McAllen Woman Frustrated with Health Insurance Provider

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MCALLEN – A Rio Grande Valley woman said she will think twice before choosing a health insurance provider for the year 2018.

She believes she is paying top dollar for bad coverage.

"The Obamacare is very important to me," Marsha Monkiewicz told CHANNEL 5 NEWS.

Monkiewicz said she's grateful for the opportunity to provide her family with healthcare.

She explained, in the past, it's been difficult due to her husband's preexisting condition.

In January, she decided to purchase health insurance. She pays $425 a month for the coverage.

"Because of the lower deductible and because it seemed to fit my needs," said Monkiewicz.

She and her husband are currently remodeling their home. Last week, she slipped on some materials and injured her arm.

To avoid making an expensive emergency room visit she called her insurance provider to find an orthopedic doctor in their coverage.

Monkiewicz said her insurance provided her with doctors who refused their coverage. 

"So in all this time I’m in a lot of pain, very painful and I said I’m going to try one more time," she said.

The results were the same.

After being on the phone for two and a half hours, Monkiewicz decided to make the trip to the emergency room.

CHANNEL 5 NEWS headed to an insurance broker to find out what key factors people need to keep in mind when shopping for the right insurance plan.

"Who is their primary doctor, what kind of medications they are taking, do they have specialist that they need to see? Or do they have a special need," explained insurance broker Tomas Sanchez.

Sanchez said those factors coupled with price are what insurance shoppers need to consider when shopping for coverage. 

He recommended insurance shoppers find a specialist before deciding on a coverage plan.

"Call their office, speak to a billing specialist. Are you in network? Are you accepting this plan? Because I’m going to pick this plan, I just want to make sure when I go into your office that there is not going to be an issue that you can’t see me," Sanchez told CHANNEL 5 NEWS.

Sanchez stressed it's also important to ensure you are purchasing insurance from a credible or government website to avoid falling victim to schemes.

He also recommended that people choose a health insurance company with a local branch. Monkiewicz said she plans on changing insurance companies in 2018.

Monkiewicz and other healthcare shoppers will have until Dec. 15 of this year to decide on a new healthcare plan.

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