I have a Banner|Aetna plan in Arizona through the healthcare.gov marketplace. When I check the member portal while logged in I'm given a long list of providers, but the majority that I have contacted either do not take Banner|Aetna at all or are in network with the exception of marketplace plans. These same providers show as in network if I search on healthcare.gov.
I only have three options, all chains with multiple locations, listed in the directory for urgent care. As far as I can tell, none of them will take my plan. And so, despite the fact that I'm trying to follow up on an ER visit for pneumonia, and would like to get in sooner than later, I have scheduled an appointment with a PCP for two months from now. It was the soonest appointment I could find anywhere. Until now anywhere I tried either said they don't take my insurance, aren't accepting new patients, don't have an appointment any time this century, or actually laughed at me that I'd even bother trying with them.
It seems that I have no way of knowing whether this PCP is actually in network for me without having my appointment and seeing if the billing goes through. The provider I found says they "think" they take my plan, including if it's through the marketplace, but that's hardly a guarantee. They said to go in to the appointment and have them check then. Is there no way of finding out ahead of time at all?
I've called Banner|Aetna, but they simply see the same list I do, which is mostly BS, and have me wait on hold while they call places I've already called and tell me what I've already found out on my own.
The last person I spoke to couldn't find anywhere for me to go while I was waiting, so she said she would call me back. Of course, she never did. But, as I said, those people don't have any more information than I do in the first place. Is there some other department I need to be dealing with? They can sure as hell find out whether something is in network no problem once they get the bill.
If the providers don't know whether they take my insurance, and my insurance doesn't know which providers take my insurance, what the heck am I supposed to do here? Half of these places won't answer the phone in the first place.
I don't want to end up in the ER again. I want to know if the antibiotics did the trick, so I want the follow-up scan the doctors at the hospital recommended. Should I just do it out of pocket? I'm getting a bit tired of spending half a day on hold. It was recommended that I get checked within a month, and that time is up. Not that I can even find out which ERs are in network, either. The one I went to already was supposed to be, according to my insurance, and according to everyone at the ER. But my $3000 bill says nope.
submitted by /u/Low-Seaworthiness973