@gently The problem is that my doctor is in NYC, and beginning January, my wife will be on an ACA plan and she cannot see an out-of-state doctor. I could possibly get her in to see him before January, but then what?

I only see him once a year in the office. He orders blood tests online, so we can go locally for that. We can get DEXA scans locally. He can prescribe Forteo - I assume it doesn't matter if he's not in her plan when ordering a medication?