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Wednesday, November, 25, 2009
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Stupid Health Insurance

jwalton

jwalton

Wednesday, December 05, 2007
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Hi Everybody.  I just felt the need to vent my feelings about stupid health insurance.  I just switched from a PPO to an HMO because I couldn't afford the PPO anymore because the rates keep going up.  Now I have to change doctors because mine are not in the HMO network.  I'...
  1. Untitled Comment
    Sherry
    Thursday, December 06, 2007 at 05:32 PM

    I'm so sorry, I hope you find a good doctor.

     

    I've had great health Ins. all my life but last Feb. I lost my Ins. because of divorce.  I can't afford any of these outrageous cost.  I've tried so many things and each keeps failing.  I'm paying out-of-pocket for my doctors and medician.  Thank God for Walmart generic prescriptions!  I never thought I'd be in this kind of shape.  It's scary!  This is a big reason why I've been so depressed!

     

    Hugs,

     

    Sherry

    Reply
  2. Check-in with your new HMO
    Kimberly Tyler
    Tuesday, December 11, 2007 at 01:12 AM

    Dear jwalton,

     

    Changing up insurance from a PPO to an HMO is difficult if your doctors are not considered "in network."

     

    One thing to try is to contact your HMO (your direct care management provider who handles all your claims) and explain the situation to him/her.  There may be a way for you to stay with your current therapist given your diagnosis and improvements with this particular therapist.  It may mean having to pay a bit more out of pocket, and a letter may need to be written by your current therapist for why changing therapists is NOT good for your heath right now and explain out the benefits (keeping costs down) with your current therapist (as trying to find a good match, less gained from therapy, etc.) will only create more money for the HMO to pay out in the end.

     

    I know it will be a drag, but it is worth the effort to give it a try.

     

    Let us know if this works for you or the type of issues you may or may not encounter as many find ourselves in similar situations.

     

    Best,

    Kimberly Tyler

    Reply
    re: Check-in with your new HMO
    jwalton
    Sunday, December 16, 2007 at 08:53 PM
    Thanks for your reply.  I already tried all the things you suggested and the HMO said absolutely NO.  It's because my HMO is for Maryland only, since my husband works in Maryland.  But we live in Pennsylvania and my doctors are here.  The only option they gave is to switch to an opt-out plan, which costs more, and we couldn't even do that until open enrollment, which is months away.  Unfortunately, we were led to believe when we enrolled that the plan would cover a limited number of providers in PA, then we found out it covers none.  So we switched so we could save money and it created this horrible mess.
    Reply
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