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Experts: Consult Your Doctor Before Making Insurance Choice

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OKLAHOMA CITY -

Open enrollment is under way if you buy health insurance through the national exchange as part of the Affordable Care Act. News 9 recently warned you about making sure there's a doctor nearby before you pick your plan. But as we discovered while investigating that story that's not as easy as it may seem.

There are some online options: Healthcare.gov lets you check to make sure your doctor is part of a plan and Blue Cross Blue Shield; the only ACA option in Oklahoma also has an online database. But those aren't always accurate.

Last week News 9 introduced you to Kristi Nimmo, who contacted us after learning of her limited options when trying to find a less expensive health insurance through the national exchange.

“When I checked the networks none of the doctors in Purcell take insurance,” she said.

Blue Cross Blue Shield took issue with that statement and pointed us to their web site that showed two Primary Care doctors in Purcell who were part of their lower cost advantage network. But through our research, that included a check with the Oklahoma Medical Board, News 9 learned one of the doctor's medical license's expired in July. The other doctor closed his Purcell office and is now practicing in Oklahoma City.

News 9 did find one doctor who is part of the more expensive preferred network, but he was listed on the healthcare.gov web site as "out of network".

“A lot of the responsibility falls on providers to update us when there is a change,” explained Max McKenzie, a Community Outreach Specialist with Blue Cross Blue Shield.

Blue Cross Blue Shield says they average about 128 changes per day to their provider network that's about 30,000 per year. They send an update the national exchange weekly.

“It is something that we work to try and improve and keep as accurate as possible but it is constantly changing,” said McKenzie.

Adding to the confusion, the Purcell Hospital and Clinic take all affordable care insurance, even though the doctors who work there may not. But Blue Cross Blue Shield says they have ways to help you sort through it all including a number of mobile assistance centers with representatives, like McKenzie, that will come to you. And their services are free.

Still, the number one thing to take from this is don't trust the websites, call your doctor yourself to make sure they are in-network before you make any decisions on a health insurance plan.

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