Even before the Affordable Care Act was made law in 2012, the Obama Administration had taken steps to make insurance affordable to the public. However, it was the passage of the Affordable Care Act, also known as “Obamacare,” which changed the way many Americans get healthcare.
Among the many changes, the Affordable Care Act required businesses with more than 50 employees to offer affordable healthcare coverage, and it required insurance companies to cover pre-existing conditions and preventative care.
Although the Affordable Care Act has brought a lot of positive changes, there are also some negatives.
When Obama Administration was first presenting The Act, one of the concerns was that people that were already covered would have to change insurance plans or change doctors. At the time the President promised that “If you like your doctor, you can keep your doctor.” Unfortunately, when “Obamacare” plans finally became available in 2014, that turned out not to be the case. There are several reasons why this turned out to be the case; and most of them have to do with the insurance companies and healthcare providers.
Regardless of the reason, many patients were devastated to discover that changing to an Affordable Care Act compliant plan often meant changing doctors as well. Even today, it’s possible that choosing an “Obamacare” plan could result in you having to change doctors – especially if you switch insurers. Below are some tips for making that process as painless as possible.
Finding a New Doctor
Finding the right doctor can often be the hardest part of the process, especially if you are in treatment for a specific medical condition. However, there are ways to make the process easier and ensure that you continue to receive the same standard of care.
Make Sure that Your Doctor Isn’t Covered
Most insurance companies have a list of providers that will tell you if your doctor is on their plan. However, it’s also possible for that list to be out of date or incomplete. If you don’t see your doctor on your insurance company’s list, double check with his office to make certain he doesn’t accept that insurance plan. You can also call the insurance company directly, because the information at the customer service line could be more up-to-date than what is at the website. You might be surprised to discover that he actually does accept your insurance but, for whatever reason, his name does not show up on the online provider list.
Get a Referral from Your Doctor
Your doctor doesn’t work in a vacuum; she has fellow doctors as friends and she also has professional relationships with other doctors both inside and outside her area of expertise. Since your doctor is the one most familiar with your medical history and your care, she is often also the best person to recommend someone to take over when you change physicians. Ask her for the names of several doctors and compare their names against your insurance provider list; be sure to follow up with a call to that doctor’s office to be sure they are on your new insurance plan.
Check the Physician Rating Sites
If you have to change physicians, and your current physician can’t provide a referral, sites like ZocDoc and Healthgrades provide ratings to help you determine which of the doctors on your plan is the right fit for you. You can even search these lists by insurance provider so that you can get ratings specific to the doctors on that plan.
If you have to switch to US Health Group, the rating site will show you the doctors for that insurance company, in your specific region, and under the specialty of your choice, saving you the effort of having to search for each one individually.
Once you have chosen a doctor, you now need to begin the process of initiating the relationship with your new provider and transferring your medical records. Thanks to the widespread use of electronic documentation, this process is much easier than it used to be.
Have a Final Appointment with Your Old Doctor
This is best done when you are still under your old plan so that the visit is covered by your insurance. If you can’t schedule an appointment until after you have already switched insurance companies, consider seeing your old doctor out of network and paying out of pocket for the cost of the visit.
The purpose of the final appointment is to check in with the doctor and get a status report on your current health. You can also use this appointment to get copies of your medical records for yourself, and to take to your new doctor.
Make an Appointment with Your New Doctor
Your new doctor should want to conduct a physical to confirm that your old doctor’s findings are correct. It will also give him a good baseline to work from. Additionally, the initial appointment is a good time for you to introduce yourself to your doctor and get to know him.
Some doctors’ offices will give you a form to get your records electronically from your old doctor. However, if they don’t use electronic records then you will need to give them copies of your medical records.