Central PA, Pennie.com, ACA insurance. problem

[EastWest Gal]

This is an informational message for those on the ACA in Pennsylvania.

I think I uncovered a problem that is not the exchange's fault, but the fault of Highmark insurance company. The list of in-network doctors and hospitals they provided to Pennie.com is incorrect. If you are looking at a Highmark plan, call the company and check their list. Even their own worker had trouble accessing a correct list, and when I stated it was impossible that their list did not include 3 major central PA hospital networks, the person on the phone struggled to find a correct answer, then looked on a different page on her own work website and found that all our local hospital systems and their doctors are in network.

So you may need to check with the insurance company and not take what they say initially at face value. Also, some of the Highmark plans do have a very limited network, beware.

 

[PaunchyPirate]

I decided pretty early that I don't trust the site's ability to work with the doctors or prescription info. But I also felt the same way using the federal healthcare.gov site. I just skip those two inputs during the search for plans. Then I click on the plan details link and then link out directly to the insurance company's own website to search for my doctors and to use their formulary to look for my prescriptions.

Highmark BCBS's provider database is a huge mess. Even on their own website. So I can see how pennie.com doesn't deal with it well. Highmark has marketed so many different categories of plans through the years that they still maintain that makes it a huge nightmare to try and figure out what doctors are in YOUR network.

Frankly, Highmark's website complexity is one of the reasons why I chose to go with their competitor in my county. Not the only reason, but it certainly was a consideration.

 

[jetpack]

I had the same issue and more. I have picked a plan and paid the initial month, but it's still listed as pending 3 weeks later. How do I make sure it went through?

 

[PaunchyPirate]

I had the same issue and more. I have picked a plan and paid the initial month, but it's still listed as pending 3 weeks later. How do I make sure it went through?

I’ve not had that issue as mine was carried over as-is from the Federal exchange. Mine was already “Complete” when I first signed in to Pennie. I didn’t need to change anything so it never left that status. I would call the help line just to be certain.