On 12/31/2009 3:07 PM, JIM WELLER wrote:

> treatments (not necessarily by expensive medivac as most patients
> are able to fly commercially. That cost is picked up by government
> health care too.)

I'm a retired Fed.  Which means I have that wonderful retirement package 
that everyone points to, GEHA in my case.  While it doesn't require that 
I visit a PPO the co-pay changes significantly if I don't.  Anchorage 
has no cardiac doctors which are PPO, no dermatologists, no GI docs, no 
ENTs, basically if they aren't a nurse practitioner or a GP we get 
nailed because they're not a PPO.  Connie asked them once point blank if 
they would cover the airfare to Seattle, the nearest town in America 
with a direct flight.  Want to guess what the answer was?  Right now 
we're in discussions with them over flu shots.  Last fall we got a 
letter from them saying they'd cover the cost of a H1N1 shot.  We drove 
over to Walgreens and got the standard flu shot, paid our portion of the 
charges with the rest covered by GEHA.  On November 27th the Walgreens 
here in Lake Havasu indicated that "at risk" people were being given the 
H1N1 injections.  We went in and got our shots.  When Walgreens tried to 
run it through GEHA it failed.  We paid the full amount.  We applied for 
reimbursement and after a month I called.  They were going to reject the 
claim because "while the pharmacy is a PPO they are not a PPO medical 
facility".  Connie looked closely at the GEHA site and noticed they'd 
changed the 2010 benefits to exclude it.  If they reject it again I'll 
have to point out that the service was done in 2009 and why did they pay 
for the standard shot.  The saga continues over a $36.00 charge.
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