One question and a ranting

Walt-Eagle,

With your involved medical care, if there is any kind of continuation clause with your insurer, they should cut you some slack - just to avoid all the visits required just to get your new physicians up to speed.

My employer is "self-insured" and just uses (currently) Blue Cross as an administrative function.  Whenever the rules don't make sense and the (current) insurer won't budge, I have gone to my employer and explained the extra cost or risk or whatever and suddenly the insurer found (that is, was authorized by the underwriter, my employer) a loophole....
If your employer is not "self-insured," this idea may not be feasible.

I've had similar changes in "plan" before and it is never good when an accountant is making medical decisions for 100s of people.  (My employer has 60,000+ employees.)  The "In Network versus Out of Network" business strategy to keep costs competitive is just as scary to those of us with subtle variations of medical care - as the price increases we are witnessing in medical care and prescription drugs.  [The price of Viagra ($15) vs. alldaychemist's Sildenafil Citrate (47 cents plus shipping) is an example of the argument for the "Network pressure" being put on our medical providers.] 
The skyrocketing costs can become survival issues for some employers.
The reduction in benefit can also cause a loss of the employees critical to survival, too.

Many blessings to you if you have to meet and greet new doctors.  Many blessings, anyways!

As for the pain in the heel, I don't know anything about bone mets but:  I find I get this whenever I am overweight (most of the time these days....) and I try to run or jump rope or such.  So, I do my cardio exercises on a rowing machine or swimming and the pain goes away.
Podiatrists will try to talk you into surgery.
I am not a big fan of this procedure. 
If this "stone bruise" is what you have, low impact exercise and dieting are cheaper and more reliable.

You might just have to spread your wings and take flight.....

C^Cedar
ICTHUS!

A heel spur or faceitis is more likely the culprit. Does sound like a spur but, could be either. Go see the foot Doc if it doesn't get better wearing a good supportive shoe. Shoe inserts are wonderful.

Plantar is also a possibility which in that case, would require a bit of treatment.

Hard to see the bottom of one's own foot. Been known to stick a foot in my mouth on occasion but still didn't see that coming....sorry, couldn't resist a TGIF :>)

Take care,
Swim

Hi War Eagle. I feel for you with the insurance companies. It is just not fair the way they treat people, expecially with the meds. I have suffered from gout for several years and I have some searing pain from it mostly in my big toes on either foot but have had what can only be gout in my left heel. You may have it too. Trust me, my PC surgery and recovery was never as painful as gout. See your regular Dr. and see if the your uric acid in your blood is high which may mean you have it. Hope you don't.

Take care

Mika

Walt,

My recommendation is not just an appeal within the system.
It is rather an appeal to your employer after the appeal within the system fails.

An example:  I once got Shigalla from brushing my teeth carelessly in Belize.
The test run to determine what was causing my problem (green diahrea....)
was sent to a specialist to be read.  Charge $100.
The insurance company was not going to pay $100 for a person to read a computer printout that already cost $100 - essentailly making me a $100 political football.
While they argue, I pay.

I wrote my employer that hired the insurance company (Then Healthcare International) to administer both the policy and the appeals... and told them that as their insurance company refused my appeal I was going to go to a state agency and complain about the double billing they "so wisely" avoided.  I didn't want to pay either.
   Not such a big deal but my dilemma:
Did they want such a fuss about one of their employees with this bug in the news for $100?

They paid the bill very quickly.

My suggestion is that if you (and as Doting wisely suggests) and your physicians can explain the long-term costs: financial, emotional, etc. of the changeover versus the savings they seek, they might override their own policy and appeals process to make your life easier.
Perhaps as you suggested at least give you a little more time.

Our owner has been known on many occasions to just step in and pay an entire catastrophic health bill of an employee.  Aside from the fact that about 50,000 people will describe him as a saint....   His paying out of his own pocket avoids the precedents for other insured not-so-catastrophic patients and pre-empts complaints from the  new provider about their exclusivity clause...
So, keeping your request a quiet and polite one might pay dividends, too.

With your Spirit Walt,
I'm sure we will see an amazing dive from heavenly heights for a large fish, soon!

C^Cedar
ICTHUS!

Post Edited (Cedar Chopper) : 10/27/2007 12:04:55 PM (GMT-6)

Cedar,

Great advise. Our appeal will go to the employer (a Hospital Network). BCBS just admins the coverage. We will try to do what is right in hopes that they do what is right. Still one question if we decide to stay with our doctors after an appeal in denied (hope this doesn't happen), what cost would be incured? The standard charges or the negotiated prices? The difference is huge. CT & Bone scan care a standard price of $12,000 while the negotiated price is almost 50% less. Zometa infusions are the same. I guess we will find out and pass on the info for all to know.

I got some inserts for the heel problem, they helped alittle. Will keep pushing through.

Wae Eagle

Walt