Covered California Enrollees Have Problems Finding Doctors

On the front page of today’s Los Angeles Times is an article discussing the frustrations many consumers are facing finding doctors one month into enrollment of their health plan.

The LA Times reports that “people are having trouble finding doctors at all and are getting faulty information on which ones are covered and receiving little help from insurers swamped with new business”.

In order to keep premiums down, most of the major health plans participating in the state health exchange have limited their networks, resulting in less doctors and hospitals for consumers to select from.  Outdated provider lists provided by the carrier and often inaccurate data on Covered California’s website are also a major culprit causing frustration for people that come to find out the doctors they thought were included in the health plan’s network are not.

As a result, government regulators and patient advocate groups are asking for tougher rules on health plans to provide better access to care.  Just last week, the California Assembly passed a bill that enables people who lost their health plan due to the Affordable Care Act changes to continue seeing their doctors if they are pregnant or undergoing treatments for serious health conditions.

What You Can Do

If you have found yourself in this situation, you can file a complaint with the California Department of Insurance by visiting their website for instructions on filing a complaint.  The California Office of the Patient Advocate  provides useful information about working with your health plan and offers advice and links to file a complaint with the Department of Managed Care.

Last, but not least, you have until March 31 to change health plans.  Affordable California can assist consumers with finding the health plan that best suits their needs.


AUTHOR - Ali Nagy