No, I think that’s just an artifact that results from their posting PDF’s for each region rather than actually entering the new information into an online database. It’s a stop-gap solution for them while they are still working on finalizing networks.</p>
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<p>A Blue Shield agent told me their online database was current (though of course they can still add to it). But I found the facilities I was concerned about on their lists. As I mentioned before, my personal doctor’s name is not listed, but she’s terrible about paperwork.</p>
Well, it’s $15,000 on the old policy, and the same rules apply – so if I’m hit by a bus in front of a non-network hospital, I’m better off if it happens in January than December.</p>
<p>CF, out-of-network providers do not have a contract with the insurance company, so they can insist on full payment beyond whatever the insurance company gives them. As I posted up-thread, however, I know how to handle creditors-- helping clients with a consumer debt was sort of a subspecialty of mine back in the day. If I intentionally see an out-of-network provider, I’ll make fee arrangements up front. If it’s the sort of thing where I’m unconscious in the hospital while the out-of-network surgeon is trying to save my life… well, I haven’t entered a contract then, have I? Just because someone sends me a bill doesn’t mean that I owe the money.</p>
<p>True, but in either case, I think getting hit by a bus would be considered an emergency, so the hospital would be considered in-network for these specific charges.</p>
<p>I agree with your last post that it may be possible to negotiate the bill with an out-of-network hospital. However, if you have significant assets, they are less likely to be so forgiving.</p>
But with the Bronze HSA PPO they are only paying 60% of the charges for in-network - so it’s not that much of a differential. </p>
<p>In network, the maximum OOP would be met with total allowed charges of $9125-- the insured pays $4500 toward the deductible, then 40% of the next $4165, in order to reach the OOP max of $6350.</p>
<p>Out of network, the max OOP is met with total charges of $14,200: insured pays $4500 toward the deductible, then 50% of the next $9700 to get to the $9350 OOP.</p>
<p>So there’s a difference, but it’s not a huge difference. Part of the reason the difference is fairly modest is because of the high initial deductible --since the insured is paying 100% of the allowed costs for either in-network or out-of-network, it doesn’t really make a difference for the first $4500.</p>
I wouldn’t tend to advertise how much I may, or may not, have in assets. </p>
<p>I tend to take a more legalistic approach. </p>
<p>If I enter a contract with someone, then I’m bound by the terms of the contract.</p>
<p>If someone renders services to me without a contract, then there is no agreement as to fees. The law says that under such circumstances, the service-provider can sue for quantum meruit, which is the reasonable value of services. My position would be that the insurance determination determines the that value. </p>
<p>How much money I happen to have in the bank is irrelevant, except to the extent that it impacts my motivation to prolong a dispute over a bill.</p>
<p>GP, I agree with you on that being hit by a bus is an emergency – I was just using that as an example for purposes of illustration. If I have a choice, I’m generally going to choose a facility that is nearby and in-network if possible. That’s why I’m probably going with BS as my ACA insurer – it looks like Anthem has cut out the best LOCAL hospital. BS has cut out some excellent hospitals from their network by dropping the UC’s – but I don’t live near those hospitals, so that’s not really relevant.</p>
<p>Calmom, your example works as long as the doctors or hospitals will agree to forgive the amounts in excess of the allowable charges for out-of-network providers. I may be hiring you to negotiate on my behalf if I ever have to deal with one of these providers. :)</p>
<p>I forgot about the deductible, so my number is inaccurate.</p>
<p>Calmom, I am assuming your legalistic approach doesn’t work as well if you’re going to the hospital for an elective procedure. The hospital will know they’re not in the provider network for your plan, so they will probably require a contract and maybe even a down payment.</p>
<p>BS has more doctors than Anthem in your region? I haven’t looked at BS network yet, but that would be a pleasant surprise.</p>
<p>I think Blue Shield is going to still offer the Blue Card program, which allows you to go to any provider in the country (outside of Ca.) that is in the Blue Shield/Blue Cross network. I am not sure Anthem is keeping Blue Card for their subscribers. Calmom, do you know what either one of them is doing with this program?</p>
<p>As I said, if I am making the choice for an out-of-network provider, I make sure the terms are set up front. I ask how much it will cost, and how they want the payment. If the terms aren’t acceptable to me, then I don’t have to go to that facility.</p>
<p>Calmom, I attempted to pay $100 per month to start paying off my husband’s $7,800 portion of his hospital bill (note that amount did NOT include doctor, PT, etc.). In the past, the hospital would have been OK with that. NOW, however, they sent me a long form to fill out. They wanted tax returns for several years, detailed list of assets, etc. So even if I did not wish to “advertise” our assets, I had no choice if I didn’t want to be accused of fraud.</p>
<p>This is how the subsidies work. Whether it is fair, correct, should be amended someway to include one’s assets, etc is not up for discussion on this thread. </p>
<p>If you want to discuss how you can amend your AGI to get some discounts, you are more than welcome.</p>
<p>So if someone lives off investment, they can get subsidies as far as they don’t generate too much income? That’s absurd because if you need $100K to live on, you sell stocks for 100K. Assume it appreciated 10%, your income is only 10K. It won’t be hard to stay below 400% poverty level.</p>
<p>Again, what you sold or bought is irrelevant to this discussion.</p>
<p>I do think it is a good thing for our nation if people can actually live off their savings for the next 10-20 years until medicare hits just to get those subsidies.</p>