Cannot wait until we can change insurance again

Jeni

Senior Member
So h just started his new job and we had to sign up for insurance ..... in the application they had a tool to put in your doctor and then see what plan they were on....
we put in my h cardiologist and it said X plan .... so we took that one NOW we find out nope ... not on this plan .........
furious that we took a company i personally HATE dealing with because the look up tool was Wrong..... my only solace is we only have til november to pick a different one and til january to get rid of this horrible company
 

We moved from AZ to PA in February. We are retirees and have had Humana for years with no problems with finding doctors or services while we lived in AZ.

My husband (who's 81) had a total knee replacement in August and the only issue he had was the muscles around the "new" knee would tighten up so the Ortho surgeon gave him an injection in November and it loosened those muscles and reduced the inflammation. That's lasted until recently, so I called around to local (within 50 miles) Ortho doc's here in our new town if they were in network with Humana. Nope. This is UPMC territory in PA, which we had when we lived here before going to AZ, but because it was after the "normal" enrollment period when we got to PA, we stayed with Humana.

I did find one Ortho doctor that's in network with Humana, but he won't give an injection and won't see my husband.

I was on UPMC's web the other day and talked to a Rep and told her what was going on with us. She said that UPMC has been given a 5-star rating by Medicare and that gives them certain privileges other companies don't have. One of those privileges is allowing enrollment at any time under certain circumstances. We actually fall into one of the categories and we will be switching our coverage.
 
I do use the insurance site to look up approved doctors. If my doctor's are listed, you think you are good to go. It is always a good thing to print out the info on the website and call the doctor to confirm.

I have had this happen in the past. I had the printed out information from the website, which showed the doctor in the plan. I was able to prove this and they allowed me to choose a different plan.

It is very important to keep records, printed documents, people you talked to, first, last name, date of conversation and time. If the person won't tell you this information, ask for a supervisor. Some agents will tell you yes just to process the call, they don't even check.

Most of this I learned when my husband was going through cancer treatments.
Make a file folder, get a note book and write down everything. It can be your life line when dealing with insurance.

I have even had to send a complaint to the OPM, Office of Personel Management in DC to get a resolution and they ruled in my favor. These steps will work if you keep documentation
 

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