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    New Medical Issue, need help

    Hi,

    I have been feeling especially tired and weak over the past few months. Even for my usual MS symptoms. I had some x-rays of my lower back done as I also have Fibro. I just happened to look at them on Mychart. It shows a serious, potentially life threatening problem with my heart. No one called me or referred me to anyone. They also know I have been having left arm pain, and attributed it to the Fibro. I have called all my doctors and don't expect to hear from them. I am also female and many of us experience back pain with heart issues. Can anyone tell me what to do? I can't refer myself to anyone, as I am on Medicare.

    #2
    As far as I know, under Medicare Part B, you do not need a referral to any other physician and/or specialist, assuming you are not covered/enrolled in a Medicare Supplement, and the physician or specialist is enrolled in Medicare and is accepting new patients.

    If you are enrolled in a Medicare Supplement plan, that plan may have referral restrictions/requirements, in which case check with your Medicare Supplement provider.

    If you are not enrolled in Medicare Part B, your coverage under Medicare Part A is limited to services involving a hospital admission, long term care facility? home health services? but not regular doctor appointments and no medical care outside of a hospital admission.

    Is the serious heart problem mentioned in the x-ray report, how were you made aware of it? I assume you have electronic access to your medical records, but curious how you reached your conclusion. Did the doc who ordered the x-ray review them with you during a follow-up office visit?

    I would contact the doc who ordered the x-ray ASAP and ask why you have not heard a thing about the heart complication that's mentioned in your x-ray report? I would be alarmed and want answers too.

    Comment


      #3
      Hi Teddy:

      Pick up the phone again, and this time make an appointment with your primary care doctor for as soon as you can get in. Your doctors can't do anything for you over the phone. You have to actually go in and see them.

      Print out the information about your heart that has you concerned and take it with you to discuss with your primary doctor. Make it clear that you're there to discuss that issue specifically and that you want it followed up on. And then follow up on it.

      Having Medicare doesn't necessarily mean that you can't refer yourself to a specialist. It depends on the kind of Medicare plan you have.

      If you have straight/regular Medicare, you don't need a referral and can refer yourself to a cardiologist. The issue there will be finding one who accepts Medicare. If you have a PPO plan, you can usually, though not always, refer yourself to any specialist on the doctor panel. If you have an HMO Advantage plan, you can't refer yourself. So you have to be sure about what kind of plan you have and what the procedure is for specialist referrals.

      If you see your primary care doctor and still feel like you need help with the quality of your medical care, you can file a complaint with your medical insurer. If you have straight/regular Medicare, go to the Medicare website (www.medicare.gov) and look up how to file a complaint. If you have a Medicare Advantage plan, go to that company's website and find out how to file a complaint. After that you can still file a complaint with Medicare if you need to because Medicare oversees all Medicare plans. And then follow up on your complaint.

      And if you feel like you're really in trouble with your heart, go to the emergency room.

      Comment


        #4
        I agree with the recommendation of going to emergency room if you are not feeling well. What exactly did your cxr report say that made you feel it was life threatening? It is true that many people have atypical chest pain and the back is one place. So many other problems cause back pain also. It sounds like you need to have some more tests. Call your doctor back and tell him/her what you saw on your report and how you are feeling. And go to the ER for any immediate concerns. Take care

        Comment


          #5
          It said I had atherosclerosis of the aorta extending into the adjacent vessels. I have contacted all of my doctors. had results faxed to my Primary (her fax is broken), got a snippy answer from my neurologist's Med Tech, ect. I guess I just wait to have chest pain and go to ER. ???

          Thanks for your answers!

          Comment


            #6
            Originally posted by Teddy1101 View Post
            I guess I just wait to have chest pain and go to ER. ???
            No. Pick up the phone again, and this time make an appointment with your primary care doctor for as soon as you can get in. Your doctor can't do anything for you over the phone. You have to actually go in and see her. So go in and see her.

            Print out the information about your heart that has you concerned and take it with you to discuss with your primary doctor. Make it clear that you're there to discuss that issue specifically and that you want it followed up on. And then you must do your part to follow up on it.

            Comment


              #7
              I googled 'atherosclerosis of the aorta extending into the adjacent vessels' and since you are experiencing sx that have been dismissed by your docs, received inadequate explanation about your x-ray findings from your docs, I think a visit to ER via the 'squeaky wheel' analogy, may be necessary and appropriate under the circumstances.

              Good luck and keep us updated.

              Comment

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