An Affordable Nightmare

I’ve basically not worked this week.

I’m having some issues related to my condition that have been tough. Since May 2013, I’d been taking Tecfidera. No real concern, though, as my neurologist was thinking about switching me to one of the infusion medications.

Last fall, I didn’t enroll in my company’s HMO offerings for a variety of reasons. Naturally, just after the open enrollment period, we received notice our private policy wouldn’t be offered for 2015. Somewhat reluctantly, my wife and I chose a plan offered on the Federal Exchange with a company we’d previously used (and had difficulties with).

We went with the plan largely because we knew that the specialists I’d been seeing accepted it.

My wife saw her PCP last week on the new insurance without any problems.

This week, I had two appointments with specialists scheduled. One of them was with the neurologist who’d been treating my MS since just after diagnosis, the other with a specialist I’d been seeing on referral from the neurologist (albeit, this time to address a problem discovered in a routine test as my PCP; since there was an existing relationship, I figured I’d let them handle it). Friday, tomorrow, I had an appointment scheduled with my neurologist to discuss changes in my treatment.

I saw specialist two late last year. He wanted to run some tests, but agreed it’d probably be better to wait until my new policy started.

Early in the week, I got a call from the second specialist saying they didn’t have my insurance information. Since I didn’t have my card on me at the moment (I’d given it to my wife when she went to pick up a prescription for me), I told the caller the company, and that I’d bring my card with my for my appointment on Wednesday.

So, yesterday we set out to my appointment. After someone rudely cut in front of us, we finally got to the check-in. Hand over my card. Paraphrasing —
“Did you get this from the Exchange?”
“Yes. The woman I spoke to said that you accept this company.”
“We do, but not the plans from the exchange.”

After a bit of back-and-forth about the cost of the appointment as an out-of-network patient, we left.

My wife reminded me that I should call my neurologist, with whom I had an appointment scheduled Friday. They don’t accept the exchange program, either.

Later that afternoon, while looking for replacement specialists on the insurer’s site, I found a doctor at my neurologist’s practice listed. Again, paraphrasing —

“Which doctor?”
“Dr. S.K.”
“Please hold….” “Sir, we don’t accept that insurance at all.”

So, cancel that appointment, too, and see the PCP Friday to get referrals to new specialists.

Meanwhile, I can’t work, and none of my conditions is being treated.

A big “thank you” to the politicians responsible for this.