Health Insurance: How do you know what you are really buying

[wompo]

Here in Nevada we can browse the new plans for 2021 and we have a couple new providers to choose from. My current BC/BS plan is increasing 100.00 per month and 400.00 increase to OOP and Deductible.



While looking at the list of providers I see that BC/BS is still listing doctors that do not take their plans as I know since I tried to use them this year. I can look at providers for various things I think I might need but how do I know if they really take my insurance. As an example last year I called before getting BC/BS and the doctors office said they would accept the insurance, but when I actually had the policy number and tried to schedule they then said they did not accept and I had to find new doctor.



My question is how can you compare plans if you can not really know if the doctors listed will actually take the insurance you buy until you have the actual plan and try to use it? This seems like a bait and switch by the insurance companies with no penalties on them that I know of. Just list highly rated doctors to lure people in then not provide them.

[Aerides]

I have not had your experience - any docs on the list have always accepted me (you do want to make sure they say, yes, to new patients, which is different than just accepting the plan.) Both data points are usually front and center on their provider info.

Personally, if I was looking at a plan and it said Dr. Smith is accepting new patients, and, when trying to make an appointment was told No, I'd call BCBS and get them to help. If there are some you are shopping now for consideration for 2021, I'd probably call them directly and ask, but know that a lot changes from year to year.

In any case, I don't think the bait and switch is so much on the part of the insurer, as the provider.

[MrsHaloFIRE]

I had identical prob with dental insurance. Triple checked. Showed up. No we font take it. Out if picket higher with the insurance than just paying cash. I absolutely showed my butt and told them I refused to pay more than the cash price and they finally relented.

A previous dentist would not decide what plans they would acceptuntil after our open enrollment pd when they could see the reimbursement rates. Tail wagging the dog

Quote:

Originally Posted by wompo Here in Nevada we can browse the new plans for 2021 and we have a couple new providers to choose from. My current BC/BS plan is increasing 100.00 per month and 400.00 increase to OOP and Deductible. While looking at the list of providers I see that BC/BS is still listing doctors that do not take their plans as I know since I tried to use them this year. I can look at providers for various things I think I might need but how do I know if they really take my insurance. As an example last year I called before getting BC/BS and the doctors office said they would accept the insurance, but when I actually had the policy number and tried to schedule they then said they did not accept and I had to find new doctor. My question is how can you compare plans if you can not really know if the doctors listed will actually take the insurance you buy until you have the actual plan and try to use it? This seems like a bait and switch by the insurance companies with no penalties on them that I know of. Just list highly rated doctors to lure people in then not provide them.

[wompo]

Just had a second Dr Office cancel an appointment today. Had appointment next week that I scheduled a couple weeks ago and they called today telling me that they don’t take my insurance after all and my appointment is canceled.

I called my insurance company and they said they would call me back by Monday with an answer why and another Dr I can call if first Dr doesn’t really take it. Of course the dr I scheduled is the only one in plan with good reviews. 900.00 a month for this?

[PaunchyPirate]

I’m not a BC/BS customer, so I’m not saying this from personal experience... but on the Highmark BC/BS website for Western PA where I am from, before you can search for a particular Doctor, you have to pick a specific name/type of policy you would be using. It’s not as easy as just saying the doctor accepts BC/BS. There are policies like MyBlue, MyBlue Access, MyDirect Blue, ThisBlue, ThatBlue, BetterBlue, etc. there must be at least 50 different plan types and I found that some doctors would show up under one plan, but not the other. Hugely difficult to figure their network. This is a reason why I went with their competitor. The competitor didn’t have such complicated distinctions.

I went to the website of one of my doctors and they simply list BC/BS as an accepted insurance. But they aren’t in all of the plans network. Frustrating.

[RobbieB]

Maybe the doctors on the list no longer want to deal with the insurance co, but the insurance co still lists them?

They cancelled but the company didn't?

Good luck!

[wompo]

The insurance company thinks they have a contract with the provider but the provider won’t accept the insurance. I called insurance and they checked and don’t know why provider canceled. Hopefully they will call me back by Monday with a resolution which will most likely be finding a new doctor.

Reason I was upset was I already called provider couple weeks ago and had an appointment for next week and then they canceled this week. Maybe provider just decided they did not like the rates. The person who called me was not very nice either, when I tried to ask why canceled after scheduling just said we don’t accept your insurance and hung up.