She had not had insurance because she worked construction, part time. Part time was all she could handle physically and she did not want to go on disability.
I dialed her number….
“Doc! I have insurance!”
“Yay for you! Off the exchange?
“So when are we going to be scheduling that PAP and mammo and bloodwork that you are so overdue for?”
“You don’t take my insurance.”
“But, Doc, I’m not switching. I am just going to cancel it.”
“No! Don’t do that. It is OK to switch doctors. We have been waiting years for you to get some coverage so you could get caught up on your preventive care. If you are worried about hurting my feelings, I completely understand, I promise. I won’t hold it against you, ever!”
“You don’t understand. I have seen these other doctors. I like YOU. I am not going back to them. But you did ask me to tell you about how it went getting signed up. It was easy!”
She went on to tell me the process and about her costs and coverage.
She was back in my office without insurance for her yearly refill appointment right on time.
Why don’t you just sign up to accept all plans?
I can’t. I am subject to whatever contracts the system that I work for has in place.
Why don’t they sign up then?
I don’t know. Perhaps these are payors with a bad historical track record? Perhaps the negotiated rates were not considered feasible for a practice? Bottom line, it is out of my hands.
So where do patients go? There are only a limited number of physicians taking some of these plans and access to care, particularly specialty care, is a problem.
What is the point of having insurance if you cannot see a physician? Good question.