Info Desk [Paperwork, ordering, wait times, procedures, booklets, prescriptions...]

Nathan Young73 said:I’m about to start a lifelong therapy regimen involving hormone treatments. It's administered via injection every few weeks—usually every two or three. However, I’m planning to work abroad for a year on a ship, and I have no idea how medical access works out there. I really need a "stash" of these hormones so I can manage my own injections during that year. Is there any way to make this happen? Like, can I just get a prescription for a large supply or something?

You didn't give me much to work with here.
If you're looking at an injectable medication, you aren't going to walk into a pharmacy and pick it up without a doctor's prescription.
Since I don't know which specific medication you're talking about, I'm not sure if it's a standard stock item or something that needs to be ordered through a private specialty prescription from overseas.
Also, is this something covered by Medicare where you get the shots at a hospital, or are you buying it yourself and either bringing it to the doctor or administering it yourself? (And if you're heading out to sea, who exactly is going to be giving you those injections?)

Either way, if you need a bulk supply, you’ll need to sit down and hammer out a plan with your primary care physician. They can write a private prescription specifying the exact number of vials you need, which you then take to the pharmacy. The pharmacist will then keep that prescription on file for you.
You might also want to ask for a formal letter from your doctor—ideally translated into the local language—to carry with you on the ship, just in case there's ever a medical inspection or check.
Hopefully, that sheds a little light on things for you.🙂

Does anyone know if there's any way to pay at a regular doctor's office or the ER through Medicare instead of just handing over cash right then and there?

I don't have supplemental insurance at the moment—yeah, yeah, I know, super smart of me, I totally plan on getting it sorted, but I'll get to it, I swear... and now here I am without it. Anyway, I've gone and pinched something or my back is all stiff or something... whatever it is, it hurts! I don't have much cash on me right now and I can't exactly run to grab it, but I could definitely use a card or maybe have them mail me a bill? Are those kinds of options even available around here?
Is it better to head straight to the ER—it feels kind of silly to go there if my regular doctor can handle it, not that I'm bleeding out or anything—or should I just stick with my primary physician?

I mean, I *could* head home, grab some money, and come back, but honestly, in this state, that sounds absolutely miserable. I'm at work right now and barely being able to walk (it felt okay when I arrived this morning, but now it’s gotten way worse), and even sitting down is a total pain...

Or does anyone happen to know how much it would cost if I just needed a quick injection or something similar?

Your post is a bit all over the place, but I’m giving you a pass because I know how much pain you're in right really hurts..

Just because you don't have supplemental insurance doesn't mean you have to shell out cash for every single injection they give you at the doctor's office.
If you go to your primary care physician—your regular family doctor—you just pay your standard $3.25 co-pays, and that's it. Of course, that assumes you actually have basic Medicare coverage.
Honestly, even if you don't have those $3.25 on you right now, a doctor isn't going to turn you away when you're in this kind of shape. You can always just come back later.

All sorted in the end—I didn't actually have to cough up anything except those $3.25.

I honestly wasn't sure if that fell under my basic coverage (which I obviously have!) and if it didn't... well, I had no clue how much it would run me.
I wasn't feeling like a million bucks that morning, but I dragged myself to work anyway, and then—boom—everything just went downhill while I was there. And of course, all I had on me was about $33 and my card, which they don't even take, obviously.

Ugh, it drives me absolutely crazy! One time I ended up in an emergency situation at this dentist—it’s basically a private practice—and she actually turned me away! Even though I had most of the cash on me (it was a bigger amount back then, and I had like 80% of it right there!), she just sent me home to go grab the rest before she'd see me. I tried to talk her into it, really, but I had to go hunting for an ATM nearby first. And this was my dentist! I've been going to her my whole life and we've never had an issue... even with the vet, if something was missing, we could usually just settle up later or leave some paperwork behind.
The reason I was asking about the ER is because my coworkers were gonna drive me there (George Richardson10 couldn't leave work right that second), and I knew a buddy of mine was asked at the ER whether he wanted to pay on the spot or have them mail him a bill. I guess I don't know exactly what kind of procedure he was getting, so maybe it's different for everyone?

I totally get that they need some kind of protection, but it feels so silly that cash is the only way to pay sometimes. People end up needing a doctor unexpectedly and they might not have the dough on them right that second—that doesn't mean they won't pay! They can literally just swing by that afternoon or the next day.

Anyway, I won't drag this into the off-topic section since it's all handled now. Thanks for the help! 🙂

I’ve got a quick question. I was in a car accident earlier today, and even though I feel pretty terrible, the hospital basically sent me home. They handed me a bunch of paperwork before I left—what am I actually supposed to do with all this?
Do I need to show it to my primary doctor? Even if I'm not planning on taking any official sick leave...
Also, I've started getting these intense chills and my fingers feel completely numb. Is that something I should be worried about, or is it just the shock wearing off?

A bit late to the party, but maybe someone can help me out,

Does anyone know what time they take urine samples for cultures at the Zapruđe Health Center?
I know they accept them on Mondays and Wednesdays, but I totally blanked on the specific hours. 🙂

swiftbear86 said:You didn't give much info.
You can only get injectable medication at a pharmacy if you have a prescription.
I don't know which specific drug we're talking about, whether it's standard stock or something ordered via a private prescription from abroad.
Also, is this covered by Medicare so you get the shots at a hospital, or are you buying them yourself to take to a doctor—or maybe doing it yourself? (I assume you're heading out to sea, so who would even give you the injection there?)?

Either way, if you need a larger supply, you'll have to coordinate that with your primary care physician. They write a private prescription specifying the exact number of ampules, which you then pick up at the pharmacy. The pharmacist keeps the prescription on file.
You might also need a doctor's letter (possibly translated into another language) to carry with you on the ship in case of an inspection.
Hopefully, that clarifies things a bit.🙂

Thanks for the info. Actually, it's testosterone that I'll have to start taking. I haven't even had my first dose yet, so I'm not quite sure how the process works. Since it's going through Medicare, does that mean I have to go to the hospital every few weeks to get it? I thought maybe it was just like that at the beginning until I figured out how to self-administer, and then I could just get a prescription and do it myself... but that would mean I'd have to pay out of pocket if I need it while out at sea, and in the meantime, I'd be stuck visiting a hospital every couple of weeks? 🙂

And I'd definitely ask the doctor about the letter before leaving—I wonder if they charge for those kinds of things when you're insured or not.

Do you think your doctor is going to charge you for a written note? I honestly doubt it.

Here’s the deal: injectable medications aren't usually covered by Medicare through a standard prescription; instead, they’re handled via the hospital’s own medication list.
If the hospital is going to cover the cost through Medicare while you're there, you might as well take advantage of it while you're still on-site.
There is also a possibility—though it's a bit of a long shot—that you could buy the medication yourself and have Medicare reimburse you, provided there's a valid reason for doing so.
Being out of the country could potentially count as a justifiable reason.
In my opinion, the smartest move is to wait and see how you react to that first dose. Once you see how it goes, talk to your hospital doctor about self-administering the injections and get their professional advice on what the next steps should be.
You could also check in with your primary care physician. In a pinch, they can write you a private prescription so you can pick up the meds while you're traveling abroad.

Let me know how it all works out for you.
Good luck!

Thanks so much. Really helpful info and recommendations. I guess I'll just see how things play out. I'm not exactly thrilled about the idea of bouncing between hospitals every couple of weeks forever, but I suppose I'll wait to see what they suggest. Then we can figure out the next steps once I leave the States—not just for boat trips, but for longer travel too, I guess. Anyway, thanks 🙂

So, I had a mole removed from my arm today, and I’ve got this referral for wound dressing changes that I’m supposed to take to my regular family doctor. The catch? I won't be around for the next three days because I'll be heading out to Washington, D.C., and I was wondering—since I'll be away from home—where in Washington, D.C. can I actually get this dressing changed using my referral?
And does anyone know if I can also get the stitches taken out there later on?

It’s still a little fuzzy from your post who actually gave you the referral...

If you went to the hospital to have a mole removed, they usually just give you a recommendation for follow-up care—basically instructions on how to handle dressing changes with your primary doctor (it’s not like a standard red insurance referral). They might even be able to schedule the dressing change right there in their own surgical clinic.

On the other hand, if you went through a private clinic, you wouldn't get a standard referral either; you'd just get a recommendation for wound care.

For patients who need a professional to handle daily dressing changes, they can head to the urgent care shifts at any local Health Center over the weekend.

In your situation, since you aren't near your regular doctor, just grab your insurance card and your medical history from today and head to the nearest Health Center.
If they won't see you, your last resort is the ER at any hospital, though honestly, I don't think that's really what they're there for when it comes to simple dressing changes.
Since you won't be home, you really should have cleared a plan with the doctor who did the procedure—maybe figured out how to manage the dressings yourself or scheduled a time to go back to them specifically for stitch removal.
Changing the bandage isn't actually that hard to do on your own. You just need some antiseptic (like Octenisept), sterile gauze, and some Micropore tape (that white medical tape on a roll).
Doctors pretty frequently prescribe a specific care routine to follow after minor procedures like this.
Take a look at your paperwork and, if you feel like it, type out what it says in the medical history you received today.☕

Help! 🙂

I applied for supplemental coverage and was already due to pay my first installment. However, the lady at Medicare insists that I previously held an orange insurance card, which means I won't be receiving a new one. I showed her the old card I had back when I was unemployed, but she just told me that one is ancient history—apparently, I should have received another one after that, one without an expiration date. She told me to check with my local Health Center and handed me some printed confirmation stating that my policy is supposedly active, which I can use with doctors for now.
The problem is, I can't find that specific card she’s talking about anywhere, and I'm stuck. I have lab tests scheduled for next week, so I need to know: can I just show up with this paper confirmation and my white ID card to get the tests covered for free? 😬 Even though I haven't actually paid a single installment yet... and besides, I don't even have that orange card she keeps mentioning. 😢
Until this whole ID card mess is sorted out, I don't see much point in paying the installment. 🤷

Does anyone have an answer for me? 🙂

The ID card itself isn't really the main thing here..
What actually matters is having a confirmation that clearly lists your ID number along with the specific start and end dates of your policy coverage..
You should definitely stay current on your installments just to avoid any headaches down the road..
If she told you the supplemental coverage is active, then it's active..
But listen, if you stop paying your premiums while still using the benefits, you might run into a situation where Medicare tries to bill you directly for services you thought were covered by your supplement..
A lot of people are scratching their heads lately wondering why Medicare sent them bills for supplemental coverage from all of last year.
It’s usually because they didn't formally cancel it in writing, so the system just assumed they wanted to keep the coverage going..
It's a good idea to carefully read through all the terms and conditions over at www.medicare.gov

swiftbear86 said:It’s still a little fuzzy from your post who actually gave you the referral...

If you were at the hospital having a mole removed, they usually just give you a recommendation for follow-up care—you know, like getting the wound dressed by a doctor (it’s not like a standard red Medicare referral). They might even schedule the dressing change right there in their surgical clinic.

And if you went through a private specialist, it’s the same deal; it’s not an official referral, just a suggestion for wound care.

For patients who need a professional to dress their wounds every single day, they usually head to the urgent care on duty at any local Health Center during the weekend.

In your situation, since you aren't near your primary doctor, just head to the nearest Health Center with your insurance card and whatever medical records you received today.
If they won't see you, I guess your only option left is the ER at any hospital, though honestly, I don't think that's really what they're there for.
Since you're going to be away from home, you probably should have coordinated with the doctor who did the removal about how to handle the dressings yourself, and then when to swing back by to get the stitches out.
Changing the bandage isn't actually that hard to do on your own; you just need some antiseptic (like Octenisept), sterile gauze, and some Micropore tape (that white medical tape on a roll).
Doctors often prescribe specific aftercare for minor procedures like this.
Take a look at those papers and let me know, if you want, what the details say in the medical history you got today.☕

Exactly, that's it—they gave me a recommendation to see my regular doctor for the dressing changes, not an actual formal referral (I'm clearly not an expert in all the medical jargon!).

Ugh, so... 😢 I won't even be home for the next ten days (unless, obviously, I have to cancel everything just to get these stitches pulled out...). I can definitely handle the bandaging myself, no problem there, but what about the stitches? Can I just show up at the ER for that? And can I go without any paperwork (since I don't have a formal Medicare referral) and just show them this recommendation?

I'm not quite sure what kind of "medical history" you mean 🙈 But here is what I have on the one piece of paper I was given:
Mole removal on the dorsum of the right hand, LA 2% lidocaine, excisio in toto, sutures, cleaning, PHD. Redress in 3 days, sutures in 10-12 days.

Anyway, thanks so much for the help!

swiftbear86 said:The ID card itself isn't the main issue here..
What actually matters is having documentation that lists your ID number and the specific coverage dates of your policy..
Just pay the installment regardless; it's better than dealing with a headache later..
If she told you your supplemental coverage is active, then it's active.
But if you skip the payment while still utilizing the policy, don't be surprised when Medicare comes looking for reimbursement for services you used without covering the supplemental portion.
Lately, everyone seems to be wondering why Medicare sent them bills for supplemental coverage from last year.
It's usually because they failed to cancel it in writing on time, so the system assumed they still wanted it..
It pays to actually read the terms and conditions on www.medicare.gov

Thanks a lot 🙂 I just needed to know if I could still get tests done without the physical card (using a confirmation instead) while I sort out the ID issue.

This might sound like a silly question, but I’m hoping someone can point me in the right direction.
I’ve come down with the flu, or maybe just a nasty sore throat... I'm feeling pretty rough.
Because of the nature of my student job, I can't just call out; I need to provide an official doctor's note or some kind of medical documentation to prove I'm actually sick.

My regular family doctor is back home in Des Moines, and since I'm currently in Washington, D.C., it’s just too much of a hassle to make the trip there right now.
Can I just show up at one of the weekend urgent care locations listed here to see a physician? I mainly need someone to examine me, potentially write a prescription for antibiotics if needed, and provide a medical summary or a recommendation for seven days of rest... or whatever the standard procedure is.

I'm honestly not sure how the after-hours primary care clinics operate here in Washington, D.C.
If anyone has any experience with this or some insight, I would be so grateful.

If your primary care doctor is based in a different city, your only real move is to head straight to the ER in whichever city you're currently staying in. Once it gets dark, just show up at the emergency room; they're required to take you in.

darktiger56 said:Exactly. She didn't give me an official referral or anything—I'm definitely not an expert on all the medical jargon—she just gave me her professional recommendation to go get my bandages changed at my doctor's office.

So, anyway... 😢 I won't even be home for another ten days or so—unless, of course, I have to cancel all my plans just to get my stitches out. I’m totally fine handling the bandage changes myself; that part is easy. But what about getting the sutures removed? Can I just head to the ER for that? Also, since I don't have a formal referral, can I show up with just this recommendation, or am I going to run into issues?

I'm not quite sure what you mean by the history of the illness. 🙈 Here's a look at one of the papers I have sitting here:
I had a little procedure today to get some skin tags removed from the back of my right hand. They used 2% lidocaine for the numbing, then did a full excision, cleaned everything up, and put in some sutures. It was pretty straightforward—just a standard minor surgery.
You'll need to keep those stitches in for about three days before they can be removed, but you should plan to leave the sutures in for about 10 to 12 days total. It’s kind of like letting a fresh coat of paint dry completely before you start touching the wall—you want to give it that extra bit of time to settle so everything heals up smoothly.

Thanks so much for getting back to me!

You can always just take matters into your own hands.
If the wound heals up cleanly, you're golden. But if you start seeing things get messy or complicated, that’s your signal to head straight to the doctor.
You didn't mention whether you had the procedure done at a public hospital or a private clinic.
When you need to get stitches removed, the hospital usually just orders that through the surgical outpatient clinic.
Maybe you could try reaching out and working things out directly with the doctor who performed the procedure.
Your primary care doctor writes a referral for you to head over to the surgical clinic for a follow-up and some processing.
I honestly think your best bet is to just give your primary care doctor a call. Reach out to your regular physician at the health center and hash things out with them directly—it’s probably the smartest way to get this sorted.
I'm not entirely sure if that alone is enough to force them to admit you at the ER.

Sometimes, it’s just easier to put things off until later.

It’s like that one student I know who’s feeling under the weather. She’s originally from Des Moines, so she could always head to the ER after 8:00 PM if things get bad, but honestly, wouldn't it be way easier for a student to just pick a local doctor right where they're going to school?
I can't remember if they still do this, but I recall back in the day, you could actually check the doctor schedules on the university student portal. It made things so much easier to navigate.

lonefalcon41 said:If your primary doctor is in a different city, your best bet is just heading to the ER near wherever you're staying right now. Once it gets dark, just head over to the emergency room; they have to see you...

Thanks for the advice
I couldn't bring myself to go out Saturday night because I was just completely wiped out—spent the whole day in bed—but I finally made it in today (Sunday) around 1:00 PM to the clinic on Runjanin Street. The doctor and the nurse were incredibly kind, there wasn't even a crowd, and she examined me thoroughly. She decided I didn't need antibiotics, gave me some pointers, and wrote up my medical history with a note recommending about five days of rest. It really wasn't a problem at all... 🙂

swiftbear86 said:Or take the case of a student who's sick but originally from Des Moines—you can always hit the ER after 8:00 PM, but wouldn't it be easier for a student to just pick a doctor in their college town?
I'm not sure how things work now, but there used to be a schedule for doctors assigned to specific colleges...

When I was in a similar situation last winter, I didn't know about these on-call shifts yet, so I went to the doctor assigned to my university instead. They just gave me a weird look and told me they were only handling routine physicals. They wouldn't see me...

I'm really glad you finally found a solution that works for you. It’s also great to hear they were actually polite to you—there are still plenty of people out there who act like true professionals, and they deserve all the credit in the world!
So, does that mean the student health clinic doesn't really exist anymore?