• A way for insurance companies to save money?

    Asked by Jalemans on Wednesday, October 8, 2014

    A way for insurance companies to save money?

    hmm... I was contacted by my health insurance company. They have a department called Integrated Health Management who apparently tries to provide some assistance. (the only people so far & it's the ins co!).

    Anyway, they sent me an Advanced Care Directive Form & included with that is a "DNR". I am still fine at this point so why wouldn't they resuscitate me & it got me thinking... I never heard from them before so a flag must have gone up because of all my bills... (I am always skeptical...) Why would the insurance spend money to help people when they don't have any requirement to do so? hmm a DNR - maybe this is how they curtail their expenses! OK, I am just KIDDING about their motives! It is funny though.

    21 Answers from the Community

    21 answers
    • lilymadeline's Avatar
      lilymadeline

      I would definitely be suspicious of this as well!!! I would completely ignore that if I were you, and if you ever want or need a DNR you can discuss that with you doctor, social worker, or hospital. I wouldn’t even want my insurance company to have their hands on something like that.....kind of would make me worry! cynical me!!!

      about 5 years ago
    • GregP_WN's Avatar
      GregP_WN

      Interesting for sure!

      about 5 years ago
    • Jalemans' Avatar
      Jalemans

      Lily, they are seriously the only ones who seem to care, which in itself is funny. My "Social Worker" isn't the least bit interested. My doctor is supposed to return by the end of the year, but her fill-in doesn't seem too interested in me. I am SURE the insurance company aren't trying to do anything fishy -- it just jumped into my head & it made me chuckle.

      about 5 years ago
    • cam32505's Avatar
      cam32505

      My insurance company sent me a case worker. She would call when I was resting, and wanted to know if I needed anything. I think her job was to navigate for me. I didn't find her services real useful, but maybe for somebody they would be. She was a nurse and would call my docot's office if I had any complaints.

      about 5 years ago
    • Ejourneys' Avatar
      Ejourneys

      I got a call from my insurance company some months ago, offering a "care manager" to help me through treatment. I requested something in writing and got a one-page letter that said, "My goal is to assist you in reaching your optimal level of health and to help you get the most out of your health care benefits. I am here to provide information in order for you to make more informed decisions about your health care and to encourage you to participate in your medical treatment plan. As part of your health benefit plan, the Care Program is voluntary and offered at no additional cost to you."

      That was followed up by another phone call, which I let my answering machine take. I haven't called back. I believe I've been doing fine with my own research. I can't help but think that this Care Program is focused more on economizing for my insurer rather than on my "optimal level of health."

      Funny thing, though -- about a week after the call, a glitch on my insurer's end dropped both my partner and myself from coverage. Suddenly I got a statement that denied more than $9500 in claims on my end alone, placed during a three-week period. I immediately got all my papers together, got on the horn, and spent about 90 minutes with a rep who got everything cleared up, thank goodness. But that timing was just a little too cute.

      about 5 years ago
    • lilymadeline's Avatar
      lilymadeline

      Insurance companies are huge corporations, and profit is the bottom line. They are not out for our best interest if it conflicts with their own. That is what our doctors are for, and why it is so important to make sure that you have a doctor that will fight for you!

      about 5 years ago
    • ld_105's Avatar
      ld_105

      I got a call very early after Dx from the ins company. They assigned a case manager who would call and check on my progress. She was very helpful when I had issues with a few doctors denying me pain meds. after surgery. She also checked out my doctors and then commented, "we'll, you certainly have good doctors." Use them (ins) to help you if possible but keep things like DNRs out of their reach.

      about 5 years ago
    • LiveWithCancer's Avatar
      LiveWithCancer

      When I was with BCBS, I got a number of offers for their services in finding the most economical services. I am not sure most economical = best and I want best! I never took them seriously and never contacted them.

      about 5 years ago
    • Janetspringer's Avatar
      Janetspringer

      I received calls from a care coordinator, but I never returned the calls. All of this makes me think a living will is not a bad idea.

      about 5 years ago
    • Janetspringer's Avatar
      Janetspringer

      I received calls from a care coordinator, but I never returned the calls. All of this makes me think a living will is not a bad idea.

      about 5 years ago
    • BuckeyeShelby's Avatar
      BuckeyeShelby

      I work in the med insurance field. I was offered a nurse case manager, and I did take advantage of it. She worked for a different vendor -- that vendor was responsible for making sure that the doctor's plans are not experimental & medically necessary blah blah blah and they make sense for my cancer. Sounds like she should be working against me, but she basically became a liaison amongst all the components of my team. She was also a resource for me. I could call or email her w/stupid questions and she didn't think they were that stupid. We got along so well that even though she is no longer active on my case, we still keep in touch via email. I always email her my results on tests and such. I found her to be helpful.

      In addition, while I never needed it, my company does provide a coordinator for complex situations, which may mean high bills. Yes, it is in part to keep costs down, but that coordinator also helps patients to make sure claims are being paid appropriately, that the doctors are charging the correct out of pocket, etc. These are not nurses, just claims/customer service folk. And I can guarantee you, there are NO DNR's sent out to the people using this service.

      about 5 years ago
    • djy's Avatar
      djy

      A DNR was made available for me to fill out before I started chemo - I think it is just standard practice - I did consider it but decided to leave it to fate - I do have a living will on file at my hospital

      about 5 years ago
    • debrajo9's Avatar
      debrajo9

      I guess I am a big " conspiracy" nut, but when MD Anderson almost demanded a living will and a power of attorney, along with a DNR, I out right refused. I thought a lot about it and have decided to give my medical power of attorney to my daughter of the heart{my daughter in law} and my sister in law. My daughter in law is an RN and knows my wishes and WHEN to pull the plug. My SIL is in the legal field and will make sure it's enforced. I will not sign a DNR...ever!

      about 5 years ago
    • Judt1940's Avatar
      Judt1940

      I've been asked before surgery if I have a DNR. I lie and say yes. I trust my daughter to make the call. We've talked about it. Feel guilty about leaving her with that decision but don't want complete stranger making call

      about 5 years ago
    • MsMope's Avatar
      MsMope

      I wonder if many of you are confusing a DNR order (Do Not Resuscitate) with Advance Directives. All of us ought to have Advance Directives (Durable Power of Attorney for Healthcare and/or a Living Will).

      A DNR order isn't all that easy to get. In my state, there are specific statutes covering DNR - certain forms and certain bracelets that must be worn. And your oncologists probably would not perform your surgeries if you had a DNR order. I asked my oncologist, and he said he would not perform my hysterectomy if I had a DNR.

      However, everybody loves Advance Directives. They exist to provide guidance to your loved ones and your doctors. For example, they need to know if you want a feeding tube or ventilator to prolong your life. Me? I'm seriously thinking of getting a legal DNR order. Why would I want to be woken from dying just to die of cancer sometime later?

      I've had Advance Directives for a long time. And more important - I've had many conversations with my husband and daughter so they understand my wishes and agreed to honor them.

      I'm surprised how many of you are suspicious. If I was offered the services of a case manager, I'd be glad to say "yes." That person might have helpful ideas. I hired a case manager for my mother when it became almost impossible to find the right place for her to live with agitated dementia.

      I was a Registered Nurse for decades. Guess what? I was never out to get you. We wanted to be helpful, you know, saving lives and helping people achieve optimum health. If you have an attitude that people WANT to help you, you will most likely get the help you need. Those of you who seem to find suspicious motives everywhere, and those who can't seem to find a single doctor who cares, may want to check your attitude. Perhaps a case manager can help you get the excellent care you deserve without having to make a lot of enemies along the way.

      I have been very happy with my care and with my insurance company. Then again, I never expected any less. It's amazing what you get with a positive and trusting attitude. People really do want to help us. Remember, I was one of those helping people, so I'm giving you the inside scoop. We like helping people. We really do.

      One more thing - a big health care system in my state has been getting rave reviews for its program to get people signed up for Advance Directives. Representatives from other countries have come all the way to our state to learn what we know - that health care is better for everybody when the purpose of Advance Directives is explained and embraced. The program is called Respecting Choices Advance Care Planning. Check it out!

      -MM

      almost 5 years ago
    • debrajo9's Avatar
      debrajo9

      My step dad was in a nursing home, had the DNR, Advanced Directive, the whole nine yards. He was even hospice. He had Alzheimer's and a huge aortic anurism {sp}. Long story short he had been on hospice for over a year when he came down with shingles. The home, the dr. the whole bunch of them REFUSED to treat him due to his "status" of DNR and terminal. That poor man suffered so much when he didn't have to. I/we are in Texas....I will stand by my above statement due to past experience!

      almost 5 years ago
    • BuckeyeShelby's Avatar
      BuckeyeShelby

      Oh Debra. That is what the comfort DNR is in Ohio. I think my mom had a 2nd stroke while under hospice care, and since we had that in place, she was not taken to the hospital, as she specifically had said she didn't want to go back there. But if she had gotten something like shingles or a UTI or something non-related to her major issues, those get treated. I'm so sorry. I don't know if any other states have something like the comfort DNR or not.

      almost 5 years ago
    • MsMope's Avatar
      MsMope

      My mother had Advanced Directives. That was one of the kindest things she did for me. With the help of her significant other, she hid her dementia from me until I was blown away by her hairdo. She had been unable to figure out the steps to getting her hair cut.

      Still, she wanted her independence. I finally had to step in when I found out her home had been invaded. A stranger called me in the middle of the night because my name and phone number were in the stolen purse she found. My mother could not recall that somebody had come into her house - while she was in it.

      So began my adventure in caring for my demented mother. After many horrible experiences trying to find help for her, my mother suffered a massive heart attack in a hospital while I was staying overnight in her room. Luckily, her Advanced Directives had enabled me to make good decisions for her. Based on a discussion with her doctor just days earlier, my mother had a DNR order in place. What more could a hospital do for an elderly person with terminal dementia? We went to hospice.

      My mother died peacefully a few days later. Everything worked perfectly for my mother - finally. After all the months of trying to find places that would care for my agitated, wandering mother, her confusion, agitation and suffering were over.

      That's my experience. Advanced Directives and the many conversations my mother and I had about her end-of-life wishes BEFORE she became ill, the official DNR order and hospice care were the brightest and best moments of the horrid last months of my mother's life. I carry huge scars of grief and guilt because I could not help my demented mother except for those Advanced Directives, the DNR and hospice. The only peace we had, the final days when I lived with her in hospice, was the gift SHE gave me - the gift of Advanced Directives. Thank you, Mom.

      I will also say that, as a nurse, I worked with dozens of people terminally ill with dementia. Every life was celebrated, and every death was treated with respect and dignity. They went as gently as possible to their deaths thanks to DNR orders. I also worked with families who had not considered dementia a terminal illness. They dithered about those end-of-life issues, so I also saw patients tortured by cruel attempts to prolong their miserable lives. Nothing broke my heart more than that.

      So - Advanced Directives are good things. They are excellent things. And it's up to the people who are designated to make decisions for patients to do the right things for their loved ones. And those conversations should be happing NOW while we CAN have them.

      My experience with hospice was a good one, one I remember without feeling great pain. I hope my experience helps others to think of hospice as a gentle, caring place. We wish we don't have to be there, but it's one place where should feel cared for and our life valued.

      My experience with my mother was good and relieving. My mom died 7 years ago this month. I remember the fallen leaves I collected in the beautiful hospice garden on the day she died. I keep those leaves in a beautiful box. They're the perfect metaphor for the end of my mother's life: peaceful, gentle, natural, calm.

      -MM

      almost 5 years ago
    • debrajo9's Avatar
      debrajo9

      Thanks Shelly and MsMope, It was a very traumatic time all around. Step dad had long periods of complete clearness then it would be gone. I understand the Comfort Care of Hospice and in general, I love the wonderful care. My step dad was under hospice care for 13 months...no one can guess when the anurisum will go. He ended up having a massive heart attack that they did follow the DNR. We expected that. It was the massive pain and suffering the shingles caused him. They were so sure that would bring on his death, but he had shingles in Feb., recovered and went on to live until the end of June. What I can't get out of my head is the huge swatch of erupting blisters from the center of his chest to the spine nearly six inches in width. I'm sorry, they could have and should have treated him...no matter how long they "thought" he had. Best, Debra

      almost 5 years ago
    • MsMope's Avatar
      MsMope

      Debrajo9: I'm so sorry that happened to your stepfather and to you. Shingles is a nasty disease. I saw the awfulness when working in nursing homes. Everyone reading this should ask their doctors and/or pharmacist whether the shingles vaccination is indicated for them. I had mild cases of shingles twice, that history in combination with my age and cancer means the vaccination is indicated for me. I'll be getting it soon.

      They never gave your stepfather medications for pain? They didn't give him medications to limit the scope (spread and duration) of the disease? That's just horrible - and cruel. I'm surprised that shingles would be considered a terminal condition; that it could end his life. Bad cases of shingles can cause people to consider suicide, the pain is that excruciating.

      Again - I'm sorry you are left with such bad memories. That's a painful, heavy weight to carry.

      -MM

      almost 5 years ago
    • debrajo9's Avatar
      debrajo9

      Thanks MsMope. It took me seven whole days to finally get them to get the Acylavier antiviral meds, which was way too late to really help. Took me five days to get them to give him the antiviral steroid cream. No pain meds except his usual "rescue" pain pill for his back ache. Tylenol-3 I think, only when the anurism pressed on his spine, He would get mixed up about asking for meds for his back instead of for the singles. It finally took me treating to bring my shingle meds from home and medicating him myself and a call to Elder Abuse Hotline. But by then it was beginning to go away...just a blood, scabbed over mess he would forget to stop scratching. Sorry for rambling on so...you do need an advocate for yourself and everyone else. People DO fall through the cracks! Dera

      almost 5 years ago

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