So let me see if I've got this straight...

[OwnedByCats]

488. Well

Last edited Fri Mar 21, 2014, 03:19 PM - Edit history (1)

My dad is in a similar situation. He signed up back in October for a plan on the exchange. He chose a company that he was familiar with in the past that he had before, a company he knew his hospital took, and to be honest, the only company that offered him a plan he could afford. My dad has various issues - arthritis that is now bone on bone pain in his hip, heart condition, diabetes and a very nasty infection on his leg. He was seeing various doctors at this hospital, after he was told they took his insurance.

The insurance company messed up. They didn't put on his insurance card what his plan was, ei. silver, gold, platinum, so the hospital thought they took it. Then we find out they don't take it. Turns out this hospital has discriminated against plans bought on the exchange. They take employee plans from this company, but not ones bought on the exchange, so after he had several appointments, he then found out the ins will cover none of them. He has had to change his hospital and all his doctors.

This would be ok, a pain, but not the end of the world - except for one thing. My dad was going to a specialist in this hospital for the leg infection. No other specialist for this within a reasonable driving distance (under 400 miles) takes his insurance. These appointments are expensive and he can't afford to pay them outright. My dad cannot travel hundreds of miles away. So he's basically uninsured for this problem. His PCP is not prepared to treat this infection. I'm scared he's going to lose his leg.

Everybody can say all they want that these things should have been checked. Back in Oct nobody knew his hospital would not take the exchange plan, that was never even known about at the time. He chose the one he could afford, the one he knew his hospital had taken forever upon their insistence that they took it - even back when he had a policy with them through his employer. What he didn't foresee, was that this hospital decided at some point the exchange plan was not good enough for them to accept. Luckily though, next year he'll get Medicare - I just hope he can keep his leg long enough.

So I see all kinds of red tape. If it's not your insurance company trying to get out of paying up in their various ways, it's a bitch to find doctors accepting your insurance AND taking new patients, or the clinic or hospital takes it, but their doctors don't, or you simply can't find a specialist in your area that takes the insurance. It's made so complicated that it's just insane.

I wanted single payer so of course I'm already disgruntled.


Edited to add: I did find out today that the hospital that took the insurance but the doctors did not for his leg infection, after some digging he was able to find one that does. Had to do that extra digging but at least we found one. He has to wait a couple weeks for an appointment, but that's better than having to wait a year from now.

Gosh, this stuff shouldn't be so hard