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New York cancer survivor stuck in ObamaCare mess over doctor confusion

Annette Frey Obamacare New York.jpg

Annette Frey.Annette Frey

Months after cancer survivor Annette Frey was dropped by her insurance provider and forced to sign up for ObamaCare, the New Yorker is still finding herself on the losing end of a bureaucratic runaround.

At the heart of her maze of problems is the fact that the plan she signed up for on the New York exchange listed doctors she needed as "in network" -- she later found out they were not. Frey tells FoxNews.com she’s at her wit’s end trying to decode what she needs to do to be able to see the doctor who diagnosed her lung cancer two years ago.

She also wants to be able to get referrals to see specialists in Manhattan and approval for six-month checkups, which include CAT scans and pulmonary function tests.

But so far, she hasn’t been able to.

Frey, now a small business owner, was forced to wait weeks to find out if she would even be able to see her primary care physician.

She was then repeatedly told one thing by her doctor’s office, promised another by her insurance provider and left in limbo while trying to untangle the contradicting information on her own. Stuck in a cycle of misinformation, Frey has made close to 200 calls looking for services she says were promised when she signed up through the New York state exchange. 

New York’s exchange, called NY State of Health, allows customers to pick from dozens of plans offered by 16 insurance companies operating through it. 

Frey chose the most expensive one.

“I signed up for United Healthcare specifically because of the doctors I needed that were ‘in network’ – something I went to great lengths to verify before signing up,” she told FoxNews.com.

But Frey says there was almost immediate confusion over which doctors and hospitals were actually participating in the plan. The lists of providers and services, she says, weren’t matching up.

“Trying to make an informed choice with this insurance was virtually impossible,” she said.

Frey, who has worked in the health care field for 15 years, said she tried to contact doctors listed in the exchange to verify their participation only to be told they weren’t in the network.

“I’m not stupid. I did my homework,” she said. “I called the doctors and they would say, ‘We are absolutely not taking that insurance.’”

United Healthcare says that Frey's case is unique and doesn't reflect how the company supports its members. 

"Our New York State of Health Marketplace network is evolving in real-time," United Healthcare said in a written statement to FoxNews.com. "Ms. Frey’s doctor has opted not to participate in individual exchange networks. We apologize to Ms. Frey for any inconveniences she experienced as this does not reflect how we like to support our members." 

Bounced back and forth between doctors, the Department of Financial Services and even New York Gov. Andrew Cuomo’s Albany office -- which she called twice in an act of desperation -- a frustrated Frey said not knowing if she was insured was taking its toll.

“I don’t think people understand the stress,” she said. “My insurance is making me sick. I can’t do this every time I need to see a doctor.”

As one of millions dropped by her previous insurance company in October due to the health law, Frey was forced to find a new policy. 

“I cried,” she said. “I am a tough New Yorker but I cried.”

She wasn’t alone.

To date, more than 6 million individual and small business policies have been canceled in what has been one of the most politically damaging hits ObamaCare has had to absorb. Last fall’s wave of cancellations came as the troubled federal website HealthCare.gov debuted to a list of technical glitches, some so severe the site had to be shut down for hours at a time.

The insurance cancellations undercut President Obama’s oft-repeated pledges that people would be allowed to keep their doctors and their insurance plans if they were satisfied with them. Obama tried to address the situation by letting state insurance commissioners and insurers re-offer canceled plans. New York, though, did not go along with that reprieve. 

The administration also announced last week that some of those who had their policies canceled could now qualify for a “hardship exemption” through 2016, meaning they would not pay a penalty for failing to buy insurance.

Frey says she decided to go with United Healthcare because of its big-brand name. But she claimed the “insurance -- the most expensive one in the exchange – was almost unusable.”

In addition to having trouble finding in-network physicians, Frey says the locations listed were also wrong.

“They have doctors signed up at locations, they don’t even work or see patients, and others whose location is correct but they still are not actually in the exchange insurance,” she said. “It’s a big mess and there seems no end in sight.”

Once she picked a plan that included her primary care physician in late December, she was then told she couldn’t actually use the insurance for several weeks. When Frey pushed back, she was then told she would be able to see her doctor for a Jan. 8 appointment.

“I was assured that everything was ok,” she said. “I said I needed confirmation I was insured and could see the doctor and that I needed to know that to be able to sleep at night.”

She says she was given that assurance and on Jan.8 she went to see her doctor.

But following the visit, she received a notice from United that denied her claim, once again saying her doctor, the one whose name was now printed on the insurance card they sent her, was not in-network. That dispute remains unresolved. 

United Healthcare says its involvement with the exchanges are a work in progress.

"We are in active negotiations with hospitals and physicians to participate in the exchange network and will continue to update our directories to reflect those changes," the insurance company said. "We also will continue to review our processes to ensure that we avoid issues like Ms. Frey had."

Multiple calls to NY State of Health were not returned.