<p>GP, are you seriously arguing with me that the exchange plans have the same price as the employer-provided group plans? What would be the point of comparing a $1500/month employer plan with a $700/month individual plan?</p>
<p>“As for a worse policy - anyone can purchase any policy offered on the exchange. They are not forced to buy a particular policy.”</p>
<p>Most unsubsidized subscribers cannot afford anything more than Bronze. The majority of the subsidized are signing up for Silver. I consider this to be absurd. </p>
<p>You do know that the subsidized people are supposed to sign up for Silver, don’t you? The reason they made the cost-sharing subsidies available only for Silver is that they wanted people to sign up for Silver.</p>
<p>You don’t have any evidence that unsubsidized people are signing up for Bronze, do you? I thought not. </p>
<p>It took me a few minutes. I found an individual exchange plan in NY with the same in network as NYSmile. It is the EPO plan that NYSmile considered. Same in network. Amazing. </p>
<p>I had a feeling the plan probably existed because… You know… </p>
<p><a href=“http://www.valuepenguin.com/ppaca/exchanges/ny”>http://www.valuepenguin.com/ppaca/exchanges/ny</a></p>
<p>Health Republic…</p>
<p>Premier…</p>
<p>I just . 
</p>
<p>around $290 for a silver…</p>
<p><a href=“https://newyork.healthrepublic.us/individual/”>https://newyork.healthrepublic.us/individual/</a></p>
<p>“PrimarySelect EPO members still have direct access to the full MagnaCare extra network too.”</p>
<p>NY magna care unsubsidized is $1500 per month for a family. Magna care is currently not accepting anyone in the ages above the 40 year age group, so I have been told from a friend who works in a doctors office, and this is coming from the doctors office side of these plans. Doctors have zero idea of what they will be reimbursed for a visit. </p>
<p>And I really hope all of you are reading the fine print on these plans.</p>
<p>20% co-insurance is ON TOP of your yearly deductible. So if you do have a planned surgery, 20% can be quite sizable.</p>
<p>Dont you have an out of pocket maximum? </p>
<p>Is that cost for an epo plan?</p>
<p>And what are you doing up so late?</p>
<p>I was talking about the Health Republic Plans that use Magna Care’s network. The same as NYSmile.</p>
<p>Interesting info on NY Magna Care.</p>
<p>Good article about how screwed up the networks are in NY.</p>
<p><a href=“http://www.newsday.com/news/health/many-li-doctors-confused-by-ny-health-exchange-plans-1.7141043”>Many LI doctors confused by NY health exchange plans - Newsday;
<p>CF, the silver plan was around $1,500 a month for my wife and me. Common sense would tell you most of the unsubsidized will be selecting the bronze plans</p>
<p>Puttung your money on the line…</p>
<p><a href=“Bloomberg - Are you a robot?”>Bloomberg - Are you a robot?;
<p>"Two of the hottest motifs right now are Obamacare and repeal Obamacare, Walia says. They represent, respectively, the idea that the law will succeed and that it will fail. The Obamacare motif is made up of hospitals, generic-drug makers, pharmacy-benefit managers, and companies specializing in electronic medical records, all of which stand to gain from the Affordable Care Act’s emphasis on cost control and its guarantee of payment. “Before the law, 30 percent of hospitals’ revenue was unbilled because you could walk into an ER and not pay,” Walia says. “They’re now paid by the U.S. government.” The Obamacare motif is up 46.9 percent in the past year, doubling the performance of the Standard & Poor’s 500-stock index (up 22.8 percent).</p>
<p>Repeal Obamacare is composed of companies that would benefit from the law’s demise, mainly medical device manufacturers, which the ACA saddles with a 2.3 percent excise tax; assisted-living and home health-care providers, which will suffer from reduced Medicare and Medicaid reimbursement rates; and medical diagnostics equipment and services providers, which may encounter reduced demand as a result of the law’s efforts to curb unnecessary testing. The repeal Obamacare motif has risen just 13.8 percent in the past year."</p>
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<p>Interesting Newsday article, GP, but I don’t think it says what you think it says. To me it says the docs doing the complaining are generally kind of clueless. They signed broad contracts which allowed the insurers to make them part of networks for new plans, and are now surprised to find that they’re part of new plans. Or they signed contracts which allowed the insurers to exclude them from certain plans, and are now surprised to find that they’re excluded from some plans offered by some insurers they had long done business with. It sounds like the insurers tried to educate them with mailings, seminars, and all the rest, but being busy professionals who generally are more interested in the patient care side of the practice than the paperwork and financial side, they pretty much blew off all of those opportunities to get up to speed, and now they’re surprised to find that they don’t know whether the insurance their patients are bringing them is good or not. Yes, it’s a bit of a mess, but it’s not a “sky is falling” kind of mess. The docs just didn’t do their homework, and now they and their patients are paying the price for that. This will all get sorted out, and the docs will probably be more attentive in the future. The sky is not falling.</p>
<p>Repeat after me: The sky is not falling. The sky is not falling . . . . </p>
<p>OK, I laughed. That Newsday article has a comment from two days ago:</p>
<p>“Don’t ask the doctor, ask the billing dept. in the office. They know exactly what plans they accept. We just went through this. 5 of 7 of our docs said they didn’t accept “exchange” insurance. Then we called the billing office-told them we were looking at one of the exchange programs (Health Republic-that uses the Magna Care) Guess what, now all but 1 accepts the Heath Republic Plan–including some very specialized docs in Manhattan. Doctors need to practice medicine, not worry about billing.”</p>
<p>Pretty close to my strategy, and I swear I didn’t write it. I’m going to ask D next weekend what she’s seeing at her company since they are in this industry.</p>
<p>I swear, the more I read on this thread, the more VERY grateful I am that I still have employer insurance. Thank God! What a mess. Had a crapload of medical issues this week, and all the doctors and dentists I’ve seen have said our insurance is the best they’ve ever seen, and so many people’s insurance are now covering very little. I think I am never going to be able to retire, because of the mess and expense of paying for crummy medical insurance.</p>
<p>Now that I think of it, I don’t know if that is good or bad to have great insurance, as if I was paying big bucks for the crummy insurance that people are getting on the exchange or the individual market, maybe I’d just go ahead and retire early anyways.</p>
<p>Hmmm… Maybe next year my son will switch to Health Republic.</p>
<p>Y’know, it’s the end of February. The billing departments at doctors’ offices and the claims offices at insurance companies have to have figured most of this out by now. </p>
<p>I commend Newsday for that article. Instead of merely reporting what the doctors are saying, the reporter went to the insurers. And you can hear their exasperation seeping through-- Oh, Jeez, we tried and tried to explain what was going on to those docs, we sent mailings, we invited them to seminars, but they didn’t pay any attention and now they have no idea what contracts they have signed.</p>
<p>I don’t have a lot of patience with highly-educated professionals who sign contracts and then don’t know what’s in them. I don’t have a lot of patience with insurers who can’t get their provider lists accurate, either. The people at the insurance companies who do the provider lists should talk to the people in claims.</p>
<p>GP, my common sense tells me most people who would be buying unsubsidized insurance on the exchanges are a lot younger than you. You’d have to pay $1500 for a Silver plan, but most people would be on the hook for a lot less.</p>
<p>Bclintonk, you nailed it as usual. I suspect your various theories about why people are getting conflicting information are right on. But I am sure that things will indeed get sorted out. I’ve said for a long time that it will take a while for the dust to settle. </p>
<p>GP and others need to just take a deep breath. The sky is not falling. </p>
<p>I agree - if I lived in one of the 30 something counties in NY I would choose Health Republic (Magna Care Extra) too, assuming it is open to people over 40 years of age. I understand it is a COOP partially funded by the federal govt. This is a new plan so it will be interesting to see what happens when they no longer can rely on federal funding. But it does seem superior to the rest. The reviews on the internet of the network are awful but that could be the few disgruntled who are likely to express their opinions on the internet. </p>
<p>Is anyone disputing that everyone of the exchange plans in NY (except for maybe Health Republic) has severely restricted the networks of hospitals and/or doctors?</p>
<p>Here is what I don’t understand. If this Health Republic can include all the fancy research and high-end specialty hospitals in its network, what the heck is wrong with all the other insurance companies in NY and all of them in CA.? Why can’t these companies figure this out, too.</p>
<p>The vast majority of New Yorkers who did not have employer provided coverage pre-ACA had access to networks consisting of -0- doctors and -0- hospitals. </p>
<p>They simply could not afford to buy insurance in their state. </p>