Regional insurance using Aetna signature ppo national network – can’t find care

Hi there, I am a remote worker from Oregon working in Miami Florida for the next year. I work for a large hospital who uses Moda health, a regional insurance company that covers Oregon, Washington, Idaho and Alaska.

When I moved to Florida I was told that I would be switched to the Aetna signature administrator ppo plan which has similar coverage. WHAT THEY DIDNT TELL ME is that my insurance is still MODA and that they utilize the Aetna network and providers, ie essentially subcontracting from them. Moda still handles the bills, and i still have a Moda card. There is a small emblem on the back of the card with the Aetna logo saying Aetna available outside Moda network for emergent care.

Finding care has been an absolute nightmare – I don’t have an Aetna number so the only way that anyone can verify my coverage is by calling the medical benefits line on my card. Getting people to do this is difficult because as far as they are concerned, I don’t have Aetna and Moda isn’t an option for their drop down billing departments. Many places have told me that while I have access to Aetna providers, they physically have no way to bill Moda(and fucking why would they, I’m 3000 miles away from the closest state that even know what Moda is). Many places just won’t even call.

I have an auto immune disorder and only have 2 months of medication remaining. I’m starting to get really nervous about how I will receive any care in this state. My job and Moda have both suggested I work with larger health organizations who will be “more familiar with interesting billing situations” but that has been far from the truth.

Is there a way for me to get my prescriptions sent by an Oregon doctor to a national mail in pharmacy? Has anyone experienced this regional subcontracting a national network bullshit, how have you navigated it?

Just really need some help and advice…thank you

submitted by /u/piralee
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