Thursday, March 06, 2014

N.C. Journal On Obamacare

Good read in this week's North Coast Journal on how Obamacare policies are working out here in Humboldt. It has me back to being worried again. 

Someone commented here on an earlier post that their old provider wouldn't accept the Obamacare policy. I called mine and asked if they would accept my Obamacare plan Anthem- Blue Cross. They said they would, but I didn't mention Obamacare. The article says other providers accept Anthem- Blue Cross, but not the Obamacare version. Guess I won't know for sure until I go in there again.


At 1:51 PM, Anonymous Anonymous said...

Or you could call them again and this time tell them the specific plan you have and ask if they accept that (and while you're at it, you could find out what the co-pay is for a standard office visit). Or you could call Anthem - Blue Cross and ask them if your doctor is on their list of providers for your plan.

Of course it would have been smarter to check before you selected your plan. The website has a feature that you could have clicked when you were comparing plans, and that would have brought up a list of all the providers that are in their "preferred provider network." Not real smart to choose a plan without looking at whether your doctor is included in their provider list. Unless you don't really care if you have to switch doctors, in which case it's a moot point.

At 2:23 PM, Blogger Fred Mangels said...

I had a real tough time with the Covered CA web site. Hard to find things on it after the qualification section. It was such a pain I gave up on the doctor search and finally just picked a plan before it disappeared again.

Funny thing is, the Anthem Blue Cross web site has a thing to find your doctor on and it doesn't seem to work,either, or it didn't when I tried it. Guess I should try it again.

At 2:44 PM, Anonymous Anonymous said...

Yes, I recall you had a lot of difficulties with the Covered California website. I didn't have those problems, it was quite easy and convenient for me to compare the plans there, including which providers were included in each company's preferred provider network. But I'm not doubting your experience at all, I have heard of others who experienced similar glitches or at least found the website hard to navigate.

Anyway, is this the Anthem - Blue Cross website that you are trying now?

It looks like it asks you for your "member number," so if it works I assume you should be able to get an answer specific to your policy.

At 8:23 AM, Blogger Fred Mangels said...

I just tried the Anthem Blue Cross web site's "Doctor Search" thing. Put in my doctor's name and it came up blank...again. Their web site is kinda wiggy, though, and there's constant alerts of technical problems.

So I went ahead and called Redwood Family Practice again. This time I specifically asked if they accepted ABC plans purchased through Obamacare. She said they accepted all ABC plans and submit them to the insurance company the same way. They haven't received reimbursement from any of the Obamacare plans yet, though, so don't know if they'll continue to accept ABC plans via Obamacare. Depends on the reimbursement rates.

But, seems to me that since they advertise as accepting CMSP, MediCal and MediCare, they'd likely accept Obamacare. Those all have among the lowest reimbursement rates in the country. The wild card is that Obamacare required the insurance companies to lower their payment rates to equal MediCare and those rates just took another 10% hit as part of Obamacare. That could be the straw that breaks the camel's back. We shall see.

At 6:59 PM, Anonymous Anonymous said...

I can understand your frustration, it sounds like you've made a reasonable effort to find out if your current health care provider will accept your new health insurance, and you still don't have a straight answer.

The answer you got from your doctor's office sounds a bit wishy-washy, and I don't think it really reflects the way these insurance plans actually work. Either your doctor is part of ABC's "preferred provider network" for your plan, or they aren't. If they are, that means they've agreed to the reimbursement rates your insurance carrier provides. If your doctor is not part of ABC's "preferred provider network" for that plan, then if you visit that doctor you're going "out of network" and it might be covered, or it might not. You need to know which it is.

I believe the Covered California plans cover an annual routine physical at no charge. So one approach would be just go ahead and schedule that visit and go in for that check-up. If there are any problems with your current doctor accepting your new insurance coverage, you'll find out at that time. Which would be a better time to find that out than when you're sick.

And of course it's a good idea to get the annual check-up anyway. The idea is that they can sometimes catch a developing health problem before you're even aware you have a problem, and it's almost always the case in medicine that the sooner a diagnosis is made and treatment begins, the better -- both in terms of health outcomes, and cost.

Anyway, just a friendly suggestion.


Post a Comment

<< Home