Albuquerque Diner

Review of Molina Healthcare New Mexico

This is not specific to Molina Healthcare in New M...

This is not specific to Molina Healthcare in New Mexico, but it's where I'm located. I'm a new customer. I chose the silver plan from the exchange, rather than some of the bronze or other cheaper plans, because I wanted that extra bit of coverage and service.

I was automatically assigned a PCP under the Presbyterian Healthcare Services Provider Group. I checked in the online provider search in My Molina, and didn't find a reason to switch to another PCP. Today, I called my PCP to make an appointment and they informed me that Presbyterian Healthcare Services isn't contracted with Molina. I called Molina and explained the problem, and they informed me that the list I can view in My Molina is not updated. The rep agreed that I could view the Provider Group for each doctor, and could use that as a guide to see who might be available. I asked for a list of provider groups (not providers/doctors) that are currently contracted, and she said that the only list they have is the one on My Molina (i.e., they do not know which provider groups they are contracted with).

I just signed into My Molina, and I see that it doesn't indicate which Provider Group the providers/doctors are in. I'm flabbergasted. This means that I can only use the address as a guide (i.e., I know that the address listed for my assigned PCP is Presbyterian, so all other doctors at that address, I assume, cannot be my PCP).

How is this acceptable? What assurance do I have that I will ever be able to see a doctor that is eligible under my plan? This business is about people's health and lives, and no one can be sure that the doctor they saw yesterday will be eligible under their plan when they try to see them tomorrow. This is insanity.

However, I don't really have another choice. Like I always do with these things, I'll live with it...assuming I don't get a deadly disease and actually need to use this thing!