Need Help Please. Network Changed after Jan 15th Deadline.
I need to help my girlfriend change her health insurance. She has MCAS and POTS, I helped her pick out her coverage in October when she turned 26, everything was accepted, fine, no issues. She signed up for United Health Care during the 2025 open enrollment period. We meticulously went through every available plan to make sure that all of her allergists and doctors were accepted before we signed up for the insurance. Everything checked out. NOW however the insurance plans networks must have changed or something, and none of her doctors, or prescriptions are covered under her healthcare plan, and is about to be on the hook for 10s of thousands of dollars a month if she goes anywhere out of network. She has been on the phone for two days with marketplace, and united healthcare, essentially being laughed. Marketplace still shows her doctors as in network, but the insurance company keeps telling her its not. She has been waiting 5 years to be approved to self administer her Xolair shots, and now two weeks before her first self administered shot, this insurance fiasco has started to unravel. What can I do to help her? Is she eligible for special enrollment to change her plan? Is there some kind of emergency situation department she can get a hold of? Everybody she has currently talked to has basically told her she's stuck with her plan and that she's screwed. Is this a common thing to happen? (to have marketplace claim doctors are in network only to change after the enrollment period?) I am at a loss for what to do, and watching her struggle every day just to make it through the day, WHILE being properly medicated, breaks my heart. To sit here and have everything she has fought tooth and nail for be taken away after years of advocating for proper medical care with doctors who are just starting to get an idea of what kind of medical care she needs.
TL;DR – My girlfriend has a rare allergic disease and requires certain medications and doctors. Marketplace said all medications and doctors were covered, however United Healthcare is telling her now that they are no longer covered. What can we do?
***EDIT***
She is 26 Years old, we live in Wisconsin, she makes roughly 25k Gross. Not eligible for medicaid.
submitted by /u/Euphoric_Heron_6618
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