Should I just, like, schedule with a bunch of specialists at once?

Kamar

So I finally have insurance, after not for...my entire adult life? I actually moved to a place that expanded Medicaid...and ended up not needing it because I also got my shit together enough to get insurance, woo. Anyway, I got the good stuff, so I can go straight to specialists and my deductible and maximum out of pocket are so low that I can just go for whatever I need without much worry.

But I'm not entirely sure who I should be seeing? I have a bunch of systemic inflammation and GI symptoms that I've had a doctor suggest might be Behcet's disease (a chronic vasculitis, first/most common symptom is mouth ulcers), but my research shows that it could just as easily be Crohn's (overlaps so much that it's indistinguishable unless they find granulomas, apparently?), or lupus, or a dozen other things. Which I guess probably all have similar treatments, i.e. try to shove it into remission with steroids and cover any specific symptoms with mouthwashes/eyedrops/skin creams/etc?

Symptoms spoilered because a few are gross. In case anyone is curious or has more specific recommendations for me.

All of these kind of come and go with flare-ups...

Chronic mouth ulcers (as long as I can remember, most of my 31 years)

Chronic skin problems (scalp acne, cyst-like acne random places on body) (as long as I can remember)

Chronic joint pain (every single damn joint, always, since I was a teenager)

Chronic, uh, prostatitis probably, under certain circumstances if I don't take ibuprofen in advance. (since I was a teenager)

Chronic fatigue (might be part of depression, but the flare-ups trigger depressive episodes for me, so...)

Frequent GI problems (GERD, pain at the, like, corners of the transverse colon?, occasional bloating only on the right side, very very slight leakiness just enough to be unpleasant feeling)

Occasional eye inflammation (10ish years)

Occasional ulcers...elsewhere (years)

Occasional completely random pain spots that go away as fast as they show up. Literally anywhere in body, pinpoint pain or, like, patches that feel like bruises or burns or something but the skin looks fine (years)

Occasional weird headaches in the same spot in my head (years)

Occasional chest pain that's proooobably just GERD or chest joints or the random pain thing, but makes me nervous as fuck anyway (years)

Does it make sense to pick up the phone and schedule with whatever in-network PCP, gastroenterologist, and rheumatologist I can find right off the bat? Any others I should tack on?

I'm in the middle of a flare-up of whatever it is, with nice big obnoxious ulcers in my throat, joint pain, and fatigue, so I figure trying to see them all ASAP while I have active symptoms is smart?

I guess I already know what I should probably do here, I'm just, like, nervous, because I haven't done this before, and maybe I'm going about it wrong? Feels weird to be dealing with it after so long of not. Like, I've only gone to walk-in clinics and psychiatrists in the last...12+ years?

Shadowfire

Generally the specialists are going to want your PCP to refer you anyway. I would talk to your PCP first because they can get the ball rolling for you and submit referrals. Then those specialists can reach out to you for scheduling. Plus your PCP might have an idea for short term relief while you work on tracking down what's going on long term.

CelestialBadger

3 doctors doesn't sound crazy! Make sure the specialists are in-network (otherwise you will be paying a lot) and see if your insurance needs you to get a referral from your PCP (as Shadowfire says). However I don't think the specialists will reach out to you even if you have a referral: usually you get the referral from your PCP, who sends it to the specialist, and you phone the specialist's office to make an appointment.

Burtletoy

A lot of healthcare plans introduced telemedicine during the Covid pandemic, too

So you might be able to get the referrals over zoom or whatever, instead of going into the office first

Kamar

Ah, my insurance doesn't require referrals for specialists, so I figured I could go ahead and schedule with them, didn't realize the specialists might want referrals. So I should just go to a PCP/do telehealth stuff first anyway?

ceres

This is all heavily dependent upon basically everything. None of my specialists have needed referrals. A couple have asked if I had one (we tend to avoid health plans that need them where we have the option), but didn't require it. If you do need/want one then everyone on both ends need some time to process that so start the process at least a week ahead.

Also, just because you don't need referrals doesn't mean you don't have a network. Check and make sure, because if there is one you might be able to see whoever you want but it will be covered differently depending on whether or not they're in-network. It can also affect how much goes toward your deductible.

Kamar

ceres wrote: »

This is all heavily dependent upon basically everything. None of my specialists have needed referrals. A couple have asked if I had one (we tend to avoid health plans that need them where we have the option), but didn't require it. If you do need/want one then everyone on both ends need some time to process that so start the process at least a week ahead.

Also, just because you don't need referrals doesn't mean you don't have a network. Check and make sure, because if there is one you might be able to see whoever you want but it will be covered differently depending on whether or not they're in-network. It can also affect how much goes toward your deductible.

Yeah, I have a network, I planned on reaching out to specialists from their search tool.

CelestialBadger

If you don’t need to go to a PCP for your insurance you might as well go to the specialists since you already know which specialists you need.

You might want to get an annual checkup with your PCP at some point though.

ceres

Sometimes a PCP is good at looking at a collection of things from specialists a bit more holistically, it's definitely worth finding a decent one who can get to know you.

DevoutlyApathetic

Kamar wrote: »

Does it make sense to pick up the phone and schedule with whatever in-network PCP, gastroenterologist, and rheumatologist I can find right off the bat? Any others I should tack on?

I'm in the middle of a flare-up of whatever it is, with nice big obnoxious ulcers in my throat, joint pain, and fatigue, so I figure trying to see them all ASAP while I have active symptoms is smart?

I guess I already know what I should probably do here, I'm just, like, nervous, because I haven't done this before, and maybe I'm going about it wrong? Feels weird to be dealing with it after so long of not. Like, I've only gone to walk-in clinics and psychiatrists in the last...12+ years?

I'd add in a dermatologist as well. Ideally one focused more on medicine than aesthetics but well, the money is in the latter part so...I'd also start making those calls now because most of them have a huge backlog to get in for an appointment.

You've got a whole bunch of things that sound like autoimmune issues that travel in packs.

Specific symptoms:

The cysts especially ring alarm bells for Hidentris Suppurativa which goes undiagnosed a lot. IANAD or anything but IME I went years without getting a proper diagnosis.