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Why I Support Prop 45: I’m Paying Double, and Can’t See My Doctors

"Not one doctor that I have recently spoken with even knows what an EPO Health Plan is."

Janis Logsdon, Brea, CA

I am paying almost $600 a month for my new Anthem Blue Cross EPO plan, which is double what I paid last year for a PPO that I was happy with. For me it meant the total destruction and loss of my perfect, for me, health care plan. With my old plan I was able to see the doctors I knew and needed to see. My regular doctors were at Saint Jude just a few minutes away. Under this new EPO, which I was baited into with promises that my doctors were covered, I have to travel from my home in Orange County to Los Angeles County, which is very difficult for me.

Not only am I paying double for less, I feel cheated because I signed up for a PPO, not an EPO. I talked to Anthem and to my doctors and was told by both that my new "PPO" health care plan would cover my needs. On top of that I owe money for doctor visits I made at the beginning of the year, when I thought my plan was a PPO and these doctors were covered. My visits to them were covered in March when my plan was a PPO. Then suddenly in May it wasn’t a PPO and my doctors were out of network. No warning until finally a claim summary from Blue Cross arrived in June telling me that my current doctors were not in my network at the time of my visit in May and that I owed out of network charges for those visits. It was the old bait and switch. I spent hours trying to get the problem resolved with Blue Cross and Saint Jude but all I got was the run around, except they were clear that they expected me to pay these phony charges.

So I now owe money for doctor visits I was told were covered. I am paying twice as much in premiums than I paid last year for nothing. The doctors who know me and are close by are not covered. I have to travel from Orange County to Los Angeles County to access in-network doctors and hospital care. And, frankly, who knows if that is true. It is time for me to get my annual physical and I don’t know where to go.