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By and by, had that "free" screening colonoscopy uncovered a malignant cancer finding an oncologist to treat it with an ACA plan would be a challenge in and of itself.
That is totally NOT TRUE.
Aurora - our largest health care system, with numerous hospitals and doctors in my county and throughout the eastern part of the state, has all its providers in the Commonground Cooperative offering ACA subsidized plans, here.
Same with Froedtert - our Medical College teaching hospital - with a huge staff in all specialities - everyone on staff listed as a provider for the ACA through Commonground Cooperative.
The plans with the widest network, offering both Froedtert and Aurora providers and out-of-network coverage, are about 25% more expensive than the plans offering only the Aurora network. But, again, that Aurora network is HUGE. Aurora is well-equipped to deal with cancer patients of all types.
A patient whose malignancy is discovered while undergoing a colonoscopy at either one of their facilities would be immediately referred to the appropriate specialist within that facility - without a doubt. I wouldn't have any reluctance undergoing cancer treatment at facilities in either system.
Geez.......the fearmongering never ends.
Another good video on C-Span yesterday, interviewing a doctor who is a big proponent of the ACA:
By and by, had that "free" screening colonoscopy uncovered a malignant cancer finding an oncologist to treat it with an ACA plan would be a challenge in and of itself.
That's not true at all. My ACA plan includes many of the best oncologists in my state.
All it takes is a little research into what doctors, hospitals, and procedures are covered before signing up for an ACA plan. Anyone shopping for any health insurance should take the time to do that.
That's not true at all. My ACA plan includes many of the best oncologists in my state.
All it takes is a little research into what doctors, hospitals, and procedures are covered before signing up for an ACA plan. Anyone shopping for any health insurance should take the time to do that.
Healthcare.gov does not show that information (I've checked)-perhaps only after you buy it rendering your claim null and void? I'd rather not subject my health insurance to a Priceline model of finding out what I bought after I paid for it.
The main reason I refuse to roll the die and trade my coverage for an ACA plan (besides the brutal deductibles) is that I cannot see who is in what network.
I freely admit the ACA plans have lower premiums(and I don't even qualify for a subsidy), but at what long-term cost?
When I bought my policy from Anthem pre-ACA I was able to see exactly who was in what plan; very convenient.
As for these oncologists raining down from the skies....
On July 8, 2013, CMS released the CY 2014 proposed Medicare physician fee schedule which estimated a negative five percent impact on radiation oncology due to the changes in the CY 2014 proposed Medicare physician fee schedule. The cuts could be significantly greater for ASTRO members practicing in freestanding centers depending on site of service and patient mix.
Physicians are bracing themselves as more cuts to Medicare reimbursement are looming.
The new cuts will come on top of the 2% sequester cut instituted on April 1, and are part of the 2014 proposed budget.
The $3.8 trillion budget proposal released by President Obama will shrink the federal deficit by $1.8 trillion over 10 years. Included in that budget is a plan to reduce physician reimbursement for Medicare Part B drugs.
The proposed budget will lower the 6% service payment to 3%. Although the cuts are primarily directed at physicians, there is mention that rebates will be required by manufacturers.
This move could significantly affect access to cancer treatment, particularly in the community setting
(keep in mind these cuts to oncology reimbursement are to help pay for the ACA)
I've worked in healthcare finance+IT for seven years at a fairly high level, please trust me when I say nothing is free.
Like any government program you'll have some winners (and in the ACA the clear winner are the major for profit health insurance companies-please remember Kathleen Sebelius is 100% their creature) but you also get a lot more losers.
Healthcare.gov does not show that information (I've checked)-perhaps only after you buy it rendering your claim null and void? I'd rather not subject my health insurance to a Priceline model of finding out what I bought after I paid for it.
All I had to do was use my state exchange to compare costs, deductibles, OOP max and a few other things to get an idea of which plans I might want - then I went to the individual insurer's websites and looked up their coverage networks for the various plans and read the fine print of what was covered. It wasn't difficult at all.
Healthcare.gov does not show that information (I've checked)-perhaps only after you buy it rendering your claim null and void? I'd rather not subject my health insurance to a Priceline model of finding out what I bought after I paid for it.
The main reason I refuse to roll the die and trade my coverage for an ACA plan (besides the brutal deductibles) is that I cannot see who is in what network.
When I bought my policy from Anthem pre-ACA I was able to see exactly who was in what plan; very convenient.
Aw, c'mon. Seriously??????
You're short-changing yourself in missed opportunities in every area of your life if you can never be bothered to put forth a little effort.
If healthcare.gov isn't showing providers, go to the insurer's website.
It ain't hard.
That's what I did right after October 1. I KNEW there were four insurers in WI offering ACA subsidized insurance. healthcare.gov was FUBAR at that time.
So, I then went to each of the four websites and downloaded their provider lists. I was doing shopping for son/dil.
Oy vey....
******
Quote:
Originally Posted by PNW-type-gal
All I had to do was use my state exchange to compare costs, deductibles, OOP max and a few other things to get an idea of which plans I might want - then I went to the individual insurer's websites and looked up their coverage networks for the various plans and read the fine print of what was covered. It wasn't difficult at all.
All I had to do was use my state exchange to compare costs, deductibles, OOP max and a few other things to get an idea of which plans I might want - then I went to the individual insurer's websites and looked up their coverage networks for the various plans and read the fine print of what was covered. It wasn't difficult at all.
Ah, we do no have a state exchange, but the federal here. Our experiences would be very different then.
Without ACA, one will most definitely find there are so many plans out there which offer and give nothing. The NON ACA plans have more exclusion than they have benefit offerings. the only way one gets a good Plan without ACA. is they buy one that MOSTLY ONLY the VERY WELL TO DO AND THE WEALTHY CAN AFFORD.
ACA is by design to give people what they expect and pay for, and they hold the insurance companies accountable to provide what they offer.
Please, give examples of all of these "exclusions" because I don't really know of any....
All I had to do was use my state exchange to compare costs, deductibles, OOP max and a few other things to get an idea of which plans I might want - then I went to the individual insurer's websites and looked up their coverage networks for the various plans and read the fine print of what was covered. It wasn't difficult at all.
Exactly.
I didn't purchase through the exchange because I don't qualify for subsidies. I went to healthcare.gov, compared plans and then went to the insurer's website and looked at the plans. What I didn't find online, I asked the customer service rep by calling their 800 number.
It was easy information to find. It took me an hour or two of research and comparing plans before I found the plan I wanted.
Healthcare.gov does not show that information (I've checked)-perhaps only after you buy it rendering your claim null and void? I'd rather not subject my health insurance to a Priceline model of finding out what I bought after I paid for it.
.
No, my claim is not at all null and void. I did some research through the health insurance providers. I looked at the plans on the exchange, went to Blue Cross, Anthem, and Health Net websites, did some research, read some documents, and called to ask further questions. I didn't even have to give them my name. Then I purchased my ACA plan. It wasn't any different than when I purchased individual coverage in the past or when I compared plans that were offered by an employer.
You can find doctors, hospitals, benefits etc. before you sign up. For example, the one big plus for me that I did not have with my previous insurance and wanted to have with this one was the ability to use the walk in clinic at CVS/Walgreen's. I love that if someone in my family has a bad earache or sore throat on a Friday night, we can run to the clinic and get an antibiotic instead of going to urgent care or waiting until Monday. My last policy did not cover the clinics, so I wanted to be sure my new one did. It was easy to find that information before I signed up for the plan, so I knew that my policy covered it before I purchased it.
My premiums are reasonable, my coverage is good, and all of my current doctors are in network. I have used the insurance on two occasions already, and I have had no problems whatsoever getting care or tests. The only difference between acquiring this policy and my last individual policy was that I did not have to fill out 25 pages of medical history going back 30 years and wait to see if I would be approved or if certain conditions would be excluded. (not even conditions I am being treated for, but potential issues because of a family history or a test I had in the past) The application process was simple, straightforward, and quick.
Last edited by raindrop101; 03-08-2014 at 10:29 AM..
Ah, we do no have a state exchange, but the federal here. Our experiences would be very different then.
That would be because you are in a red state, where the state WANTED to make it as hard as possible to sign up.
But, let's say you are in Florida - you can still do the simple legwork that others in the thread have done. The state regulates what health plans can be sold, so when you go up on the Federal exchanges, it will tell you what plans are offered. I put in Alachua (Gainesville) and only silver plans, and I get a range of plans, HMO, EPO and PPO, mostly offered by BCBS. The first three are:
Blue Cross Everyday Health 1477
Blue Cross Everyday Health Plus 1477P
Blue Options 1440
you can download a "mini benefit summary" PDF, which has a link to a page with all their networks and click from there to see who is on the networks.
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