Re: Email from Covered CA

terrier3 · ‎03-10-2010

@The Monkey on My Back wrote:
@terrier3 wrote:
@The Monkey on My Back wrote:
@minkbunny wrote:
What is the point? If you can change back to whatever doctor you choose, why couldn't you just stay with the doctor you had chosen?

Sounds like another boondoggle. Just heard on the radio that in 2017 Aetna will pull out of the the health care exchanges in every state but two. Didn't hear what two that was.
I don't understand the reasoning behind it. It took a while to find a good PCP. If I get booted from her patient list I may not be able to see her again.
The reasoning is that many people don't choose a primary MD. They wait until they are very sick.
If they had a primary and went for regular check ups, a lot of costly illnesses might be prevented.
Aetna is playing hardball. They can't get what they want re: a totally separate issue, so they are throwing a tantrum. ACA has been VERY good for them...look at their stock prices.
It be more prudent to focus on those individuals rather than impose a blanket change in policy.

It's one phone call.

Say Nay · ‎03-12-2010

@terrier3 wrote:
@The Monkey on My Back wrote:
@terrier3 wrote:
@The Monkey on My Back wrote:
@minkbunny wrote:
What is the point? If you can change back to whatever doctor you choose, why couldn't you just stay with the doctor you had chosen?

Sounds like another boondoggle. Just heard on the radio that in 2017 Aetna will pull out of the the health care exchanges in every state but two. Didn't hear what two that was.
I don't understand the reasoning behind it. It took a while to find a good PCP. If I get booted from her patient list I may not be able to see her again.
The reasoning is that many people don't choose a primary MD. They wait until they are very sick.
If they had a primary and went for regular check ups, a lot of costly illnesses might be prevented.
Aetna is playing hardball. They can't get what they want re: a totally separate issue, so they are throwing a tantrum. ACA has been VERY good for them...look at their stock prices.
It be more prudent to focus on those individuals rather than impose a blanket change in policy.
It's one phone call.

Not relevant.

I am on a PPO which pay more for so that I can make my own decisions. If I am kicked off from my current PCP who is in high demand there is no guarantee that I will be able to select her again.

_____ ,,,^ ._. ^,,,_____

ms traditional · ‎03-09-2010

the risk pool of ACA is not balanced. it's not just Aetna if you have been following the news (United Healthcare made a move in this direction and Blue Cross Blue Shield has commented on this issue too). the losses have been mounting due to an imbalance of those filing claims vs healthy younger sign-ups' offsetting premia. do the math.

terrier3 · ‎03-10-2010

@ms traditional wrote:
the risk pool of ACA is not balanced. it's not just Aetna if you have been following the news (United Healthcare made a move in this direction and Blue Cross Blue Shield has commented on this issue too). the losses have been mounting due to an imbalance of those filing claims vs healthy younger sign-ups' offsetting premia.

This entirely depends on where you live.

BCBS of WNY dropped some forms of ACA last year - they just took clients with higher incomes and lower premium tax credits.

They are now back into managed Medicaid, CHP and all ACA income levels.

The way insurance companies are reimbursed only is partially due to health levels of their enrollees. There is a lot involved behind the scenes.

terrier3 · ‎03-10-2010

@The Monkey on My Back wrote:
@terrier3 wrote:
@The Monkey on My Back wrote:
@terrier3 wrote:
@The Monkey on My Back wrote:
@minkbunny wrote:
What is the point? If you can change back to whatever doctor you choose, why couldn't you just stay with the doctor you had chosen?

Sounds like another boondoggle. Just heard on the radio that in 2017 Aetna will pull out of the the health care exchanges in every state but two. Didn't hear what two that was.
I don't understand the reasoning behind it. It took a while to find a good PCP. If I get booted from her patient list I may not be able to see her again.
The reasoning is that many people don't choose a primary MD. They wait until they are very sick.
If they had a primary and went for regular check ups, a lot of costly illnesses might be prevented.
Aetna is playing hardball. They can't get what they want re: a totally separate issue, so they are throwing a tantrum. ACA has been VERY good for them...look at their stock prices.
It be more prudent to focus on those individuals rather than impose a blanket change in policy.
It's one phone call.
Not relevant.

I am on a PPO which pay more for so that I can make my own decisions. If I am kicked off from my current PCP who is in high demand there is no guarantee that I will be able to select her again.

That is HER decision, not the marketplace.

Say Nay · ‎03-12-2010

@terrier3 wrote:

That is HER decision, not the marketplace.

And... so? That does not address my question/statement.

_____ ,,,^ ._. ^,,,_____

CelticCrafter · ‎03-09-2010

@The Monkey on My Back wrote:
Did anyone else get this email from Covered CA regarding their "new feature"???? I wonder how may hoops I will have to jump through to switch back to my PCP. Not happy at all with this change.

Snip:

"...Beginning January 1, 2017 your health care insurance carrier will match you with a Primary Care Physician. Once your PCP has been matched you will be able to change to another physican at any time you choose.."

They should absolutely not be allowed to do something like that.

Is there a way for you to opt out of it?

If you are happy with your current PCP, I think I would also notify them that you are not going to make the change the insurance company is recommending.

Allegheny · ‎03-19-2010

A little off topic.and I have to vent.

You know I am just sick of it all. The insurance companies, the pharmaceutical companies, the ACA, insurers dropping out of the ACA in certain states.

People trying to keep up to date, understand all the issues and provisions and having to jump through hoops. Seriously, what is wrong here?! Is this how it is supposed to work? Should it be so complicated? Our country and citizens deserve better than this.