Community Chat

[Mindy D]

I was looking at my current plan and other plans from my plan provider. I've been looking for a dermatologist and I chose two that I'm interested in. Both showed up in my plan and the other plans I checked about for 2021. The two doctors were also profiled on internet sites which also listed my current and 2021's healthcare plans as a plan they both take. These doctors have no affiliation with each other. When I called the offices of both doctors I was told that they only took the PPO from my plan provider. One office said that they have made repeated attempts, by phone and writing to get the plan's information corrected to no avail. So, if you are choosing a new plan and a particular physician is important to you, call that doctor's office to verify they will be with your plan. Check first. 

[Annabellethecat66]

I have an insurance agent.  I've been with him for a long time.

I give him a list of my medicine and Drs and he puts them in the computer and out spouts out a few to choose from.

From there he delves further into each of them.

It doesn't cost me a penny.  I assume he gets money from the companies.

Sometimes he suggests insurance companies he doesn't even represent.  

He's very honest.  I go over to his house, fill out the papers, write a check so it is automatic withdrawl.

I have a few medicines I must have.  I always tell him they are the most important.

The prices through the years vary.  I saw where pressure is being put on these places that make the medicine for us to pay whatever Canada and Europe pays (which is always cheaper than US) for us to pay.

It's supposed to take place in a few months I believe.

[noodleann]

Great advice, @Mindy D . I've always known there can be changes throughout the year, but to have critical information like providers wrong in the open season decision-making data for consumers is scary. We should get a second shot at a provider in such cases, IMO. Never happen, but they could penalize the insurers who are providing bad info--unless it's the information sources (websites) failing to correct their databases.

Perhaps it's not a bad idea to double-check lists of maintenance medications if they're expensive, too, to make sure they're not listed as covered when not, or are a different tier, etc.

Caveat emptor.

[Mom2Dogs]

@Annabellethecat66 ....I handle my drug and health plan in the same manner.  It's very easy and convienent to sit with the agent in my home with no pressure.

[Cakers3]

@Mindy D   Do you have a PCP?   If so, let him/her make the recommendation(s).

Our PCP makes referrals because he knows the doctors/specialists and he knows who is in-network.  We have never had a bad experience with anyone he recommends.

Often the appt. is made while we are there or if the doctor/specialist calls they verify the insurance anyway.

Just a suggestion that always works for us. 

[Annabellethecat66]

@Mom2Dogs Yes, I don't think a lot of people understand just how easy it is to go with a good honest agent.

They know how to weave in and out of these plans.  Some are trickier and others.

I call it 'double-speak'.

[ECBG]

Thank goodness as a former state employee, I'm on their plan.  We have a giant bargaining chip.

[SilleeMee]

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@ECBG wrote:

Thank goodness as a former state employee, I'm on their plan.  We have a giant bargaining chip.

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Me, too. But we have only 4 plans to choose from...all very good ones I might add.

[Cats3000]

We're very, very lucky.  We're on Medicare and Medigap policies.  We get all of our healthcare (except dental) through a major medical center.  All providers (primary care and specialists) there are covered.

[goldensrbest]

I find this insurance discussions, so very confusing.