Affordable Care Act Scene 2 - Insurance Premiums

<p>Ha, of course if your doc isn’t covered, you may have an issue. The point was, just checking 5 miles seems arbitrary. Our current practice is a tad further than that. </p>

<p>And, though it may illustrate something to someone, just a count of docs doesn’t help if GP’s doc or someone else’s, isn’t on that list. Or if it doesn’t include enough choices for the sort of doc you need.</p>

<p>Bottom line: research, ask questions and make the best choice you can.</p>

<p>94930 is Fairfax, a lovely town in Marin that is right on the side of Mount Tamalpais. You would have found a lot more doctors if you hadn’t chosen an area where the western half of the 15-mile radius circle has no roads, houses, doctors offices or hospitals, only sweet sweet redwoods and mountain trails.</p>

<p>Actually the ACA did attempt to address the dearth of providers in rural areas, in two ways. It provided $1.5 billion over five years for the National Health Service
Corps for “scholarships and loan repayment for primary care practitioners, including doctors and nurses, who work in areas with a shortage
of health professionals.” And it also provided loan repayment for pediatricians who would agree to practice in rural and other underserved areas.</p>

<p><a href=“http://www.whitehouse.gov/files/documents/health_reform_for_rural_americans.pdf[/url]”>http://www.whitehouse.gov/files/documents/health_reform_for_rural_americans.pdf&lt;/a&gt;&lt;/p&gt;

<p>That’s great! I like that a lot.</p>

<p>Me too. I appreciate that use of my taxes for sure…</p>

<p>[Reports</a> of erroneous WA health exchange debits | kgw.com Portland](<a href=“http://www.kgw.com/news/Enrollees-report-erroneous-debits-by-WA-Healthplanfinder-235244701.html]Reports”>http://www.kgw.com/news/Enrollees-report-erroneous-debits-by-WA-Healthplanfinder-235244701.html)</p>

<p>Gives a whole new meaning to double dipping. :p</p>

<p>I am assuming 94390 is a typo.</p>

<p>I have no idea what was wrong with 94960 which is San Anselmo, a nice town in Marin.</p>

<p>Corte Madera is a nice choice. </p>

<p>A 30 mile radius from Fairfax includes SF.</p>

<p>Do you know what I find amazing about the WA story? </p>

<p>How many people live paycheck to paycheck in this country.
This country is a mess. </p>

<p>Ok… Off the soapbox.</p>

<p>How is the network in Austin Texas?
This question has some meaning to me.</p>

<p>It’s sad that so many people live paycheck to paycheck. It surprised me that someone said their account had been mistakenly debited of $800 (which is indefensible) and they therefore didn’t have the money to pay the nanny. I would have thought someone with the resources to pay a nanny would have had more liquidity.</p>

<p>"How is the network in Austin Texas? "</p>

<p>We don’t worry about doctors. We send them off where people can’t get enough despite having 10000. :D</p>

<p>Of the one thousand doctors within 15 miles of my zip, probably half of them are acupuncturists, chiropractors, physical therapists and family marriage counselors. :slight_smile: I noticed the list includes all these other professionals as well as doctors.</p>

<p>Ok…</p>

<p>Is the Univ of Teaxs in Austin covered under any individual plans?</p>

<p>GP, you have 1,000 doctors in your area and in your potential network?</p>

<p>You have got to be kidding…</p>

<p>Ok…I found this link about Austin…</p>

<p><a href=“http://health.usnews.com/best-hospitals/area/austin-tx[/url]”>http://health.usnews.com/best-hospitals/area/austin-tx&lt;/a&gt;&lt;/p&gt;

<p>The 1000 is for my current plan. It’s around 200 with the new plan. For some reason Blue Shield has a problem with where I live.</p>

<p>I have this feeling you arent really going to have a problem finding a doctor. ;)</p>

<p>So far, How many doctors are in your area with Blue Cross?</p>

<p>A relative worked with Blue Shield on ACA. :)</p>

<p>Just tried it on the Anthem site and only got 128 doctors within 20 miles of my zip under the new plan. That’s worse than BS. Hopefully, that number isn’t correct.</p>

<p>I am going to take the over 128 side of the bet. </p>

<p>Do you want 128 or fewer? :)</p>

<p>The Anthem site has to be incorrect because a number of specialties were missing. Anyway, I am more concerned with hospitals than doctors. I can always pay a doctor out of pocket, but a hospital is a different story. I just want to see all the best research and specialty hospitals in my network. Anthem is close, at least in Ca, although I got to figure out what is a tier 2 hospital and what are the restrictions on using doctors there.</p>

<p>dstark, the only betting I am doing today is the Mega Millions Powerball lottery. Bought one ticket at my local coffee shop. After I win on Tuesday (over $500 million) I will stop thinking about Obamacare.</p>

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<p>I can tell you that a huge number of doctors listed in my region under the old plan are chiropractors. California has decided that chiropractic is not an essential benefit, and so it isn’t covered on any exchange plans. That means that all of the chiropractors are being dropped. </p>

<p>You don’t need to know my zip code, I checked the listings myself. Blue Shield includes the local medical facility that is most important to me, Anthem doesn’t. I don’t know what the situation is in Southern California, but in Northern California it’s come down to Sutter-owned hospitals. </p>

<p>I also posted that my own doctor doesn’t seem to be on any new network, but I don’t know if that’s a paperwork problem on her end. </p>

<p>I do see a chiropractor – I started just recently, and have been paying from my HSA. It’s frustrating that it isn’t going to be applied to the deductible, but the cost is too low to make much of a dent anyway. If I had to choose between giving up my chiropractor or giving up my MD— I’m sticking with the chiropractor. If it was just a matter of my personal doctor, I’d save my money and switch to Kaiser - I don’t see my doctor doing anything different than any other doctor would do, except that perhaps another doctor would do a better job of nagging me to get age-appropriate preventive services. But I want the other, Sutter-affiliated facility for the serious stuff. That is, if I had a medical emergency, that’s where I’d head.</p>

<p>In any case, I don’t see the value of counting up the number of doctors listed – I’m not collecting doctors. A lot of the doctors on the old network weren’t accepting new patients – and some are probably older and retiring. So I can see when the insurance companies put out a new network that simple attrition will reduce the numbers somewhat.</p>

<p>Also, in response to another post above: I don’t live in Marin and have never posted anything that I am aware of that would lead anyone to that conclusion. So I don’t know where that comes from- maybe someone has me confused with DStark. I think I’ve posted my county/region before and if someone wants to sift through my posts on this thread, they are welcome to do so. I’m not playing this game: I’ve selected my plan, paid my binder premium, and am moving on with my life. ;)</p>

<p>I just want to point out that GP has selected for example an HMO instead of a PPO. I am curious as to what the reduction is had a PPO plan been selected. There is a pretty significant differential between the cost of an HMO plan vs a PPO plan (at least in my case) and perhaps this is in part related to network size?</p>