Humana Gold Plus HMO
Humana promotional materials to not make it clear what the working definition of "in-network" is.The materials indicate that your primary physican can refer to to any specialist in the Humana Provider directory.
My eye surgeon is in the Humana book. However my eye surgeon is not a member of the medical office that my PCP is. My PCP is with Dupage Medical Group, a group of over 300 doctors. My PCP and/or his business office refuses to give me a referral to any doctor outside of their DMG group.
I had known about these restrictions prior to signing up I would have choose a different provider.
Either a PPO plan with Humana or maybe Blue Cross. This is incomplete information. I had no way of determining this in advance.
Humana should be sanctioned by Medicare and pay penalties.They should be required work with all those impacted to make sure they can see the doctor of their choice.
Monetary Loss: $1200.