Can anything be done if no reasonable in network available?

[vic120]

Got messed up this year I buy a BC HSA off exchange each year but I check the other plans,

This past year after checking the other plans I found as unusual the BC HSA best fit my needs, So I went to the HSA and purchased

Only later to find out the began a second HSA this year with a lesser network, same deductible same coinsurance same everything except one is the S network which I always had and the other is the L network

So I ended up in the wrong network, SO I my wife and I lost Docs Ok, My special needs son still had his therapy Ok

But there is the issue now, My son needs a surgery, He is special needs Non verbal and a flight risk, He has to stay overnight which is scary being a flight risk as he is

So originally the surgery was set for children's hospital but they canceled due to not in network

Was going to get in another hospital but they called back and cancelled because they are not equips and don't have pediatrics, His Doc checked into network and said there is NO pediatric hospital in network

so far the insurance company is no help at all

But isn't the Ins company supposed to provide and in network option or cover out of network as in network if there is no in network option available?


Another thing as a side not I don't understand My insurance card says PPO but they say it means something else not preferred provider and its actually and HMO, I forget what baloney they said PPO meant but don't get that either

 

[somarco]

My insurance card says PPO but they say it means something else not preferred provider and its actually and HMO, I forget what baloney they said PPO meant but don't get that either

PPO Select, perhaps?

 

[vic120]

PPO Select, perhaps?

No I forget now what it was went through it a few months ago on the PPO thing

It was something that had nothing to do with network though it was shocking

 

[vic120]

PPO Select, perhaps?

They were very clear it was HMO

To be fair I didn't expect it to be PPO when I signed, I always thought it was a network plan just didn't realize it was going to be a different network

I didn't even notice it till I had got turned down at my docs office few months ago and I was looking at my card and it said PPO on it, That's when I called

But they said that its not a network designation it meant something else I forgot what it was because I was frustrated with the situation in general

 

[somarco]

Very few docs participate in MAPD HMO plans. As you know, the MAPD market is not my gig, I doubt you can change anything at this point. Too bad you didn't know this during the Jan - Mar open enrollment.

 

[vic120]

Very few docs participate in MAPD HMO plans. As you know, the MAPD market is not my gig, I doubt you can change anything at this point. Too bad you didn't know this during the Jan - Mar open enrollment.

Oh its not medicare its my own ACA HSA plan

The network that is supposed to be on my plan is good they just created an identical plan with crap network this year in addition to the original, I accidently enrolled into instead of the correct network

 

[goillini52]

Oh its not medicare its my own ACA HSA plan

The network that is supposed to be on my plan is good they just created an identical plan with crap network this year in addition to the original, I accidently enrolled into instead of the correct network

Can you call the Marketplace and explain the situation, and see if they'll let you switch?

 

[jdhealthylife]

What state are you from?

 

[vic120]

Can you call the Marketplace and explain the situation, and see if they'll let you switch?

I already did that when I got turned down from my docs offcie few months ago I may try again now with this situation with me son though

Working on a network extension appeal form from ins co now though got this today

 

[vic120]

What state are you from?

TN