How can I find out about the financial aspects of epilepsy treatment?

Most doctors have office managers or business managers who can answer questions about financial concerns or insurance coverage. In cases of financial hardship, many doctors are willing to accept payment plans or reduced fees.

How does my health insurance affect the medical care I receive for my epilepsy?

As managed care and health maintenance organizations multiply in our country, the access to doctors both expands and contracts. It expands because people with these health care plans will have access to pediatricians, neurologists, and other physicians. It contracts because the number or choice of doctors available in such plans is usually limited. For example, a specific plan may include only a few neurologists and no epileptologist (a neurologist with special training in epilepsy). Furthermore, because specialty care is more expensive, some managed care plans may restrict access to epileptologists.

Where can I find a doctor who accepts my type of insurance?

Local Epilepsy Foundation (EF) affiliates may be able to provide the names of doctors who accept insurance; those who accept Medicaid, Medicare, or worker's compensation; or doctors who are willing to see patients at reduced rates. They may also know of clinics where care is given free of charge.

Where can patients with Medicaid go to obtain good care?

Patients with Medicaid can often obtain good care at public clinics in teaching hospitals, where the coverage is accepted in full payment. At many teaching hospitals, patients may be able to attend an epilepsy clinic supervised by an epileptologist. But because the doctors who directly provide the care at teaching-hospital clinics are often residents in training with limited knowledge and experience of how to diagnose and treat epilepsy, it is important to make sure the residents are supervised by an attending doctor with whom you can speak. This is also important to maintain continuity of care, as residents frequently get "rotated" into new positions.

How readily do doctors accept Medicare and worker's compensation?

Medicare reimburses doctors more fairly than Medicaid does, and many doctors accept Medicare. Medicare allows physicians to charge certain maximum rates for services, which are often lower than the standard rates charged for a service to a person who does not have Medicare. Worker's compensation programs are regulated by the state and have fixed fees for medical services. Doctors who care for people with worker's compensation must accept the allowed fee as full payment. Some doctors will not accept patients with this coverage.

Topic Editor: Steven C. Schachter, M.D.
Last Reviewed:12/15/06

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