retzie

My last insurer claimed not to have any information about whether doctors were accepting new patients, so things like this happened all the time. They said I had to call around their in-network list to find one who was, then call the insurer to get them added as PCP.

I believe this is an insurer/HMO issue, rather than anything to do with ACA.

OnwardandUpward

12 phone calls later- I asked where I was calling THE PHILIPINES- I'm living in Texas- still no result.

Operators keep giving me name of a doctor but none are available or like the last one a pediatric doctor etc etc.

Nightmare.

OnwardandUpward

It's a fake policy so far as I can see.

I've paid 2 months of premiums and all I can access so far is telephone numbers overseas, four of them were for weird stuff like 'take this survey' to win a holiday then if you don't you get disconnected.

It's United Healthcare Platinum policy in Texas via the government exchange.

OnwardandUpward

My son says it's got to be 'crossed wires' with a telephone answering service and to find an office to go see someone, so I googled- the closest office listed online seems to be Austin. Though I'm sure I've seen 'United Healthcare' buildings in Houston...and it being such a big city it seems unlikely there's no office here.

Do I have health insurance or not is my big question- clearly the card they sent is meaningless.

I looked online @retzie and only 7 female doctors show up in my zip code on United Healthcare list- none of them people I was referred to today. So I'm really not sure what I'm supposed to do next.

retzie

Where did you get these phone numbers? Have you received your (gigantic) welcome pack, or just the card? (The pack tends to be much slower to arrive, so don't panic if you haven't.)

The phone call issue sounds very unusual to me. Try calling the marketplace help line - if nothing else, they will be able to confirm that you have a legitimate policy, and make sure you are calling the right numbers.

Call them all directly and see if they are accepting new patients; if so, make an appointment right away. You can then call the insurer and ask for them to be made your PCP. Keep in mind that the second step only needs to happen before the actual appointment; you don't need to get this mess sorted in order to just make the appointment.

Mrs Danvers

Maybe show up at the offices? Awfully confusing situation you're describing.

As for our journey through obamacare, my daughter also got a medicaid dental insurance plan through the mail last week. Silly of me to have worried about her having to pay for the pediatric dental insurance. She has called the medicaid offices twice now to tell them she doesn't need medicaid.

OnwardandUpward

Thanks.

Just logged onto the website and the doctor PCP allocated to me has changed again, when their office opens I'll call and see if she's even taking patients.

United Healthcare number is on the back of the card Mrs D. But I think some of the times I called the call was mis-directed; it's a remote call centre in The Philipines.

I've received the 'welcome pack' and the card now, not that either is much use, the doctor on the card isn't accepting patients and the 'welcome pack' is the small print of the policy and all the exclusions, just gives website links to check out drs etc. And on each website page it reminds me it's my responsibility to check coverage as the information may be inaccurate!

I've read about other people being forced onto medicaid, it's all so crazy.

retzie

Is it a 1800 number? Perhaps something funny is going on with the exchange. Try looking on the United website for a direct (non-free) number.

It's not to say that the welcome pack is actually useful, more that it correlates with actually being enrolled in a policy!

I know all of this is very frustrating - I suggest focusing on the fact that only a primary source (doctor's office) can be trusted and working backwards from there. Now everything is open after the holiday, hopefully you can get some answers.

Hang in there

OnwardandUpward

Thanks @ retzie.

The call centre was just advertising BS- 'we're open even on public holidays. Only not really'! ( I didn't take either quiz to see if I could win a Caribbean holiday )

Latest PCP doctor- not taking patients. Called United Healthcare, 'but she's on my list'! Well you call her then- and the other 5 I've been assigned so far.

90 minutes later the rep said she had to go- but promised to keep calling the doctor offices on her list and to call me back. I had to go to work by then anyway.

Not heard from her yet and it's gone 4 pm here. Ie 6+ hours ago.

I am trying to treat it all with equanimity, and I have a throat infection now too, probably all the bloody stress, I'll just go to HEB and pay for that tomorrow.

But if this is my experience of trying to FIND a doctor- any doctor- in my locality, one of the largest cities in America with a massive medical presence here...does make me wonder which doctors I'll actually get to see.

I'm off work now for two months- I was planning to get a hernia repair operation, having no idea it would all be this bad. Been looking at doing it in England with BUPA
Self-pay costs
Prices there much cheaper and they seem to give a full price up front.

Since all referrals must go through a PCP for this insurance policy Platinum United Healthcare in Texas my considered opinion is do not buy this. I wish I'd paid extra to buy a private plan now- there are so many flaws in the reforms I don't see how they can work- the websites, the pricing, the compliance, the government trying to tell doctor businesses who they should see.

I would hope my experience is not typical- but I have yet to have someone tell me a positive Obamacare outcome...and I voted for this reform too, I'm stunned how many problems there are.

The only two good things about US healthcare were consumer choice and no waiting...it's one thing to say yes I have purchased some health insurance ( and will be fined if I don't, ironically ) but quite another to say I now have access to healthcare.

sir_eccles

This sounds like an odd situation. I would echo what someone said earlier, this is just the insurance company being a dick not necessarily the fault of the ACA. In fact I would go as far as saying that the fact that the insurance company seems to be limiting you to doctors that aren't accepting new patients is contrary to the spirit of the ACA.

Perhaps this is something you can go to your local congressman's office for help?

scrubbedexpat099

In Colorado there are Navigators to help find providers.

scrubbedexpat099

PS you have Private Insurance.

OnwardandUpward

Before the offices closed I called back United Healthcare and asked to speak to a manager and start a complaints procedure. The person who was supposed to follow up with me had not called me back.

The rep was entirely unhelpful at first, trying to call me ignorant from her attitude, she said 'don't call it Obamacare, that's why you aren't getting anywhere'! But that's what the doctor admins ask when you call in- is this an Obamacare policy and if it is they say we're not working with that.

@ Boiler I know it's technically a private policy, but it's nothing like what I've bought commercially here before. I have bought homes, cars, emigrated overseas and haven't spent so much time on it as this. I've never had so many issues to buy anything in America. I've spent literally weeks on it already.

Anyway, the plot thickens ( it's all starting to feel like a really long-winded and boring PBS drama ) when I insisted that yes of course your company has a complaints procedure, yes of course they have to comply with federal regulations,no you can't force a doctor to see a patient etc etc the next thing is I was offered my old doctor- she wasn't even on the list online, and how the insurance company knows I've seen her God only knows- I was self-pay all that time and can't think I've done anything official via her....but the lady changed her tone ( I actually think it was a different rep ) and said what about this? and offered me my old doctor.

Her office was closed by this time so I'll call today, I'll be very pleased if I can see her, she's an immigrant like me and she worked with me to the best of her ability given I just could not have most of the tests I need. Everything just escalated too expensive.

I think she would love to treat me and get my health problems fixed.
Last time I went to see her she was very concerned and told me I had a heart irregularity on top of everything else.

I just logged online and she's now listed as my PCP, so I called- and have an appointment next Tuesday!

She's my favourite doctor locally, she really tried to help me as far as possible when I wasn't covered, and of course she's the doctor who knows most about what's wrong with me.

I don't know what the hell is going on with the ACA, but for now I am just going to take care of myself.

scrubbedexpat099

As has been discussed before one maybe the only cost control measure is that these policies have lower reimbursement rates. So if a Doctor only has limited capacity for new customers they are not that attractive.

OnwardandUpward

@ Boiler thought's why I bought Platinum...and frankly I don't see any difficulty with it. They made me pay two months up front.

It's been a long time since I took on the government, but I've got two months off work now with nothing better to do...

I'm really not a political crusader on the whole but the last time I did was when I lost a baby second trimester, you can't imagine what a difficult experience, I was in a NHS hospital in the UK, having been told I needed an operation within a few hours.

I was on a ward with women on heart monitors, and then the person in the next bed was from Pakistan, spoke no English, a translator was brought in, and basically what I was listening to was the description of her family performing a home abortion because the child was the wrong sex. This went wrong and lead to an emergency situation for the lady.

I was married back then and we both wrote and insisted on better services- and a local hospital was opened.

But I refuse to let this go. I'm going to look for a lawyer. I have been disgusted with the President for a long time, he thinks he's so bloody clever.