Stupid Health Insurance

By 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've been seeing the same therapist for almost ten years and I really like her and now I have to find a new one. I just don't need this aggravation on top of dealing with depression and anxiety. If anyone has any advice I'd really appreciate it.

Comments (3) | Add comment

Sherry

12/ 6/07 5:32pm

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

Kimberly Tyler, Health Guide

12/11/07 1:12am

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

jwalton

12/16/07 8:53pm

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.

Stupid Health Insurance

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