just got Medicare and have ?s

[onethatcares]

I need to refill my bp meds and called my primary who in turn told me I have to have a physical exam every three months in order for them to order a refill.

My question is:

I have been on this med for about 10 years, lisinopril, I got 90 day refills 4 times a year without a physical exam. Am I being scammed? Is Medicare paying for more than what I should be doing?

Hopefully this makes sense.

[HoneyBadger]

1. Seriously?

You get BP meds without a doc checking your BP every 3 months? Not on Medianything, but went through all the prils and currently on Losartan. Every 3 months I spend 5 minutes with a doctor.

[onethatcares]

4. seriously,

for a long long time it's been one exam a year. that consisted of blood work, office visit, how ya feeling talk. the wait was 25 minutes longer than the time my doc took with me.

[HoneyBadger]

16. Hmm, wonder if my volatility is the reason

In 4 visits, might be 100/65, 150/70, 130/65, 110/70. The -prils worked better, but could not stand the side effects.

[csziggy]

15. I'm on Losartan and haven't had more than yearly exams so far

In fact for the first five years I was on it, I didn't get regular exams, to the point the insurance company was sending reminders that I was supposed to have blood tests once a year.

I start on Medicare in July so that may change as it did for the OP.

[Horizens]

2. I've been on Medicare for a year and

Have no such requirement. I see my GP twice a year and have a physical once a year. It's been that way since I began going to him since that age of fifty.

[doc03]

13. Same here I have been on Medicare for 4 years and I see my doctor twice a year. I take BP

medicine, blood thinner and cholesterol meds.

[diddlysquat]

3. This sounds right.

I am a type 1 diabetic and was told that I have to see my doctor every three months or Medicare may refuse to pay for needed pump supplies. Medicare doesn't actually pay for prescriptions so I am not sure how that figures in. I used to be "about " every three months but now I have to be really sure to do that. I take blood pressure medicine also but no one said anything about that.

[marybourg]

5. Spouse has been on Medicare for 25 years,

I have for 10 yrs, never heard of this. But neither of us are on meds for high b.p. although I take a b.p. med for another condition. Call your Rx insurer- part D or private - and ask if this is their policy. If not, sounds like it's your doc's policy. Maybe someone with high b.p. and on Medicare - should be plenty - will have an answer for you.

[shraby]

6. I have blood work done 2 times a year and the meds are good or re prescribed with a

call to the docs office in between.
No problem with having them paid for.

We have part D and a supplemental policy to cover what medicare doesn't/

[chillfactor]

7. I have been on Medicare for 10 years...

I go in every six months to see the doctor for a few minutes and get my prescriptions renewed for 6 months...and get a three months supply every time I get a refill. I use Walgreen's for my meds...even though some of my meds are very expensive, I am on 6 medications and pay $1.20 for each of them. Seems to me it is not Medicare that is the problem but your doctor who should have been requiring you to come in for a visit. I cannot imagine a doctor who does not check your blood pressure or order blood work when you are on any kind of medication.

[independentpiney]

8. exams every 3 months sounds excessive for bp meds

I have a few rxs including blood pressure meds and I only see my doctors every 6 months on a medicare advantage plan. My wife also on medicare is on lisinopril and sees her primary 2x a year. She does have to see her psyhc dr every 3 months for controlled meds though. So the 3 month exams aren't a medicare requirement. Have you had recent health issues or borderline bp numbers that might make them want to monitor you more frequently? If not they maybe looking for unnecessary billings.

[onethatcares]

9. thanks to all the replies

information is great. I wasn't sure the billing was needed.

[BlueStateLib]

10. For a $70 evaluation visit, Medicare usually pays about $49

[vlyons]

12. I think that it's up to the individual doctor.

Call around to other primary care Drs in your med group and ask them what their policy is. You can also ask your pharmacist what percentage of Drs that they serve use this rule.

[Warpy]

11. If you've just gotten a new primary, you might need to go in once

to clear this up. If a new primary insists on quarterly visits in the absence of serious illness it sounds like a scam and you need to find a different primary.

Some office worker likely got his/her wires crossed and one visit should clear it up.

[TexasProgresive]

14. I agree with the other posters.

Are you aware that DU has a Social Security & Medicare (Group)?
http://www.democraticunderground.com/?com=forum&id=1261