“I’m a pretty level headed person. I’ve been following the Healthcare.gov story in the news and figured it was more of the usual partisan stupidity out of Washington. I decided to do my homework before getting too worked up.
I went on to my state exchange and compared the available plans. Gold. Silver. Bronze. All very logical. I spent some time comparing options and found a plan I liked. So far so straightforward. No complaints. No plan shortage in my state.
The problems started when I picked up the phone and attempted to communicate with a living breathing human being. I figured it would be a good idea to confirm that my OBGYN’s practice is covered. To make a long story short, I have a pretty serious pre-existing condition that could hypothetically kill me. My OBGYN is one of the best in the state. Moving to another practice is NOT AN OPTION.
Knowing how the system works, I called my OBGYN’s office and asked them to confirm that my doctor’s plan was covered. Should be a five minute call. No luck. Sorry. They don’t have the information yet. Probably yes. They helpfully suggest I give the health plan a call. Well, that’s logical, I think to myself. It takes time for new plans to about the plans to make it through the system. So I take their advice.
I call the health plan involved and politely tell them why I’m calling and what I need to know. Guess what? They don’t know either.
In fact, they don’t seem to know very much about their plans at all. And they don’t seem to care very much either. The answer is probably no. If the code isn’t listed, it doesn’t exist. I push. Okay, then. Well, the answer is probably yes. Now I’m starting to really freak out. They want to sell me a plan and they can’t tell me what I’m buying?? What the hell? The woman tells me to call the state health exchange. These plans are their responsibility.
I call the state health exchange. Surprise. Surprise.The woman I speak with doesn’t have an answer either. In fact, she doesn’t seem to understand why I need to know at all. She starts giving me attitude, then tells me to call my health plan. I am stuck in a surreal healthcare system loop. It takes no less than eight phone calls and conversations with two supervisors before I finally got a definitive answer. I can see my OBGYN. I’ve also come to a terrifying conclusion: nobody knows anything. And if I push, they say what they think I want to hear. I won’t believe that my doctor is actually part of their network until I actually submit a claim and they actually pay it.
This is not how you fix our healthcare system.”
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