Hi all. I’m in Texas and have a Marketplace plan with a low maximum OOP in-network and no coverage out-of-network. Last week I went to the ER because I was experiencing extreme shortness of breath, and ended up being admitted to the hospital with a pulmonary embolism (blood clots in my lungs). I made sure the ER and hospital were both in-network with my insurance. I was in the hospital for five days, during which time I was seen by a few specialists, including a pulmonologist and a hematologist, who told me I’d need to be on blood thinners for at least three months (to prevent new clots from forming), and would need to follow up with the pulmonologist pretty regularly for a while. I was discharged a few days ago with an Rx for a 30-day supply of the blood thinners I have to take, and instructions to schedule a follow-up appointment with the pulmonologist in two weeks.
Well, I called to schedule my appointment, and was informed the pulmonologist doesn’t accept my insurance. I’m dreading the bill I’m sure I’ll receive for this out-of-network care during my hospital stay (not like I had any choice), but the bigger problem is that now I’m on my own trying to obtain critical follow-up care. I looked up in-network pulmonologists and started calling them today trying to schedule an appointment, but since I’m a “new patient” they all say they are booked for months, like until September. I will have run out of blood thinners long before then, and there’s a good chance I will die if I get another clot in my lungs. What the hell am I supposed to do? I feel like my only option is to go to the out-of-network pulmonologist that treated me in the hospital, and just resign myself to being bankrupted by the medical bills, which is messed up because I supposedly have insurance. This is so insane and frustrating.
submitted by /u/cellar__door_
[link] [comments]
Hi all. I’m in Texas and have a Marketplace plan with a low maximum OOP in-network and no coverage out-of-network. Last week I went to the ER because I was experiencing extreme shortness of breath, and ended up being admitted to the hospital with a pulmonary embolism (blood clots in my lungs). I made sure the ER and hospital were both in-network with my insurance. I was in the hospital for five days, during which time I was seen by a few specialists, including a pulmonologist and a hematologist, who told me I’d need to be on blood thinners for at least three months (to prevent new clots from forming), and would need to follow up with the pulmonologist pretty regularly for a while. I was discharged a few days ago with an Rx for a 30-day supply of the blood thinners I have to take, and instructions to schedule a follow-up appointment with the pulmonologist in two weeks. Well, I called to schedule my appointment, and was informed the pulmonologist doesn’t accept my insurance. I’m dreading the bill I’m sure I’ll receive for this out-of-network care during my hospital stay (not like I had any choice), but the bigger problem is that now I’m on my own trying to obtain critical follow-up care. I looked up in-network pulmonologists and started calling them today trying to schedule an appointment, but since I’m a “new patient” they all say they are booked for months, like until September. I will have run out of blood thinners long before then, and there’s a good chance I will die if I get another clot in my lungs. What the hell am I supposed to do? I feel like my only option is to go to the out-of-network pulmonologist that treated me in the hospital, and just resign myself to being bankrupted by the medical bills, which is messed up because I supposedly have insurance. This is so insane and frustrating.
submitted by /u/cellar__door_ [link] [comments]Read Morer/HealthInsurance