Now I know why. Because even if you do have a job, even if you do have "health insurance", it doesn't really mean anything.
When I graduated college, I was no longer a full time student, which meant that I could not be covered under my parents' health insurance plan (at least, not without paying more). Since I started a full time job, I was offered various health insurance packages by my employer. I did not foresee myself requiring extensive health coverage, so I selected the cheapest insurance plan offered. From my start date all the way up till now, I have not needed to use my health insurance for anything.
However, in order to matriculate into school this coming fall, I needed to have a physical examination to indicate a most updated status of my health, as well as my immunization records. Before, I always went to my primary care physician (PCP) under my parents' insurance plan for a physical. We call, we make an appointment, I go and I get asked some questions while they check my blood pressure and what not, and then I leave with a nicely signed form indicating that I am healthy. Because I switched insurance plans after starting a job, I could no longer see that PCP and had to find a new one which was within my insurance plan's network. No problem, right? I'll just call the company and ask them for a list of physicians that are in their network.
I call Blue Cross Blue Shield (BCBS) and I ask them, how do I find a PCP? They give me the link to their website and directions on the search function. I ask them, which plan am I considered under? My card says Blue Plan Choice 2, which is not one of the options in the drop-down menu on the website. They tell me that it's considered an HMO Blue plan, and I should find PCPs that accept HMO Blue.
I follow their directions and the website spits out a list of PCPs in my area. I look under the ones that says "Accepting New Patients" and I start calling. There are a bunch in the hospital that I work in, so I'm pretty pleased because then I won't have to travel very far for my appointment. I call the first name on the list. What's that? Not accepting new patients? But the website says... oh, okay then. Thanks for your help.
Call the next number. Hi, is Dr So-and-so accepting new patients? No? You can transfer me to the Internal Medicine department? Sure, that'd be great, thanks!
Hi, I was wondering if I could schedule an appointment for a physical? Oh, you're not taking new patients? Is anyone taking new patients? None of the attendings are taking new patients... The only people taking new patients are residents and they don't accept my health insurance.
Oh.
This happens for 2 other hospitals on the list that the website gives me.
Finally, I get through to another hospital that is a bit further away but still reasonable. They schedule me an appointment with a doctor. I ask the receptionist, "Does Dr. Blah blah accept HMO Blue?" and she responds "Yes."
FANTASTIC. Even though the website is extremely misleading and out of date, I've found myself an appointment!
I call BCBS back and let them know excitedly, I've found a PCP! Please update my information! They ask me the name of the physician, and when I tell them, they say "Oh, I'm sorry, Dr. Blah blah is not in our network. So we can't cover the cost of your physical."
WHAT.
I tell them the situation. I told them that their website was completely useless and not helpful, and that the receptionist at Dr. Blah blah's office told me they accepted HMO Blue. Her response was, "Sorry, she's not in our system so regardless of what they said, we can't cover this appointment."
Fine, I tell her. Then how about you give me a list of doctors in your network that I can see. So she does. I get a list of 7 doctors around the area who are supposedly taking new patients. So I start calling.
First number on the list: "I'm sorry, this number is no longer in service --"
Okay... (insert annoyed face)
Second number on the list: "I'm sorry, Dr. XYZ is not taking new patients at this time."
Third and fourth number on the list: See response for above.
I'm getting pretty desperate now. I ask the receptionist if there's any way they could just fit me in for one appointment. I wouldn't be coming back for any more. I just need this one physical to go to school. The receptionist laughs at me. "Who takes one-time patients? No one does that!"
Sigh. You have an appointment open. You told me so before I told you I was a new patient. Why can't I just have that appointment and be done with this? You'll never have to see me again!
Finally, I call the last number on the list. Dr. ABC is taking new patients and has an opening for a date that is before I leave the country for the summer. I take the appointment. I'm incredibly relieved. I call to cancel my old appointment and thankfully they don't charge me a cancellation fee. I call the insurance company to update my PCP information and they say everything checks out, she's in the network and the give me the OK. The woman on the phone, who is very nice, asks, "Is there anything else I can help you with today, ma'am?"
I said, "Yeah, actually. How do I lodge a complaint? Not with you! But I've had some issues with the system."
She actually sounds apologetic as I explain to her the situation, and very nicely replies, "I'm sorry for the inconvenience. Unfortunately, we are not responsible for updating the physician contact information. The physician has to update that as well as their status on accepting new patients. We actually don't have any control over what their information is listed as on the website."
Okay, fine, that's not their fault. How about when they told me I'm HMO Blue, and my first PCP said she accepts HMO Blue, but they won't cover me? Is it because I have some limited form of HMO Blue?
"No... I've never heard of something like this happening. Usually physicians are pretty good with knowing which insurance plans they accept."
Basically, if I really wanted to lodge a complaint, I'd have to contact every single one of those physicians and ask them why they won't update their status or get their insurance plans right.
What a waste of time.
Why won't anyone take responsibility for this extremely inefficient system? In the end, it's the patient who is getting the shaft and there is nothing being done to correct this. Let's not even talk about the quality of health care being given out right now, let's talk about whether or not this health care is even accessible. How about improving the access to care even for those who are already insured?
Do I really have a right to complain though? In this society, what you pay for is what you get. I chose the cheapest option so I get the lowest quality care. If I didn't need this physical, I probably wouldn't bother with getting health insurance at all. It's more of a headache to use it than to not. Is this how universal health care is going to be like? If we're getting plans where no one is held liable for anything, then why bother getting the plan at all.
I guess it will be interesting to see this from another perspective in a few years. In the mean time, I'm happy with finally getting what I was looking for, but I'm going to remember this when I enter the field as a health care professional. And I hope I'll never be responsible for putting any of my patients through something like this because I personally understand how much this situation sucks.
