Woman Fights Health Insurer In Months-Long Wait For Birth Control

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Frustrated by a potentially six-month wait to obtain birth control, a Tarzana woman has launched a social media campaign against her health insurer, saying the company’s list of physicians is misleading and a referral to an out-of-network provider would mean fronting a $1,200 bill.

Rosie Wiklund, 29, said Wednesday she’s received much support and feedback on Facebook and Twitter since she began writing about how difficult it has been to access a female doctor who can prescribe an IUD, also known as an intrauterine device.

The mother of three said she wants IUD — a small, T-shaped item placed inside the uterus to prevent pregnancy — as a birth control method because she doesn’t care for the pill’s side effect and has an allergic reaction to barrier methods.

“We all deserve healthcare. Because I am insured and my husband employed, we have the highest share of cost at sliding scale clinics. We are not in a position to pay out of pocket,” Wiklund said.

Wiklund’s story is becoming common in California, where many with health insurance can’t find physicians or speciality care, said Carmen Balber with the nonprofit consumer advocacy group, Consumer Watchdog.

“This one symptom is part of a larger problem, which is skinnier and skinnier networks,” Balber said.

Wiklund said she obtained health care coverage through Anthem Blue Cross and was given a referral to an OB/GYN back in May. But the physician assigned was male. Because she is a survivor of rape, Wiklund said she prefers to see a woman.

So she began the search through the web directory only to find some phone numbers had been disconnected. Other providers said they weren’t accepting Anthem HMO. And others were no longer accepting new patients. One doctor she found said she couldn’t see Wiklund until October.

“Here’s ‘THE THING’ I only ever wanted,” she wrote recently on her Facebook page. “Birth control placed within a month. And a female GP. These should be my rights. In 2015 we should never have to BEG and PLEAD for birth control or access to a female physician in the second largest city in the country.”

Wiklund said after Anthem representatives attempted to find her a female doctor, they referred her to an out-of-network provider, Planned Parenthood, for an examination and an IUD insertion. But she would have had to pay around $1,200.

It’s money, she said, she can’t just shell out. Anthem said they would reimburse her, but Wiklund said she is a stay-at-home mom. She has three small children and they are living on her husband’s wages as a registered nurse.

Anthem said in a statement that it takes its responsibility to provide timely access to birth control “very seriously and has made extensive efforts” on Wiklund’s behalf.

“From her initial call, Anthem found the member an appointment to see an in-network provider within seven days. At that point, the medical professionals (and not Anthem) determine how and when to prescribe birth control, including what the appropriate testing regimen is, etc.,” according to the statement.

But Wiklund said she called the office of the physician Anthem found and learned she would only have a consultation, and there would be other testing requirements that would delay insertion of the IUD. She also said she was asked if a medical student could insert the IUD.

“That was never a real appointment,” Wiklund said, which is why she requested to be seen at Planned Parenthood.

Anthem said it made an administrative exception, granted the request and would pay 100 percent of bill charges via either a claim filed or a reimbursement.

According to Consumer Watchdog, California is ranked as the worst in referring doctors.

“It should not be six months to wait for a female OB/GYN. There are rules in place that are supposed to ensure access. More and more, we see those rules aren’t being strictly enforced,” Balder said.

Misleading insurance directories led California Insurance Commissioner Dave Jones to sign a set of emergency regulations earlier this year requiring health insurers to update their directories weekly and to have enough providers.

It appears to be working, said Janice Rocco, deputy commissioner for the Department of Insurance. “We are seeing the health insurers updating their directories more quickly than prior to the regulations so that policy holders have more information,“ Rocco said.

But the regulations do not cover HMO plans such as the one Wiklund carries. That falls under the department of the California Department of Managed Care.

Wiklund acknowledges Anthem has responded to her grievances, but she’s unhappy that she’s had to reveal personal information about herself and spend so much time on the telephone and online to get contraception.

“I have THREE amazing beautiful children under the age of 5 years and our family feels complete for now,” Wiklund wrote on her Facebook page

Reach the author at [email protected] or follow Susan on Twitter: @sabramLA.

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