Transitioning Healthcare

This was a difficult article to write, weirdly. Many of the incidents happened soon after I moved to a new state, but I felt guilty writing about them.

Where I lived previously, I drew the winning ticket with my healthcare. I had the best specialists, cohesive healthcare teams, and “cheap” insurance that covered nearly everything.

Insurance changes in my new home state

Given the success of my insurance in my home state, I decided to remain with the equivalent of that insurance in my new state. My new insurance was through the same parent company as my old one, and the language used to describe the policy was nearly identical. It was also taken by specialists in my new town (who only take “premium” insurance”; whatever that means).

My old insurance covered all my medications, and I didn’t even have a prescription co-pay. If a procedure was done in the prescribing doctor's office, then the procedure was fully covered. I did not have a primary physician co-pay, and even my specialist co-payment was not too bad. Yes, I pretty much hit the jackpot.

Red flags with my new insurance policy

I worried a little about my new insurance but was very excited when I saw the same company with nearly the same coverage, except it was $250 more expensive—red flag #1.

I combed through the insurance policy and was relieved to see that it was nearly identical to what I had previously, except I now had a specialist co-pay, primary co-pay, and medication co-pay that were all twice as expensive—red flag #2.

I am on several medications, so I checked to ensure they were all on the new formulary. They were. I did not yet know that there was a third red flag above my head. I heard it was difficult to get pain meds in different parts of the country, so I sent my medical records to the new rheumatologist ahead of time. I even carried a copy with me, just in case. I naively thought that if doctors saw how long I had been on the opiates (for example), they would be willing to continue care. No. It was quite the opposite. Red flag number… who knows?

Disappointed in my new RA healthcare team

This “premium” rheumatologist, one of the highest-rated rheums in the area, doesn’t prescribe classified meds because there are “too many restrictions and hoops to jump through.” It sounded like he just wanted to practice easy medicine.

I had to then find a primary doctor who would prescribe them. Explain how it’s better for a primary doctor who is not even treating me for the condition to prescribe those meds. I know what it is: lazy practicing.

I did find a primary doctor who said to my face she would be happy to prescribe the meds I needed if I came in every 3 months for a med check. I didn’t have to do this before, but if that’s what it takes in this new state, fine. That was an extra $120 a year but whatever. It wasn’t OK because she treated me like a drug seeker when I advocated for my meds after I ran out. I knew it was dangerous to stop these medicines cold turkey after 8+ years of regular use. Guess what? I went through a pretty severe withdrawal.

I finally found someone who would help

I did find a very kind nurse practitioner (NP) who prescribed the meds (and has been ever since) who was horrified that the doctors were so nonchalant about me stopping the meds cold turkey. Unfortunately, there are issues with her, too. She is only in the office twice a week and prescribes less than a month’s worth of pills. I’ve had to cut my pills in half or forego them all together to have enough for the entire month. Because of these issues, I have gone through withdrawals 4 times since October 2021.

This is all just the tip of the iceberg, so I am so next, I will discuss my insurance, my rheumatologist, and my prescriptions.

Have you ever had a rude healthcare awakening after you moved or switched insurance? LMK in the comments!

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