Looking for help on what to do if all rheumatologist offices in the area are out of network.

I am being referred to a rheumatologist for positive ANA, chronic joint pain and swelling. When I looked up rheumatologists in my area through my insurance (Molina marketplace), there is only one option in my city, and a few more over an hour away.

I called the one in my city, but they aren’t accepting patients for over a year (or potentially ever again?), and my GP said the rheumatologist is retiring or moving, so I need to look for a different one.

It seems kind of stupid that I would have to travel an hour and a half to go to a specialist, so my question is if there is any other option. I don’t live in a rural area or anything, there are at least ten out of network rheumatologist offices within 30 miles. I don’t have much experience with insurance, so I don’t know if there’s some way to negotiate with the insurance company about what offices or prescriptions they will cover.

TLDR: there are no in network rheumatologist appointments in my city for at least year, maybe longer. If I call my insurance company (Molina marketplace) is there something I can ask them to do? Or am I just SOL?

Thank you

submitted by /u/Entropical-island
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I am being referred to a rheumatologist for positive ANA, chronic joint pain and swelling. When I looked up rheumatologists in my area through my insurance (Molina marketplace), there is only one option in my city, and a few more over an hour away. I called the one in my city, but they aren’t accepting patients for over a year (or potentially ever again?), and my GP said the rheumatologist is retiring or moving, so I need to look for a different one. It seems kind of stupid that I would have to travel an hour and a half to go to a specialist, so my question is if there is any other option. I don’t live in a rural area or anything, there are at least ten out of network rheumatologist offices within 30 miles. I don’t have much experience with insurance, so I don’t know if there’s some way to negotiate with the insurance company about what offices or prescriptions they will cover. TLDR: there are no in network rheumatologist appointments in my city for at least year, maybe longer. If I call my insurance company (Molina marketplace) is there something I can ask them to do? Or am I just SOL? Thank you
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