“You’re too poor to see that kind of doctor”

I’d like to see a functional medicine doctor*. It sounds simple, but that sentence has complexities beneath the surface.

If I said I’d like to see an eye doctor, it would be easier: I would make an appointment with one of the dozens of eye doctors in my area who take Medicare and MassHealth. I would get my eyes checked and my insurance would pay the bill. Simple.

Of course, not every doctor takes insurance. Well, maybe I shouldn’t say “of course,” because a few years ago I just assumed they all did. And now, I’m surprised when a friend questions me. “What do you mean they don’t take insurance? Don’t all doctors take insurance?” Um, no, they don’t actually. Still, even if one rheumatologist doesn’t take insurance, another one will. The ones with the focus I want might not take insurance, so I might still be stuck, but it will be in a different way.

You would think it would be that way with every specialty, but it’s really not. When it comes to functional medicine, the entire specialty seems to be out of reach. I found several functional medicine doctors in my area who are highly recommended. Some don’t take any insurance. Others take a few select types of insurance. Most don’t take Medicare. One takes Medicare, but not MassHealth, and he works for a concierge service that charges an additional $365 per year. Medicare would cover 80% of the bill, but without MassHealth, I would have to pay the other 20%. That could easily be $150 per visit. On top of that I’d have to pay the $365 per year. And many of his tests aren’t covered by insurance, so I would have to pay for those, too.

Hanging out with a bunch of other people with chronic illness and chronic pain this week, I asked if anyone knew of a functional medicine doctor around here that take both Medicare and MassHealth. someone immediately responded, “You’re too poor to see that kind of doctor.” Normally I would try to argue with her, but this time, I’m afraid she might be right. I just can’t seem to find a functional medicine doctor who takes my insurance and without that, how can I afford to go?

I’ve gotten my medical expenses down. Thanks to a relatively low insurance premium and almost no copays, I’m paying only $500 or so every month. Of course, that includes visits to my naturopath, who isn’t covered by insurance at all. If I went to a functional medicine doctor it would have to be instead of my naturopath, and I’m not willing to make that tradeoff right now. Yes, a functional medicine doctor could order tests that a naturopath can not in my state. But I have a good relationship with my naturopath. I trust her. I’m not willing to throw that away to take a chance on someone new right now.

So once again, I see money (or a lack thereof) throwing up a roadblock in my journey to recovery. And once again, I remember how incredibly lucky I am to be able to pay for a naturopath right now. I know that many, many others are not so fortunate. Still, it’s so frustrating to see so many potentially helpful doctors who are just a different form of insurance away.

*If you don’t know what a functional medicine doctor is, check it out. I haven’t seen one myself, obviously, but I’ve heard good things.

If you’ve seen a functional medicine doctor, what has your experience been? What kind of medical care has been restricted by your lack of funds? And if you know of a functional medicine doctor in the Boston area who takes Medicare and MassHealth, please let me know!!!

10 Responses to “You’re too poor to see that kind of doctor”

  1. Lorna says:

    Haven’t heard of those kind of Drs before. So went off to have a read. I don’t know whether we have those in the UK but I’m off to the Dr next week so will ask her.
    I see why you would want to see one, on paper the idea seems wonderful, a Dr for complex people like us! However, it stinks royally that you have to pay even more money to see one. I completely understand why you need to keep your naturopath, a good relationship can’t be ignored.
    Yet again I’m wishing that getting help was simpler.
    Take care
    Hugs xx

  2. Kyra says:

    I’ve run into that too. People keep suggesting all these alternative treatments to me, and they look at me blankly when I ask how they think I’m going to pay for it.

    I will say that I have a psychiatrist out here in western Mass who uses a functional medicine approach and takes my Medicare/MassHealth. He’s great and has given me a lot of helpful information. But I get frustrated with him because he wants me to take all these supplements and things that cost hundreds of dollars a month. Every single time I see him, he asks, “Didn’t I recommend [fill in the blank]? How come you’re not taking that?”

    “Because I’m living off $700 a month, and it costs $90 a month.”

    In some ways, it’s nice to have some alternatives to strictly mainstream medicine, but a lot of the time, it seems kind of pointless because I can’t afford the treatments he recommends.

    • chronicrants says:

      Kyra, I’m glad to hear you have a good doc, but it does sound frustrating. I’m always amazed by how much the supplements cost, and I try to hold off on the some of them. My naturopath has been very understanding, though, and considers price when suggesting things. Maybe give him a budget: tell him you’ll spend $X per year, and he can suggest filling that budget any way he wants. Then maybe he’ll see how hard it is!

      I hope you can find some affordable alternatives!

  3. anet37 says:

    I don’t know if we have doctors like that in Canada, unless physiatrist might be included. I’ve always wanted to see one but they are very scarce. Guess we will all have to learn to be our own practical medicine providers. Too bad about the big gap in genetics that I just can’t fill

    • chronicrants says:

      You’re so right. I’m glad to be my own researcher, but unfortunately I need someone else who can order tests, so I get stuck. It’s so frustrating that I can’t order my own bloodwork!

  4. Karen J says:

    Oh, CR – “like” in sympathy, also very well written!
    But, ye gods, the system – the system sucks rocks!!!

  5. Julie Ryan says:

    And in some states (mine included) some of these Drs aren’t even allowed (naturopaths fffpphhh!). Functional medicine Drs barely exist but when they do they rarely take insurance, although I don’t think it’s because they don’t want to. I think most of the time it’s that the insurance won’t take them. I’m with you I’d love to seek out some of these options but they don’t really “exist” for me for multiple reasons. I’m lucky that my chiro performs acupuncture and there fore it gets billed as a treatment there (and therefore covered).

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