much time in my care since she could see my condition was very complex and we were struggling to get to her office from Puyallup before 5pm. (her latest appointment on Thursdays (her only day to treat patients there.)
Her advice? Find a physical therapist! (Of course, she didn't recommend anyone and she never followed up to see how I was doing.)
The sports acupuncture office in Bellevue has really phenomenal reviews online and seems to be very much into all kinds of sports medicine, apart from their specialty, dry needling. They also offer massage.
Perhaps they can refer me to other like-minded practitioners for treatments they do not provide (like real ART chiropractic.)

[DallasYankee]

Originally Posted by CalWorth

It wasn't bad here until recent years. Private practitioners had to join one of the 3 groups or flounder. My very good PCP was getting ready to retire but that forced the issue, they probably would have practiced longer.. The Virginia Mason Clinic on 8th closed. Some MDs retired, some died. No one replaced them. My specialist has held on for years, to their credit. But they are retiring & there is no replacement.

I've been told by 2 individuals who know that if we exhibit cardiac symptoms, get in car & head south.

Well, if that's the only choice to head South (where - to Oregon, LOL?), then I 'd rather get out of here.

[MechAndy]

I must have missed your part about sports acupuncture, sorry.

Funny story,
I met my friend that does sports teams on a desert camping trip in Nevada years ago.
She just finished giving a horse acupuncture at a local ranch.
I was so in awe of what she told me I just had to know more so I sat with her and talked with her for hours.
With out asking she told me what my problems were and corrected them (with no needles though ).
I never knew I couldn’t properly turn my neck or about the few other issues she fixed too.

She is out of Los Altos CA and every time she comes up and visits I feel much younger .

[rkcarguy]

It's important that anyone considering moving here, especially if you are on Medicare, to check healthcare availability and get set up with a practice BEFORE you commit/move. And I don't mean just a phone call to find out if there are openings, you need to lock up that opening, transfer records, sign papers, whatever you need to do.
Heard a couple stories of people who moved here, went to follow-up on the openings that were available only to find they had been filled, one only a day later. Even then, there is no guarantee. My last two PCP's moved out of state, and luckily I was able to find a Physician's Assistant with one opening and more recently a good MD who had an opening because a patient died.

[DallasYankee]

Originally Posted by rkcarguy

It's important that anyone considering moving here, especially if you are on Medicare, to check healthcare availability and get set up with a practice BEFORE you commit/move. And I don't mean just a phone call to find out if there are openings, you need to lock up that opening, transfer records, sign papers, whatever you need to do.
Heard a couple stories of people who moved here, went to follow-up on the openings that were available only to find they had been filled, one only a day later. Even then, there is no guarantee. My last two PCP's moved out of state, and luckily I was able to find a Physician's Assistant with one opening and more recently a good MD who had an opening because a patient died.

rkcarguy, we are not there yet but already I can see this is not a congenial place for anyone with health issues or senior citizens.
And it's such a shame: perfect weather, nice, friendly people (compared to Colorado, at least LOL!), lots of cultural and ethnic diversity and many hi-tech companies that provide lucrative jobs.
Anytime a state restricts, controls and denies procedures and treatment options and seeks to dictate how chronic conditions can be managed while allowing a substance like marijuana to be 100% unregulated all in the name of "high Standards", only bad medical outcomes can ensue, IMHO!

[pnwguy2]

As I have posted elsewhere, if your income is below a certain amount, I believe 17-18k, you will get 100 percent no cost insurance in Washington State. What is interesting if you have a net worth of say 300k you still get free coverage at that income level. WA is among a minority of States that offer this kind of coverage.

[CalWorth]

Originally Posted by rkcarguy

It's important that anyone considering moving here, especially if you are on Medicare, to check healthcare availability and get set up with a practice BEFORE you commit/move. And I don't mean just a phone call to find out if there are openings, you need to lock up that opening, transfer records, sign papers, whatever you need to do.

Medical offices will not make appointments until you are living in the community. They do not care what your intentions are. They already have long wait lists for current residents.

[StealthRabbit]

Originally Posted by DallasYankee

Well, if that's the only choice to head South (where - to Oregon, LOL?), then I 'd rather get out of here.

Headed south?...
HC doesn't get cheaper (or available) until you reach Mexico.. far south of there, but I you'll find excellent and affordable medical care .

Other options at Patients beyond borders web site. 14m people per yr travel internationally for HC.

[Glenview94602]

Originally Posted by DallasYankee

I had to look that one up Glenview as I never heard of them before. (My previous insurance providers were Cigna and United Healthcare (in Colorado).
I am certainly aware that Premera/BCBS offers very limited care for physical therapy; this is why I delayed going that route for this sports injury. A lady with whom I have taken yoga classes told a horror story about Premera denying her more than 6 visits even after the PT told her she would greatly benefit from longer - term access but since they would not relent on terminating her treatment and she couldn't afford to continue her visits as a cash patient, she just had to accept it and live with her condition.
I am determined to find a way around this awful bureaucracy and not learn to accept what can't be changed here like traffic or having to live in a remote location with few amenities.
Since dry needling is allowed here only in acupuncture offices, that is where I am going in tandem with the highly recommended PT.
I am allowed 12 acupunture visits per year; after that I am financially able to continue as a cash patient and would actually prefer that - Premera and Evicore then would have no say in how many needles can be inserted, the location/ area that can be treated, the frequency of sessions, etc.
I hope I will not need to see a PCP and orthopedic surgeon for MRIs and xrays.
IMHO, avoiding protracted and possibly unnecessary medical costs and multiple provider visits is the wisest course, particularly when I have experience with proven methods that worked for me in the recent past.

I have worked for both BCBS companies (Premera and Regence) in this state. Evicore is the system that some plans use to review for medical necessity of physical therapy, chiro, or massage. Some self funded plans like Amazon or Microsoft might choose to opt out of using them, or others might opt in to that requirement. Evicore is essentially contracted by the insurance carriers (or maybe it is a carve out...I am not sure) to deny claims for physical therapy related services...again typically after 6 visits due to a WA state law.

I currently work for Premera and I'm thankful that the main group I work with does not use Evicore. Others do and it sucks.

[SusVelo]

Originally Posted by CalWorth

It wasn't bad here until recent years. Private practitioners had to join one of the 3 groups or flounder. My very good PCP was getting ready to retire but that forced the issue, they probably would have practiced longer.. The Virginia Mason Clinic on 8th closed. Some MDs retired, some died. No one replaced them. My specialist has held on for years, to their credit. But they are retiring & there is no replacement.

I've been told by 2 individuals who know that if we exhibit cardiac symptoms, get in car & head south.

Driving while having a possible heart attack might be the worst advice I’ve ever seen. At worst get an emt to you and then get flown somewhere.