<p>The insurance plan changed June 2013 to ACA compliance, same exact plan a $22,000 cost to employer plan. first part of surgery done by same surgeon May 2012, out of network as current situation. Insurance company paid usual and customary charges, this particular surgery in May 2012 was 36,000, we had to pay 9,000 out of pocket. </p>
<p>This was a major national insurance carrier. When we were looking for alternative options, no doctor I spoke to would pick up a patient mid care, as it was a multi step surgery, this particular procedure is not done often. </p>
<p>You may believe it is not the direct effect of ACA, in the minds of the insurance carriers it is. The network of available doctors agreeing to participate shrank, the reimbursement rate for out of network providers was switched to medicare rates. Our out of pocket expenses will not be applied to our maximum yearly cost. </p>
<p>In fact and its kind of comical, this child has only satisfied $200 of her yearly individual cost of $500. And that was just some labs and X-ray costs. </p>
<p>Medicare rate reimbursements will be the new phenomena, call and ask your providers which method they use. You might be shocked how many are now using it. </p>