Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
Does anyone else know of doctors who are declining to accept patients who get healthcare under the ACA? I'm seeing this and wonder if others are yet.
Primarily, the insurance companies on the exchanges will be offering HMOs - doctors in their network. So, yes, many doctors won't participate in these. Nonetheless for those who don't have insurance now and want it, the available networks are a godsend.
The ACA was designed to provide affordable health insurance for those excluded by virtue of cost, preexisting conditions, whatever,
There are many doctors who don't take Medicare, Medicaid now.
It's still a free market with one important distinction - people cannot be denied coverage.
Based on my discussions with my doctor on the generalities of the ACA, I don't think he will accept the program's patients. I know he does not accept Medicaid patients now.
Does anyone else know of doctors who are declining to accept patients who get healthcare under the ACA? I'm seeing this and wonder if others are yet.
In TX, the largest insurance company in the individual and family market is BCBS. They have over 50% of this market. They are my current insurance company and I have received several letters from them.
As elsewhere, Doctors in TX are either in the 'BCBS PPO network' or not in that network. BCBS has said they will sell PPO policies through the exchange in 2014 in addition to their other business sales and non-marketplace insurance policies.
In 2014, any Doctor I use will only know that I have BCBS PPO insurance. They will not know if its brought over the exchanges, brought directly or part of a corporate package.
Yes, the Doctor may decide to pull out of the BCBS PPO network at any time if they feel the BCBS PPO reimbursement rate is too low. No change from current market practice. This year we had a huge issue with Memorial Herman hospital threatening to do this before a settlement was reached.
So, I see no evidence that TX Doctors will be declining patients who buy policies on the health marketplaces. Maybe Medicaid and Medicare as mentioned by a previous poster.
You said, you are seeing this...kindly supply full data.
Does anyone else know of doctors who are declining to accept patients who get healthcare under the ACA? I'm seeing this and wonder if others are yet.
The ACA IS NOT a type of insurance, it is an exchange where insurance can be obtained. A doctor has no way of knowing if my insurance was purchased direct, from an agent, or off of the exchange. My wife has BC/BS and I ham on Medicare, I can assure you tomorrow I'm going to check prices on the exchange versus what we are currently paying. If we can get her policy cheaper we will go that way, our doctors could care less as long as they get paid.
You must be listening to too much far right BS to even ask the question.
UHC, BCBS, Aetna and others are NOT participating in the exchange marketplace in WI, although they are generally dominant otherwise. They all say they're taking a "wait and see" stance for 2014.
We have, as far as I can determine, WPS (Wisconsin Physicians Service), Molina (out of CA), Wellpoint Compcare, and Cooperative Coalition (never heard of them) - all four operating as HMOs, as far as I can glean.
Our exchange offerings will definitely have limited networks. I'm hoping Froedtert is in one of them because my son was hospitalized there in July and still sees a doc there. Hospital is 2 miles away. Son/dil will be buying on the exchange. They are now uninsured as of 9/1. Without the ACA, he is uninsurable.
My Doctor said that she has no way to know if the insurance was purchased on the exchange or provided by an employer, or individual coverage. The office accepts and is part of certain insurance programs and if the insurance the person has is part of that program, be in ACA or otherwise, they will accept it. The only way they will know is after a period of time if they happen to figure out the insurance card/group identification numbers that will identify it as a plan offered only via the Marketplaces.
I think what many Doctors are saying is that they may participate with only certain insurance companies but not all insurance companies. If coverage was from a company that sells on the exchange that they are not signed up with, they won’t accept that insurance, BUT, they also won't be accepting individual non-exchange insurance issued by that company as well!....
….The other reason is they may accept certain plan types from that insurance company but not other plan types from that same insurance company. If the insurance sold by the exchange is not the type of plan they participate in, they won’t be accepting individuals who bought that plan from the Marketplace, BUT, they also won't be accepting that type of insurance plan from individual non-exchange insurance issued by that company as well!
Just saying they won’t be accepting "Marketplace insurance" while not explaining that it's not the Marketplace Insurance but rather the specific insurance company or type of plan of an insurance company that dictates their acceptance is really taking you for a dope and they want to fool with your head!
Based on my discussions with my doctor on the generalities of the ACA, I don't think he will accept the program's patients. I know he does not accept Medicaid patients now.
What "program". There is no program. It's legislation, not a "program". If you are talking about the exchanges, it's a WEBSITE to shop for insurance from traditional carriers.
Quote:
Originally Posted by Ceece
ACA hasn't gone into effect yet so who is declining who?
Tell us EXACTLY what "you are seeing". Seriously.
Many parts, most parts, of the ACA are already in place, some for a couple years now
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
