A California man has been seeking treatment for Lyme disease, something he contracted while on active duty as a Marine, but he’s having a hard time finding a doctor in the San Francisco Bay area that accepts his insurance.
The insurance company’s advice? Cancel his plan. KPIX-TV, though, says the fact that he can’t find a doctor within a reasonable distance violates state law and nothing appears to be taking place to fix the issue.
The former Marine identified by KPIX by only his first name, Kyle, is covered by Anthem BlueCross through the state exchange Covered California.
“I was on the phone with Anthem for two hours while they were trying to find me a doctor within 20 miles. Finally a supervisor came on the phone and said ‘Sir, we have to go, we have other people to help,’ and advised me I need to cancel my plan,” Kyle told the news station.
KPIX pointed out that California’s law requires insurers to have enough doctors within 15 miles of a patient’s home for them to acquire an appointment in 15 days or less.
When Kyle looks at the list of doctors that Anthem on its website, he said it shows more than 80 doctors within 20 miles, even though in reality he can’t find one.
The news station reported that the state’s Department of Managed Health Care previously said it will look into the matter of insurers being in compliance with an adequate number of doctors, but it declined to comment when contacted again by KPIX regarding the issue and possible fines.
The news station did find records that show Anthem has been fined more than $100,000 since February but not for violations for lack of doctors. The insurance agency told KPIX that it is working on expanding its network and said Kyle’s experience does not sound like something that would come of its customer service.
Covered California’s Dana Howard told KPIX that it has seen “some cases” of people having to switch insurance plans due to a lack of doctors, but she added that they “don’t have a count” of how many nor could they provide the number if they had it.
Watch KPIX-TV’s report about the issue: