Sunday, August 17, 2014

Eureka Family Practice Accepting Obamacare

This might be news since Eureka Family Practice's newsletter of March 2013 (pdf file) explains why they weren't accepting insurance from Covered California. That page has been updated to say as of May 1, 2014 they have contracted with Covered California. 

There's no mention of Covered California on the Redwood Family Practice web site site at all. They only state they take all insurance, including MediCal and CMSP (strange, as more and more providers don't take MediCal). I'm going to call Monday and suggest they update their web site to mention they don't accept Covered California. Might save them and potential patients some headaches.

Good to see I have somewhere to go, if needed, with Eureka Family Practice. I'll hold off for a while before switching, though. Maybe Redwood will eventually take Covered California, too.

As an aside, I noticed Quest Diagnostics was listed as one of Anthem/ Blue Cross' network providers. They do blood tests and such. I stopped by there the other day to make sure they accepted Covered California policies. The gal there said they did but I'd have to call A/BC to see if they covered the tests I wanted. Hmmm??? You think Quest would know that already.

She said the tests I wanted done would cost $320.00. That's what it cost last time I had it done at St. Joseph's. Too expensive for me. We got to talking and she did something on the computer, then told me if Anthem/ Blue Cross covered it, I'd pay $250.00. Still too expensive for me. Guess I'll have to go back to the low cost blood draw place just a couple blocks away.

Quest Diagnostics (corner of Buhne and Harrison in Eureka) was empty when I went in there around 10:30am Friday. Costs aside, if you want a blood draw done quick, it looks like that might not be a bad place to try.


At 10:26 AM, Anonymous Anonymous said...

None of this would be necessary if we had single-payer healthcare. The insurance industry (obviously) successfully fought it. Some day we'll join the ranks of developed, enlightened nations that recognize the value of human life.

At 10:42 AM, Anonymous Anonymous said...

The worst is still yet to come. Been in the planning and development states for over 200 years. There will come a day, in the lifetime of our children, that we will wish for these days again.
If WE THE PEOPLE, do not stand up and stand our ground, fight for our rights and be steadfast. It is our children and grandchildren that will pay. And pay very heavily they will.

At 12:30 PM, Anonymous Scooter said...

I was recently referred to EFP, to their headache clinic, but they do not take medi-cal. The only headache specialist on the northcoast won't take my Obamacare mandated medi-cal (partnership health plan of Ca). Bummer.

At 12:48 PM, Blogger Fred Mangels said...

That might not be too surprising that they'll take Covered CA but not take MediCal under Obamacare. Maybe reimbursements have changed under Covered CA? I'd be surprised if they'd take it otherwise.

I approached EFP two or three years ago to see if I could use them. I was on County Medical Services at the time but had a share of cost of up to $650 a month so pretty much paid out of pocket for everything.

I knew they didn't take MediCal or CMSP but thought since I paid cash, maybe they'd make an exception. Nope. They explained to me that if they had to refer me to some other provider, they'd have to refer me to one that didn't accept MediCal/CMSP, so in the long run it wouldn't work.

That makes me wonder what's going on with Covered CA? I didn't expect EFP to accept CC, but Redwood Family Practice, which does accept MediCal/CMSP, doesn't accept CC.

More and more providers don't accept MediCal/CMSP. If CC is along the same lines, why wont RFP accept it? Or, why do they still accept MediCal if they also don't accept CC?

Goofy, but maybe negotiations are still taking place and RFP will change their minds? I'll wait for a while and see what happens.

At 4:38 PM, Anonymous Anonymous said...

But isn't Covered CA, still nothing more than a Marketplace of insurance with different providers and carriers? Each policy will have slightly different reimbursement rates for different items. That is why insurance is so oonvoluted. So I doubt any provider could just make a blanket, "Yep I will take Covered CA." without knowin what is in each individual plan. You are right most providers do NOT take MediCal.

At 6:52 PM, Blogger Fred Mangels said...

My understanding, although not too clear (just what little I've read in some papers), is that in order for the insurance companies to participate in the Covered CA subsidies, they had to adopt the reimbursement rates similar to MediCal/MediCaid.

That would mean, if what my understanding of the situation is is correct, that the Covered CA plans- regardless of what private insurance companies normally would offer- will reimburse under CC pretty much the same way as MediCal.

And again, more and more providers won't accept MediCal.

Maybe things have changed? Since Eureka Family Practice stopped accepting MediCal some years ago, but is accepting Covered CA now (although I'm unsure of the specific details of how that works), maybe they've changed CC reimbursement rates?


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