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Chris Dunn reached out to CBS13 hoping we could get answers.
He needs his surgery yesterday. But instead of scheduling his date, he and his wife are navigating a confusing maze of doctors and insurance plans.
"Then it goes down, my feet are numb, like I can do this, and I can't feel it at all," he said.
His ailing back has him in almost constant agonizing pain. He walks with a limp and hasn't had a good night's sleep in months.
"I can't sleep on my back," he said. "I roll around all night, because I can't lay flat. I can't lay anywhere for more than five, 10 minutes."
He's still working, despite the pain. But finding a surgeon to fix his back has turned into a full-time job of its own.
"We get this coverage and go to the best doctor to fix Chris, and they tell us we're out of network," said his wife Tammy.
In January, they transitioned from an Anthem Blue Cross Plan over to Blue Cross Covered California. She says they had to switch to avoid the premium skyrocketing, but didn't realize their provider network would be smaller.
We took their concerns to Covered California's Dana Howard to get answers.
"A lot of people, this is the first time they're purchasing insurance," he said.
For privacy reasons, he couldn't comment on the specific case, but said in general that consumers should do their research before purchasing plans.
"I would suggest they contact the plan to make sure what doctors are available to them," he said.
Tammy says she finally found an in-network doctor, but the problems don't end there. We looked him up using the couple's plan info, and the Blue Cross website shows him as in-network.
But that same doctor's officer told Tammy he won't see patients with insurance from Covered California.
"It's like we're a second-class citizen," she said. "We can't get the coverage we need."
For Chris, it's another stop in a long road to the surgery he needs.
"To this point where it feels like I'm going to be in pain," he said. "I can't find nobody to do it."
CBS13 wasn't able to reach the doctor tonight, and a late-hour contact with Blue Cross didn't get to the bottom of it, so we're still pushing for answers.
Update: Another CBS13 Viewer Says Doctors Denying Covered California Plan
CBS13 Video coverage here.
Commissioner Jones recommends Covered California exclude Anthem Blue Cross and Blue Cross of California from participating in Small Business Exchange
Recommendation based on pattern of excessive and unjustified premium increases
This recommendation comes after the Commissioner determined that Anthem's July 1, 2013 7.2 percent average quarterly rate increase on small employers is unreasonable the third Anthem small employer rate increase found to be unreasonable in 2013 alone. The 12-month cumulative increase for these Anthem customers is 17.6 percent. Had Anthem reduced its rate increase to a reasonable level, it would have resulted in $37 million savings for policyholders over a 12-month period.
[...]
Commissioner Jones also is recommending that Anthem's sister company, Blue Cross of California, also not be permitted to participate in the Small Business Health Options Program Exchange because the two companies share corporate officers, are ultimately owned by the same parent company, and have moved policyholders between the two sister companies.
[Link]
Clearly, the Patient Protection and Affordable(tm) Care Act is a resounding success...