insurance

[faith smith]

My family is being screened for HCM. I have it (61), and my brother (63), my two sons (36 and 34), and my daughter (32), and her daughter (2) need to be screened. NEMC, where my doctors are, is to do the screening. My doctor said the 2-year old did not need to be screened. The first person to try for a screening was my daughter (pregnant). She was told that she needed a referral from her primary care. Her primary care said she had to go to a cardiologist in her (the primary care's) group to be recommended because this group no longer referred to NEMC. We share primary care physicians, and when I called to question this, the insurance people there said that I wouldn't be covered either if my diagnosis changed, since 2 years ago, when the group stopped referring to NEMC. (Since I've been diagnosed now almost 15 years, my diagnosis has changed, and as little as two years ago, it changed dramatically!)

How can my daughter get her insurance to cover screening at NEMC when her primary care won't give her a referral?

[Lisa Salberg]

Re: insurance

This is a complicated question... and the policy has to be read carefully. Call the office and have the policy with you and I can help you read it.
Lisa