Friday, March 06, 2015

Obamacare Confusion

I wrote a month or so ago about going to the doctor and them saying something about accepting Covered California health insurance now. They told me the time before that they don't even bother billing Covered California. Any claims made were between Anthem/ Blue Cross and me.

Covered California is the California version of Obamacare. They must have been serious because they only asked for a $25.00 co- payment last time as opposed to the $80.00 I normally pay out of pocket.

Then, a week or so ago, I get an e-mail from Redwood Family Practice followed by a regular letter saying I owe them $45.00 more for that last visit. There was an itemized list showing Anthem/ Blue Cross only paid nine dollars and change for the visit. Wtf? Not that it matters as I think people should pay for routine visits, but it was kinda nice saving some money.

But what's the deal here? I thought Redwood Family Practice was an in- network provider now?

Then yesterday I get a letter from Anthem/ Blue Cross itemizing a claim Redwood Family Practice sent to them for my last visit. A/BC says I should have paid the whole $80.00, although it would be applied to my deductible. What???

I go up to the Anthem/ Blue Cross web site and see if my doctor is listed on their network provider list. Nope, at least not yet. They also showed a claim of $80.00 applied to my deductible.

It seems I'm back at square one with this Obamacare policy although I'll have to wait and see if they're just slow acknowledging RFP is an in- network provider now or maybe they got into another squabble and quit on each other? I suppose I could call and ask.


At 10:12 AM, Anonymous Anonymous said...

Hang in there and hope you will be able to get Medicare soon, the single payer insurance that should be available to all. What I do not understand (actually I do, it is called the insurance lobby) is since there is a system already in place and working well, why not just lower the age for Medicare to the date of birth as long as one is a legal US citizen?

At 11:04 AM, Anonymous Anonymous said...

Well 80 bucs isnt bad,how much is your monthly insurance premium?Give us a little more details so we can understand. How much a year do you pay for insurance?and @anonymous, your statement is not quite reality"there is a system already in place and working well" have you ever investigated medicare? because you must know it is broke and will be completely not working because of debt in 3 years

At 12:13 PM, Blogger Fred Mangels said...

I pay $61.00 a month now. Not sure what the federal subsidy is, but probably around $500. It was $77.01 last year, then they switched me for some reason.

I don't mind $80, at least since I only go in once or twice a year. If, or I should say when, it gets to the point I have to go in more often, that could be a problem.

As far as anon blaming the "insurance lobby", I'm not sure that rings true. Most practices, including Redwood Family Practice, accept Anthem/Blue Cross policies. It's the Covered California version they have problems with and often won't accept.

At 1:10 PM, Anonymous Anonymous said...

I believe 10:12 is blaming the insurance lobby for its hand in crafting the Affordable Care Act. It didn't get passed without buy-in from the insurance industry.

Single-payer (Medicare or something like it) is the way to go, the world over. That path was washed away early on in the US reform effort. Big Money simply wields most of the power in Washington.

At 5:42 PM, Anonymous Anonymous said...

Meanwhile the taxpayers are still subsidizing Fred's healthcare costs


Post a Comment

<< Home