I'm about due for another colonoscopy, sigh.

Oof, no fun. Hope it goes as well as possible!

They've all been clean so far, thank goodness.

We got our eyebrows waxed! Ranks up there with haircuts in this household.

Manicures are essential to my well-being, so I completely understand!

Out of interest (this is genuine - I'm worried it'll seem sarcastic and it's not meant to).... how do you just DO all of those things? Like, would your insurance cover it? I mean, could you just decide you'd like a "routine heart health check" without pre-existing knowledge of a heart problem?Or do you pay out of pocket?

X's company offers several very good insurance plans and we pay the higher price for the best of the lot, so I can in fact see any specialist who takes my insurance (which a great many of them do), no referral or anything needed, for a $35 fee. When I went to my shoulder specialist and mentioned I was having back issues, he recommended a spinal specialist and I simply called up and made an appointment.

Sometimes more paperwork is needed; for example, insurance generally won't cover physical therapy unless it's prescribed for a diagnosed condition, so every six months I have to get my doctor to put a new prescription on file with both the PT office and my insurance company. The spinal specialist wanted me to get an MRI, and insurance makes you get an X-ray first before they'll cover the MRI, just in case the X-ray provides sufficient information that the more expensive MRI isn't needed. But when you pay for these high-end plans, a lot of what you're paying for is not needing to jump through hoops, so mostly it just works.

If I want to see a doctor or get a test and my insurance won't cover it, I can pay out of pocket. That's what I do with my therapist; insurance payments for psychotherapy are so stingy that very few therapists take insurance at all. I submit receipts to my insurance company and get reimbursed the amount of that stingy payment.

I'm not seeing all the listed doctors there—that's a combined list for all four of us. But I am seeing nine or ten of them, so I'm glad I can do it without much hassle!

This is really interesting, thank you!

On the NHS here, you’d have to persuade a GP to refer you and then wait ages, but it would be free, but you’d get whatever was felt to be the most cost-effective way of doing it. Not knocking the NHS, obviously. Weirdly, I do now have private health insurance via my wife, but am nervous about using it in case something goes wrong and we end up having to pay because I made a paperwork mistake.

How does it work once you have a relationship with a specialist? Like, once you've been referred to a dermatologist once, can you see them for annual skin screenings without being re-referred?

Ooh, interesting. It depends who thinks you need an annual screening. Usually, unless there is a particular problem or risk of problem that means the NHS guidelines agree you need an annual check, then no. Say you had a Weird Mole, and your GP agreed you should be referred, and the dermatologist guy was like “I’m fine with how this mole is but I’d like to see you again in 6 months to see if it’s changed”, then his secretary would book you in for 6 months. If there was felt to be an ongoing need, then that might keep happening. If, however, he said “yeah, that IS a weird mole”, you’d have the appointments relevant to that, as an outpatient in his clinic (his “clinic” being the days of the week in which he sees Weird Mole patients in the relevant department of the hospital, not like his own clinic unless he’s private), eg consultation, whipping it off, and follow up. And if he’s satisfied that eg the mole is off and it’s fine, you’d be discharged from his clinic and if you then felt - perfectly reasonably - that you’d like all your moles looked at by him annually, you’d still need to go back through your GP (who would need to think they looked sufficiently weird for a specialist to look at them). You could pay out of pocket to see him whenever you liked, if he also did private work.

Equally, tbh, this would be true of my health insurance. I need a GP’s referral usually to indicate that something is necessary and then the insurance will pay up. I THINK. But I’m an insurance novice.

That's a lot of appointments!

I need to book eye tests and dental for me and the kids (opticians are open but our closest one closed down), have a massage next Wednesday, and may chase more physio if actually doing the exercises I have doesn't help me or in particular Conflux.

Thankfully other appts have worked quite well via phone (child mental health services have embraced phone and video appts, as have the sleep clinic).

And even more thankfully, my AZ vaccine appears to have fixed my long Covid. So the chest Xray I had on the same day was a bit redundant, though always good to know my lungs work.

Oh WOW! You rather buried the lede there! That's fantastic news!