Beauty

[VaBelle35]

On 3/26/2015 1978christian said:

On 3/26/2015 ChynnaBlue said:

You can keep your doctor on your health plan, your doctor decided not to keep you.<br /> <br /> Did you ask her for her cash-only prices? Many doctors who do cash-only also offer reduced prices. Have you called your insurance company to get a recommendation from them? My insurance company has a website that lists all doctors that accept my insurance and whether they accept new patients.<br /> <br /> I live in a city, so I'm lucky enough to have a lot of options. I've been through 4 different healthcare plans in the last 15 years (job changes) and had kept all the same doctors (primary care, 0B/GYN, specialists) throughout. Recently I changed because I moved from one end of town to the other. My doctors are all in a linked system, so even though I changed my doctors, the new doctors all had my healthcare and insurance records in their linked system. The system also operates several after-hours and urgent care clinic, so I have access to doctors after work and on weekends and they also all have access to my medical records and can see what I was last treated for and what medications I'm on.

$125 per visit and $200 for extended visits. We have so few choices here that I can look in the phone book for doctors in my area. I have been on websites that say they are accepting new patients but when I called, they aren't any longer. They don't keep their websites up to date.

But you will get part, most or all reimbursed at out of network rates. And, if there truly are no doctors in your area, you need to work with your insurance company to get an Exception for that doctor to be in network rates. If you are AARP eligible you may be able to talk to an advocate about your situation. You have more options than you think.

[adelle38]

Several factors are responsible. The doctor shortage has been in the making for decades partly because of our aging population. Until we regulate insurance companies they will continue to control the purse strings of our health care.

[lavenderfields]

On 3/26/2015 ChynnaBlue said:

On 3/26/2015 1978christian said:

On 3/26/2015 VaBelle35 said:

But you can keep your doctor. You pay cash and you are reimbursed the out of network rates.

Which would be more than what I would pay with a PPO. We already pay over $1600 a month for insurance through my husband's union and you can't opt out.

Wow... that's your real problem. Why can't you opt out? You could probably get a cheaper plan through the ACA. My insurance is through my company and my annual cost is $572.

My husbands union has a healthcare package in his contract that includes dental, vision, and medical. So much per hour is deducted from their hourly wage to go toward health coverage. It is part of their package in their contract.

[lavenderfields]

On 3/26/2015 BLH said:

On 3/26/2015 brandiwine said:

On 3/26/2015 traveler said:

Ahh, a bash ACA thread.

I don't see it as a bash, it's reality. I know of many small community docs that don't have time or staff to deal with all the paperwork and payment delays. They have decided to go to a cash only practice. I was in a small community out of state when I found myself in a local ER. I have Kaiser insurance and they accepted it no questions asked. It took Kaiser 5 months to pay the doc. I was calling them weekly to get them to pay. I was in my Kaiser pharmacy a few weeks ago and a young couple was trying to get their meds and they were told there was a "mix up" with their coverage. It appeared the Colorado connect for health had deleted 10's of thousands of people from their list. A computer glitch yet again. These problems are nationwide. In my opinion this is one of the biggest mistakes in history.

It is a bash. I work for a doctor in a small rural community and we love the ACA. We are making more money because more people have insurance. As a matter of fact we get our money faster then before also. No complaints here!

I am just sharing my experience as a PATIENT who pays a lot of money for healthcare.

[VioletEyes]

On 3/26/2015 RespectLife said:

On 3/26/2015 traveler said:

Ahh, a bash ACA thread.

HARDLY a bash thread. OP is simply pointing out what has happened to her BECAUSE of it.

Sorry, OP, it has happened to many of my friends too. I don't care which way you spin it...if you are unable to stay with your doctor because of the new health care plans...you HAVE lost your doctor. They can't be expected to participate in the myriad of new plans! My friends did lose their doctors, NOT all doctors are participating in these new plans.

They lost their previous health care plans that were working for them and were forced into paying MORE for new high copay, high deductible plans.

Not ONE person I know has reduced rates. Not ONE person I know has lower copays. Not ONE person I know has lower deductibles. They are all paying higher premiums AND higher out of pocket expenses...such as 'Out of Network' would do to you in this case.

The total lack of truthful information given to citizens while this was being hatched behind closed doors is a disgrace on this country. Remember "We have to pass the health care bill so you can find out what is in it". Sadly, now we know what is in it.

I wish you the best in trying to find the care you and your family need.

The higher premiums have nothing to do with ACA. It has to do with whatever plan your employer has put you on. And that has to do with the insurance company.

[VioletEyes]

On 3/26/2015 Chrystaltree said:

Your doc isn't dumping you, she's dumping the insurance companies and it has absolutely nothing to do with the Affordble Care Act. This might be new to your area but it's been happening elsewhere for several years now. Some call them boutiqe practices. Physicians have fewer patients, they can spend more time with each patient and what care or tests or surgeries they order don't require authorization from an insurance company. Insurers have made it difficult for physicians to do what they were educated to do, care for their patients. There are thousands of rules and books of paperwork; audits; payment reductions. So some doctors have decided that it's easier for them to opt out agreements with insurance companies. I think this trend will grow. You can stay with your doctor as a self pay patient. Call your insurer and ask them how to submit a claim for reimbursement; make sure you request the proper forms for reimbursement and make sure you understand....really understand the process for reimbursement. You can also find a new doctor; a 3-4 month waiting list isn't such a long time to wait at all. I've been with the same physician group for 30 years and I have to wait that long for routine or yearly physicals.

Informative and accurate post....

[Mj12]

On 3/26/2015 Chrystaltree said:

Your doc isn't dumping you, she's dumping the insurance companies and it has absolutely nothing to do with the Affordble Care Act. This might be new to your area but it's been happening elsewhere for several years now. Some call them boutiqe practices. Physicians have fewer patients, they can spend more time with each patient and what care or tests or surgeries they order don't require authorization from an insurance company. Insurers have made it difficult for physicians to do what they were educated to do, care for their patients. There are thousands of rules and books of paperwork; audits; payment reductions. So some doctors have decided that it's easier for them to opt out agreements with insurance companies. I think this trend will grow. You can stay with your doctor as a self pay patient. Call your insurer and ask them how to submit a claim for reimbursement; make sure you request the proper forms for reimbursement and make sure you understand....really understand the process for reimbursement. You can also find a new doctor; a 3-4 month waiting list isn't such a long time to wait at all. I've been with the same physician group for 30 years and I have to wait that long for routine or yearly physicals.

Absolutely correct. I've also heard the term concierge medicine. Same thing, and has nothing to do with the ACA. It's been going on for years and years.

[OkeyDokey]

I can't blame a dr for dumping a lot of the insurance companies. This is likely to happen more and more and people will likely eventually carry only major medical insurance for catastrophic illness. Our insurance company, which we have had coverage through for many years, is suddenly refusing to pay for legitimate, medically necessary procedures. There is no wonder docs are dumping them and informing the patients of their intent to do so. Patients are going to the dr, the dr doesn't get paid by the insurance company because they are finding excuses and loop holes to not pay, then the dr waits forever to get payment from the patient (if ever).

If someone only goes to the primary care dr a couple of times a year and pays for only major medical, they will save money in the long run. It is going to take the public a while to catch on to this, but we are finding it out all too quickly in our situation where one of our children needed emergent care on two occasions last year, plus a regular check up with a specialist that she will need to see once yearly for many years to come. Having every single charge turned down is a wake-up call. Insurance companies are a large part of the problem.

In addition, there is a dr shortage in every single specialty including, and especially primary care. Check out the fee schedule for your dr and see if her prices for services are something you can live with. If so...maybe you can cut some of your insurance expense and continue to see her too. Win-win. For you and the doc. Just saying.

[lavenderfields]

On 3/26/2015 RespectLife said:

On 3/26/2015 traveler said:

Ahh, a bash ACA thread.

HARDLY a bash thread. OP is simply pointing out what has happened to her BECAUSE of it.

Sorry, OP, it has happened to many of my friends too. I don't care which way you spin it...if you are unable to stay with your doctor because of the new health care plans...you HAVE lost your doctor. They can't be expected to participate in the myriad of new plans! My friends did lose their doctors, NOT all doctors are participating in these new plans.

They lost their previous health care plans that were working for them and were forced into paying MORE for new high copay, high deductible plans.

Not ONE person I know has reduced rates. Not ONE person I know has lower copays. Not ONE person I know has lower deductibles. They are all paying higher premiums AND higher out of pocket expenses...such as 'Out of Network' would do to you in this case.

The total lack of truthful information given to citizens while this was being hatched behind closed doors is a disgrace on this country. Remember "We have to pass the health care bill so you can find out what is in it". Sadly, now we know what is in it.

I wish you the best in trying to find the care you and your family need.

Thank you for your understanding and compassion, RespectLife. I agree with you 100%.

[Tinkrbl44]

Uh, people ....... This ISN'T about the ACA.

I read the OP's comments twice, and her MD is opting out of ALL PPO insurances, because of the insurance companies' actions and delays. That's not Obamacare.

I also agree with the other poster that said $1600 a MONTH to insure two people is BEYOND STUPID ...... and not being able to opt out? Yikes!

If it were me, I'd call the State Consumer Affair regulators and lodge a complaint!