<p>Cedar Sinai is not in any of the exchanges in Ca. </p>
<p>dstark, I wouldn’t be so sure you can go to Stanford or UCSF for medical care. Maybe Stanford since they are in a PPO region but UCSF is in an EPO region. I am still not convinced someone in a PPO network can use a provider in an EPO network, despite what an agent may have told you. </p>
<p>The agents for Anthem and BS are generally wrong most of the time. There are many posters on this thread who easily know more than they do. Until there is a provider search tool on Anthem’s website, none of us can know for sure…</p>
<p>We Californians have talked about Kaiser in the past. Samurai Landshark has talked about Kaiser. </p>
<p>Kaiser is a hmo so it has its own limited network. No UCs. No Stanford. Usually Kaiser’s pricing is very competitive, but during the first year of ACA Kaiser’s pricing looks a little high. </p>
<p>I like Kaiser. I may join Kaiser in the future. I live much closer to another hospital in Anthem’s network. Some people really like Kaiser. I know people that have had professional dealings with Kaiser that think it is a fantastic place and have signed up with Kaiser. </p>
<p>Others tell me it is a middle class meat market. :)</p>
<p>Idad, we have the same situation in Rhode Island. BCBS is the only provider (no competition due to state regulations) for direct pay customers so we have no choice, other than the gold, silver, or bronze plans offered by BCBS. The plan that BCBS will roll me into (bronze) will cost be 100% more than my current plan. I can lower my deductible to a gold or silver at 200% or 300% of my current premium.</p>
<p>I’ve never had an issue with a car insurance company.</p>
<p>I was kicked out of the hospital as a young twenty something after I had a complicated C-section, after only a day and a half. we would have paid out of pocket, since I really needed more care, but the insurance company told my doctor that if she kept me there, they wouldn’t deal with her in the future.</p>
<p>I had amazingly expensive insurance at the time, and still do.</p>
<p>The two other times I needed to use the insurance, they wouldn’t pay and we had to pay out of pocket. Once was an emergency with one of my kids. The other was some other thing.</p>
<p>At no time in my life has insurance paid for anything we actually needed. The only reason to have the damn stuff is so you can get in the doctor’s office to begin with.</p>
<p>Now, they are restricting networks. It’s appalling.</p>
<p>GP, I am in the PPO region for Anthem. UCSF is listed in SFs network. Stanford is listed in the network in Santa Clara County or San Mateo County.</p>
<p>I have been told twice by Anthem those places are in my PPO network. There are newspaper articles about Anthem and Stanford or Anthem and the UCs.</p>
<p>I believe Stanford’s own website says they have a deal with Anthem and I already didcussed this with you and provided the link. </p>
<p>So… You provide the info… That Anthem’s published network is wrong, the contracts arent signed, the newspapers are wrong ( the articles were not opinion pieces. They were more like press releases) qnd the websites are wrong. </p>
<p>I actually called in and listened to the Covered Ca. meeting in Sacramento today. It was surreal listening to them talk about the spectacular success of the exchange in Ca. They referred to the non-grandfathered individual policyholders as just 1% of the state. (even though were talking about hundreds of thousands of people). They kept saying these plans were substandard and non-grandfathered people should be thrilled to pay for the wonderful exchange plans. Not once did any anyone mention these plans have very restricted networks or that you might not be able to see your doctor anymore. The outcome was pre-scripted. I knew one minute into the meeting what they were going to do.</p>
<p>dstark, I may not be able to keep my plan after March 31 but I am going to keep my network. I have a few ideas I am working on; I refuse to capitulate to our overlords in Sacramento.</p>
<p>Lerkin, there have been outrages over home insurance. </p>
<p>In calif, there was so much outrage over the auto insurance industry that now it is a regulated market. Auto insurers have to receive permission from the state when they want rate increases. There is a proposition that is going to be on the ballot to do the same thing to the health insurance industry.</p>
<p>dstark, please provide the link which specifically says that people in a PPO region can use providers in an EPO region. Other than having two agents tell you this, give me some other proof. You can rely upon what agents tell you, I’ll wait till I see it in writing or on Anthem’s website. Isn’t it a little bit weird that Anthem doesn’t have a provider search tool on their website yet? Less then 30 days to go (Dec 15) and this is not yet available. Unbelievable.</p>
<p>I have seen that PDF file. It doesn’t say anything about being able to see providers in other EPO regions. It just lists every provider for each region. For example, we know if you live in San Francisco, Los Angeles, San Diego, Orange County, you cannot see any of the providers located in other regions in that PDF file</p>
<p>Just to let everyone know another trick that Blue Shield is trying to pull in Ca: if you go to their website and search for doctors within 30 miles of your zip code, not only do you find very few doctors, but many of them are refusing to see new patients. You have to play with the search tool to discover this little wrinkle. It seems like some doctors are signing up for the exchange but refusing to see new patients. Nice</p>
<p>Kaiser will send bone marrow patients to City of Hope and kidney transplants to UCLA - but even when they authrorize an out of netwrok referral to a specialist, they still might not pay for treatment. </p>
<p>Kaiser has a good reputation for routine monitoring and treatment. But they are not known for cutting edge or complicated treatments for serious or rare diseases.</p>
<p>Kaiser has highest rates of all insurance companies in Covered California. They did this intentionally - didn’t want to get too many new patients, especially sick ones. </p>
<p>A few years ago, Kaiser was reputed to hire foreign trained doctors who didn’t speak English very well. I think that has gotten better lately, no?</p>