Guaranteed Healthcare

In 2008 I took a new position, which led to switching to a new health insurance provider, Health Net. Right away I had some disagreements with them over coverage, as they refused to pay for a yellow fever vaccine when I traveled to Ecuador (required to enter the country). They cited the fact that the shot was not administered in my PCP's office - um, it CAN'T be, CDC regulations restrict yellow fever vaccinations to CDC approved sites, such as the one to which my PCP had refered me (the only one in our county). Health Net didn't care, claim denied.

Over the next 2.5 years, the small office for which I work changed health plans three times, eventually landing back with Health Net. I requested the physician I'd had since first enrolling with Health Net in 2008, a physician who'd been accepted by each insurance company since. Health Net denied him as my PCP, saying that he was 'not accepting new patients' - never mind that I was a continuing patient & had initially gone to him through them. Rather than consulting me about a second choice of PCP, they then assigned me one - in another town 20 miles away. I rely on public transit, & have no car. Was the message here that I was not meant to access care? Hmmm.

I contacted Health Net & informed them that this PCP was unacceptable. They said I could request a change of PCP, but that it would take 6 weeks to process, & any appointments I needed in the meantime would have to be through the assigned PCP in the town 20 miles away. I went on their website, where they have a convenient tool to see a map of PCPs accepting new patients in your area. I found a number of PCPs shown there within 10 minutes walk of my address, which they of course have on file. Hmmm.

Using this information from their website I selected a new PCP & submitted the change request. 6 weeks later I received my new card w/ the new PCP. I then called that office for an appointment - imagine my surprise when I was informed this doctor had RETIRED. Um... hmmm. At this point I tried going through our insurance broker. She sent me a list of PCPs from Health Net - the list included both the retired doctor & my old doctor whom they'd denied because he supposedly wouldn't take 'new' clients! I then contacted the old doctor, got them to schedule an appointment (thus reactivating my file in their records system), & have informed Health Net that this physician recognizes me as a continuing patient. I'm currently in the process of getting Healh Net to (re)approve him as my PCP. Fingers crossed!