So, I got a letter yesterday from my insurance saying that our pediatrician would no longer be accepting our insurance. I'm in the process of interviewing for another job (I have our current insurance) so I'm not sure if I want to find a new pediatrician when my new insurance may be covered by our current pediatrician. DD was born 6 weeks early and I'm very particular about his medical health and am not crazy about trying to find another pediatrician since his current pediatrician specializes in preemies. According to the letter there appears to be a 90 day grace period. Should I stick with my current pediatrician assuming I will find a new job that covers this pediatrician? Or start the search for a new pediatrician. Or should we see about getting our son covered by my husbands insurance so we don't have to switch pediatricians. I'm not sure if our pediatrician leaving our insurance group would be considered a "qualifing event" though. Thoughts????
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If you have a 90 day grace period that gets you really close to the end of the year. So, I would stick with your current doc and use your 90 days. If you don't get a new job by then, it will be the end of the year and therefore open enrollment for benefits election so you'll have the opportunity to switch your son to your husband's plan (assuming your ped accepts his insurance). In that case you'll only have about 3 weeks where you don't have insurance coverage for the pediatrician, and you can just pay out of pocket if you have to have a visit in that time frame.
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Speak to the pediatrician to find out if they are referring their patients to another pediatrician. Also discuss what their billing discounts are for cash paying customers. Lastly, understand what your "out of network" insurance coverage is. Typically all providers are covered, just some are considered out of network and the insurance is less (perhaps 80% coinsurance instead of 90%).
Once you are armed with more information, maybe you can make a decision.
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Id go with the grace period to get you closer to open enrollment in the event that you need your husband's insurance. The pedi dropping your insurance doesnt qualify as a "life event" to switch insurances. You would have to lose your benfits altogether. Also, @MamaG: has some great ideas. Ask if they are referring another pedi and what out of netowrk coverage costs. Get as much info as you can to make the decision
This happened with my OB when I was like 24 weeks pregnant. I know how you feel =o/
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I work in insurance/HR, so I can offer some help.
Your pediatrician dropping out of the network is not a qualifying event for you to change to your husband's insurance. Find out when his open enrollment and effective date of coverage is. If it is 1/1/13, then you can switch over your DD (check to see if the pediatrician will be in his network). If his effective date isn't until, say April or May, then you'll have to wait until you get a new job or you have your open enrollment to change your DD over.
Even if you do get the new job, you may not know if there is a waiting period for benefits to begin (I have some clients that have benefits start day 1 and others that start after 6 months).
I agree w/ @MaMag's recommendations, definitely reach out to the Pediatrician's office.
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I'd also make sure to call the pediatrician's office and find out what insurance they will be accepting, just in general. If it is something like they are only taking one specific insurance, what happens with your new job may not make a difference, you know?
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If there's any way you can avoid a lapse in your coverage, I would advise you going with that path. Trying to get new insurance when there has been a total lapse in coverage can impact you negatively in the eyes of the insurance company/premiums. Just food for thought.
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If it's your insurance company that dropped the pediatrician and not the other way around, it might be worth calling your pediatrician to complain.
I got a letter from my OB saying that my insurance was planning on dropping him, and to please call/email to complain. I didn't, but I guess enough people did - because 2 weeks later I got another letter saying that he would remain part of the Cigna network.
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