Will Humana Have a Heart?

[FLM2]

This is the POS network.

As for the gentleman that told me that this is what I deserve when I try to find the cheapest plan around. I made sure that doctors and hospitals were in network.

I know that you are well versed in Florida. Do you happen to have a license in Georgia?

The pediatrician and primary doctor for the father were both in Humana. Here, in the Metro Atlanta area, most insurance providers - Humana, BCBSGa, Coventry - have a pretty robust network. If you were to go to Healthgrades > Find a Doctor | Doctor Reviews | Hospital Ratings you would see what I mean.

The same holds true for hospitals. In this case CHOA, Egleston, Northside and Emory St. Joes.

That is why I, specifically, asked for feedback from Georgia agents, who are familiar with the Atlanta area, and may have come across this situation.

While it appears that you know the Florida market, and I think that's just peachy, do you also hold a Georgia license, and work the Metro Atlanta area? If so, is Wegener's one of the diseases you routinely ask about?

Thank you, though, for your response. Due diligence is definitely needed, even in this ACA environment.

I have a Georgia license and have about 50 clients, mostly in the Atlanta area, they are divided among the Coventry One, Aetna, Golden Rule, and Humana National POS network. Most of my Humana clients have been with them for several years and my reluctance to offer Humana has really accelerated with all of their hospital losses in Florida over the past two years so it is a recent reluctance.

I never heard of Wegener's before your posting today.

I never thought that a health plan could get away without having any facility that treats a disease, my thought was that if I was diagnosed with a serious disease I would want access to the best hospital rather than the one or two offered by a lesser network and want my clients to have the same choices. So I apologize for making a somewhat off topic response, it was not my intent.

I decided that if my Off Exchange clients were going to pay the very high premiums for these plans they should always have the major national hospitals in network. In the case of Wegener's, both Johns Hopkins and Mayo Clinic, two of my 3 reference hospitals for determining strength of network, are listed as specializing in the treatment of this disease.

I wasn't trying to blame you for this, just pointing out the steps I've taken to offer the most comprehensive network for my clients so the chance of these types of events is minimized-I hope Humana steps up and covers this, I don't see how they can deny a claim if they don't offer any in-network facility for treatment.

 

[Bob_The_Insurance_Guy]

My post was not intended to be defensive. This goes to show that, no matter how much due diligence you do up front, these plans can kick you in the butt when something like this happens.

And, I do thank you for your response.

I did my homework up front. That's why I chose Humana over BCBSGa and Coventry. Sadly enough, if they would have selected Kaiser Permanente, it would have been covered in the KP network. That being said, it is very difficult getting those who don't like KP to enroll in KP.

#1, I agree with you. I should have not mentioned the Evil Empire in the same conversation as the rest.