If you read my previous blog post about signing up for health insurance under the Affordable Care Act, you know that I was able to sign up through Healthcare.gov and then through NY State of Health Benefit Exchange. I am now in the process of trying to find the best policy. But I am stumped. I haven’t been able to locate the formularies being offered by the insurance plans on the NY State of Health Benefit Exchange. Additionally, I’m not sure what plan my amazing, absolutely fantastic internal medicine Doctor is taking. And just so you know, I will find a plan that includes her, she is THAT fantastic.

I did two things simultaneously.

1. I called the 800 number listed on the NY State of Health Benefit Exchange.

“Hello, this is Tom, how may I help you?” (To protect my source, Tom is not the name of the person I spoke to.)

Tom and I went through the drill. I can’t find the formulary. Tom understood completely and assisted me while we both simultaneously searched the www.MetroPlus.org/Marketplus web site. Only after a good ten minutes of searching did we locate it. The link on the New York State of Health Benefit Exchange was not working (fyi, there seems to be an issue with the HTML programming and it doesn’t link correctly).  Please see the image below:

metroplus_marketplus_formularySee that really small print at the bottom (I’ve circled it so you can see it) – that’s what we clicked. The formulary was checked for the medications that I take when I’m having a medical issue, so we moved on to Doctors.

2. I emailed my Doctor and asked her which health insurance companies her practice was accepting.

While we were waiting for my Doctor to get back to me – which she did within minutes –  I was able to download the .pdf of the provider directory (also circled). Unfortunately, she was not in the provider directory. The Doctor, in her email, noted that she wasn’t sure and she would ask.

So, I moved on to another insurance company.

All in, to look at ONE insurance plan, check the corresponding web site AND check the Doctors and Formulary, took me ONE hour. If I wanted to look at ten insurance plans, it may take me approximately ten hours.

I’m sure by this time you’re wondering what I got back from my Doctor’s office. The insurance companies that my primary Doctor takes is as follows:

Fidelis No
Freelancers d/b/a Health Republic No
Healthfirst NY Yes
Metroplus No
Oscar Insurance No

My advice to you dear readers? Once you have been approved as eligible through your State’s health exchange, start with your Doctor’s office and ask them which insurance they sill accept. Try to reach your Doctor if at all possible and not just the front office. In my case, there really is only ONE insurer that my primary care Doctor’s group will take.

More blog posts will be coming once I decide on a plan, but I’m guessing that I’ve already found it based on my Doctor’s response above. I feel as if I’m getting closer, but I’ve logged about ten hours getting this far. How are you doing with your State’s insurance exchange?

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One Response to Affordable Care Act, Signing up, Part 2

  1. […] the New York State of Health Marketplace. You may have read my blog posts on signing up Part 1 and Part 2 and wondered how I […]

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