<p>College Confidential upgrade has improved GP’s stature tremendously on CC.</p>
<p>Last week the man had 0 posts but now he has 1235 posts. He should send a thank you note to Roger Dooley now that he can send PMs!</p>
<p>Texas, yeah, I am now a senior member. This is probably like going from an entry-level position to senior vice president in one step. It must be my winning personality.</p>
<p>GP’s identifying info says both “New Member” and “Senior Member” at the same time. Does the second one refer to our age? :)</p>
<p>It’s your charm and your go-getter attitude, GP. Especially that persistence.</p>
<p>This recent PBS transcript has a good explanation of generic drug pricing issues.
<a href=“http://www.pbs.org/newshour/bb/health/july-dec13/generics_12-23.html”>http://www.pbs.org/newshour/bb/health/july-dec13/generics_12-23.html</a>
I continue to find that I need to do a price check before deciding where to buy. On several drugs we take, Costco without using our Rx plan is substantially cheaper than our Rx plan, and would still be so even if we met our deductible and were only paying the co-pay rather than the full cost. </p>
<p>I have done drug appeals, long before Obamacare was even a word. They take time, but you get there. Appeals in general with insurance companies take time. If you feel like you’re not getting a fair shake, you can file a complaint with your state division of insurance, which definitely lights a fire under the insurance company’s butt, and often direct attention from a special team operating out of the executive offices.</p>
<p>Or you can file a class action lawsuit. Been there, done that, and a certain health insurer would surely have been better off following the policy provisions as written when I first requested that they recalculate the benefits than in paying for the class settlement. But, some companies (like some people) are experiential learners.</p>
<p>This is a silly question, but can you fill a Kaiser prescription at Costco, if opt to pay out of pocket? </p>
<p>A woman I know at work has Medicaid, now. She has a physical disability and has had Medi-Cal prior to being switched to Medicaid, as CA is an expansion state. Had a serious health problem this month and needed a doctor’s visit. </p>
<p>Contacted doctors, told she was going to be put on the waiting list. First available appointment is April. She was told to go directly to ER for visit where she was given an xray and a prescription for antibiotics. </p>
<p>She told me about it, today and is just shaking her head. She is working two jobs, cannot get employer based coverage - supported ACA and is saying this is not an improvement for her own situation. She has not previously had difficulty getting appointments under MediCal. </p>
<p>Well, there are a lot more people on it now so… yeah. Sigh.</p>
<p>“This is a silly question, but can you fill a Kaiser prescription at Costco, if opt to pay out of pocket?”</p>
<p>You can but you have to get the doctor to give you the script. H did this to get his asthma drugs from Canada once. It was not easy. But it happened. </p>
<p>Samurai Landshark – it shouldn’t be a problem. You will need either a paper scrip or for Kaiser to fax it over.</p>
<p>The woman has two jobs and she is living barely living above poverty at best. Hmmm… Not good </p>
<p>I am out of purgatory, but it was good I was in it. :)</p>
<p>This is my anecdote… The amount of people who are going to have individual health insurance is going to double in a year. Double. Around 15 million people or so people are no longer going to be uninsured. 15 million people. And in two more years another 15 million people are going to be covered. </p>
<p>Another proposal for health care insurance came out recently and I hope people read that proposal. I hope people understand that proposal.</p>
<p>I missed GP’s wonderful bs posts. My favorite was the post from November complaining about the top hospitals not being in networks. I dont know why a link from November was posted. Turns out these hospitals were in negotiations with insurance companies and more insurance companies are including these hospitals in their networks.</p>
<p>Cedars for one, but GP knew that already.</p>
<p>Sloan Kettering, the Mayo Clinic, Seattle…, go look it up today. </p>
<p>She just finished grad school and looking for full time work. Her hourly wage is quite good, but like me, working for agencies that never provided enough hours to get benefits. They always keep you at just under the hours required for benefits. </p>
<p>Her prexisting health condition made her eligible for MediCal since she was a kid - not sure exactly how that works. </p>
<p>SL, Just asking: she couldn’t get a fast appt with “her” docs or she would have been a new patient? </p>
<p>dstark, can we prod you for a link?</p>
<p>From what I understand, she has to see new docs. Getting an appointment was impossible. They told her to go to Harbor UCLA emergency room, because demand for a scheduled appointments of any kind was high. </p>
<p>She waited for 13 hours, there. </p>
<p>Dumb question but I thought Medicaid is synonymous with Medical in CA? </p>
<p>It is, now. </p>
<p>She was on Medi-Cal, which is now Medicaid. I am not sure if reimbursement rates are same (I would imagine they are). She said was now considered part of Covered LA or maybe t was LA Covered? I believe this is why she has to see new doctors. </p>
<p>Samurai – I think you are missing a piece of the story. Medicaid in California is still called Medi-Cal – that hasn’t changed. You can verify this just by going to the Covered California web site at <a href=“https://www.coveredca.com/”>https://www.coveredca.com/</a> – just scroll down to the picture of the calculator next to the “shop and compare” link – you’ll see that they refer specifically to Medi-Cal. </p>
<p>But here’s a better link: <a href=“http://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/Medi-CalEligibility2014.aspx”>http://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/Medi-CalEligibility2014.aspx</a></p>
<p>Basically, there is now an additional path to get on Medi-Cal, but the program hasn’t changed – and your friend did not need to change her coverage if she was still eligible. There may have been many reasons she needs to see a new doctor, but a change in her coverage is not one of them. </p>
<p>Here’s another article exploring the impact of the ACA changes in the LA area: <a href=“Obamacare Brings Changes To Medi-Cal For Patients, Health Care Providers — Hometown Station | KHTS FM 98.1 & AM 1220 — Santa Clarita Radio - Santa Clarita News”>http://hometownstation.com/santa-clarita-news/health/obamacare-brings-changes-medi-cal-patients-health-care-providers-39631</a> – if anything, access for patients should be improved because of ACA-mandated increases in provider rate payments, but the article explores a wrinkle on that. </p>
<p>It sounds like your friend was trying to get signed up as a new patient with a new primary care provider that didn’t have an opening for several months, and when she told them that she needed urgent care, they suggested going to an emergency room based on her statements and the symptoms reported. But that doesn’t sound like an ACA issue. </p>
<p>Samurai, “LA Care Covered” is one of the health plans available under Covered California – I’m pretty sure that it’s an HMO. See: <a href=“L.A. Care Covered Plan | L.A. Care Health Plan”>L.A. Care Covered Plan | L.A. Care Health Plan; and <a href=“https://www.lacare.org/aboutlacare/healthcarereform/coveredcalifornia”>https://www.lacare.org/aboutlacare/healthcarereform/coveredcalifornia</a> (These are two different sites, but both pertain to the same health group – I was confused at first but you can see that the logo is the same on both sites).</p>
<p>So it sounds like maybe your friend is no longer on Medi-Cal but chose LA Care as a subsidized plan via Covered California – it’s possible that she was confused during the process about what she was signing up for – it’s also possible that Medi-Cal in the LA area is now contracting with LA Care – but again, I think that you aren’t really getting the whole picture. </p>
<p>calmom, is your cat really half pink?</p>