In America today, most of us depend on health insurance to cover the majority of our fees for health care from our specified providers. We get insurance coverage through our employers and on an individual basis.
The questions are:
How good is my coverage?
Why is my doctor not on my plan?
Why are there limits on the types of services I can receive?
Unfortunately, insurance carriers limit their provider rosters and therefore not all medical providers are “in network” on all insurance plans. It appears that the insurance carriers develop an exclusive “club” letting some join and others not. Additionally, the carrier’s rosters are not always up to date and therefore perpetrate an illusion of their insurance provider participation as “full”, when in fact, some providers have retire, moved or even expired!
Our experience, that even when notified of incorrect information in Provider Directories that are posted on the internet, insurance carriers do nothing to correct the mis-information. It would make sense as one provider leaves an area that another provider replaces that provider and this does not happen.
Another thought: As new doctors graduate form medical school and open their practices, how are they going to be able to accept insurance to treat patients if they are not on these plans? And how will they get on these plans that have already turned away thousands of others?