Anyone tried ACA Oscar EPO plan in Austin? Need foot surgery…any advice?

Individual/Marketplace Insurance Forum
1

Hey all, really stressed here trying to figure this out.

My current plan ends this year, so I’m looking at the Oscar EPO plan since it looks like I can keep my main doctors on it. Problem is, my orthopedic doctor, who I might need for ankle surgery, is dropping Oscar next year but staying with Sendero. If I go with Sendero, I’d lose access to other doctors, including my psychiatrist at UT, which I’d rather not do.

I’ve only seen this orthopedic doc once since I was previously with a podiatrist (long story), but I have several foot issues, and my ankle is bad enough that I’ve been on crutches for over a month. They think it’s a torn tendon along with other problems like possibly Morton’s neuroma.

Does anyone know a good orthopedic doctor on the Oscar plan in Austin who’ll still be covered in 2025? I’m trying to get an MRI approved right now and expect surgery will be needed.

Right now, I’m with Ascension, but they’re dropping public coverage next year. This whole process is confusing and stressful. Any advice is much appreciated!

2

I feel your pain, Oscar’s network changes are tough to keep up with. It might help to call around or check the Oscar site for a list of orthos covered next year in Austin.

3

Hey, my friend had a similar issue. He ended up checking out the doctors available under both plans, comparing their reviews, and seeing who was recommended. Sometimes even checking with the current doctors you trust can lead to a referral to someone in-network.

4

I’ve been with Oscar in Austin for a while, but with how often they drop providers, I’d say it’s good to check with any current doctors to see if they have leads on in-network options. Best of luck!