Medication for high blood pressure
originally posted: 11/22/2006 revised: 11/16/2012
Q: If a health insurance plan has a deductible of $500 or $1000, do I have to come up with the deductible before I can go see a doctor for high blood pressure medication?
A: Theoretically a doctor could require cash at the time of treatment if you have not yet met your insurance policy deductible. In reality that seldom happens. The best workaround is to use a doctor who participates in the PPO network of your health insurance plan because these doctors have agreed to submit the claim to the insurer first and then seek payment from you later. Participating providers do not require cash up front.
Your out-of-pocket cost for treatment of blood pressure are likely to be minimal. Typically a doctor's visit fee of about $100 once every three months and medicine cost of about $10 per month, for example, might be typical.
Other types of medical procedures could result in higher out-of-pocket costs. Since policy deductibles are increasing and are expected to be even higher in the future, this raises a concern about whether this may be an obstacle to obtaining immediate treatment when needed. In these case, once the claim is processed and the patient portion is calculated, most doctors will accept reasonable payment plan – for example $100 per month – rather than require the cash payment in advance.
We often recommend Celtic Insurance Company for long term major medical insurance for healthy applicants in most states, so the following comments pertain to how to find a PPO participating doctor for Celtic Insurance. Celtic uses the Cigna PPO national provider network. (Your health plan may use a different network).
See https://www.mycignaforhealth.com/ for a list of doctors in your area that participate in the network covered by the Celtic Health insurance plans. Then after you find a doctor you want to use, go to www.Celticenrollment.com to enroll for permanent medical insurance plan. This will allow you to make an appointment with the PPO doctor without worrying about having the deductible money up-front.
Finally, consider that commercial major medical insurance carriers now issue coverage to those with controlled high blood pressure at standard rates. Controlled blood pressure is no longer an obstacle to obtaining health insurance. But if you have been diagnosed but have not been treated then you are not eligible for commercial major medical insurance until after treatment begins. In this case, use a short term medical insurance policy for a few months until your high blood pressure is controlled. Having a short term policy ensures that you will not be denied an initial appointment with a doctor's office because you lack insurance. The cost of this initial treatment will be an out-of-pocket cost, not covered by the short term medical insurance.