<p>"I’'d just enroll for the best plan during open enrollment, get all my doctor needs done within a couple weeks, and cancel my policy for the rest of the year. I’ll wait till I get really sick to get insurance full time. Probably savings in the long run for me. "</p>
<p>A body doesn’t know when it’s open enrollment time . Anytime after open enrollemt ends you could get get sick or injured. I had no control when my body decided to attack itself. Took two months to get a proper diagnosis, a boat load of tests, several doctors, an invasive procedure to rule out cancer, many different drugs and 1 trip to emergency room, until finally getting a diagnosis with 4th doctor to see me. and two months after symptoms became acute. I now required daily medication and pelvic floor physical therapy. I’m approaching $18K in medical bills. Fortunately, I have great insurance and my OOP has been less than $300, but if I did it the bearcat way I’d be SOL. And my condition isn’t even life threatening and requires no surgery but is incredibly painful and debilitating without treatment. I was perfectly healthy before I became sick. </p>
<p>My cousin, who is only 45, just found out last week (after open enrollment ended) that she has stage 3 colon cancer and needed emergency surgery after being rushed to ED hemorrhaging profusely. She would be in a world of hurt if she didn’t have health insurance and would have to wait until next Nov. to get it. I’m sure my bills are miniscule to what hers will be. </p>
<p>Unless you have a qualifying life event - and getting sick isn’t one of them - you cannot get insurance now except during the once a year enrollment period which only runs from Nov. 15-Feb. 15, for coverage beginning Jan.1st of each year. </p>
<p>Anyone planning to do what you are suggesting is taking a pretty big risk and not the brightest bulb in the package. </p>
<p>The article is full of praise for Obama and does not sound like it could have been written by GP who would never ever say such things. That makes it factual enough for me! I tend to believe there could be a problem with medicaid coverage irrespective whether the writer made up the 96 number. I would be shocked if it was exchange plan since the insurance plans do provide a list of doctors and one can always call the insurance company to ask to cover out of network if they have no doctors willing to take on new patients.</p>
<p>I thought the three anecdotes were interesting. They sounded like they were true and pointed out issues that need to be addressed.</p>
<p>I suspect the woman on Staten Island bought a policy that had an adequate, if small, network with almost no doctors on Staten Island. It’s absurd to sell her a policy that forces her to go to Manhattan or one of the other boroughs to get treatment. The insurance company had no business selling a policy to a woman on Staten Island that had no local doctors for her. If her story is true (and I don’t disbelieve it) her insurance company is at fault for an inadequate network. They better step up and fix it.</p>
<p>The woman on Medicaid (with the Horizon card) is pointing up an already-existing problem that surely is worsened by the Medicaid expansion. In some areas, but not all, it was already difficult to find a doctor that accepts Medicaid. That problem demands a legislative solution, though I don’t know what it could be.</p>
<p>And the Susan Estrich op-ed is saying something that no supporters of the ACA disagree with: some people are having trouble finding providers that accept their insurance, the insurance company websites are inaccurate, and this needs to be fixed.</p>
<p>Covered California got 1.4 million exchange enrollees through the enrollment period. In addition, 1.9 million Californians enrolled in Medi-Cal, California’s Medicaid program.</p>
<p>“[Covered California director Peter] Lee said insurance companies are reporting that 85 percent of all enrollees have paid their first month’s premium.”</p>
<p>Agree with your next to last post, Fang. No one has said ACA is perfect, despite certain assertions to the contrary. There is a lot that needs to be fixed, and it will be. In the meantime, perspective is a wonderful thing. We have many millions of Americans who now have decent affordable insurance. I know that doesn’t count for much with some, but it’s a very big deal to those many millions. </p>
<p>“And the Susan Estrich op-ed is saying something that no supporters of the ACA disagree with: some people are having trouble finding providers that accept their insurance, the insurance company websites are inaccurate, and this needs to be fixed.”</p>
<p>For crying out loud, then the politicians should get off their posteriors, stop patting themselves on the back for giving away insurance for practically nothing and fix the dam* problem. </p>
<p>Also, states have laws about adequacy of provider networks: the plan has to have X doctors for every Y people, and has to have adequate numbers of specialists (or allow people to go out of network if they need specialists). Why don’t the states get off their duffs and enforce those laws?</p>
<p>And states ought to get tough about insurance companies provider lists. Seems to me fraud statutes ought to apply: if I look at the insurer’s website, see that my doctors are listed, buy a policy on that basis, and then discover that the insurer’s website has no relationship to reality, that ought to be fraud, and it ought to be actionable. We may need stricter laws about provider lists, and we certainly need enforcement of existing laws. Insurers should be forced to make truthful provider lists easily available at the time insurance is purchased.</p>
<p>Solving Medicaid is hard. But making insurers tell the truth should not be hard.</p>
<p>My friend, a specialist and I were talking about this whole new system. His office is requiring cash on the barrelhead before any visit or procedure. People will claim they have insurance, show a card, and then the insurance company says they don’t. He says it’s amazing the number of people who feel that they should not have to pay their doctor bills. So it’s cash up front, work out the insurance later. </p>
<p>The only way to add to the number of providers taking ACA plans is to raise the reimbursement levels and that will necessarily raise premiums.</p>
<p>It’s amazing the number of people who are under the impression that Obamacare means free health care for all. Period. “Obamacare, doesn’t that just mean it’s free?” is a real-life quote from a college student I know personally. This is not a dummy and not my kid. Thankfully.</p>
<p>Obamacare reminds me of my experience at the post office on April 15. I file my taxes in Oct but mail my estimated taxes by certified mail on April 15. There was literally a line out the door that day (probably 25 people waiting) and of the 5 windows, only 2 were open. One of the window agents was dealing with one customer for around 15 minutes, leaving one window for all these people. </p>
<p>After wasting at least half an hour waiting, I asked to speak to the supervisor. He told me there were other agents but they were busy doing other things. I told him that answer defies belief. There wasn’t one manager at the post office who thought about the service requirements for April 15 and how to meet the demand.</p>
<p>No one forced you to wait until April 15th to mail your estimated taxes. You could have done it before April 15th and not had to wait at all. It’s your fault you had to wait for someone to help you. </p>
<p>Tatin, I sure wish Anthem had thought to put more people on their phones in early January. The oh-so-efficient-and-responsive private sector was caught completely off guard. Or else they were protecting their profits at the expense of their customers, which is why we needed ACA in the first place. </p>
<p>This must be pre-ACA, right? As some posters have made clear, insurers now have to give people who bought on the exchanges a three-month leeway to pay their bills. [I’m not defending that policy, merely stating that it is current law.] Therefore, before March 31, no one who showed a current 2014 insurance card could possibly have been denied by their insurer yet. </p>
<p>My doctor’s office has instituted a policy of having people pay their co-pay at the time of their appointment. Makes sense to me: if you believe in co-pays at all, as a way of reducing unnecessary use of care, then you should be happy to increase the “pain of paying” by making people pay at the time of service. So I went in last week for a nasty infection, and they asked for the $10 copay. I handed them a ten dollar bill. No, no, they said, you have to give us a credit card. Well that sucks. As it happened, I did have a credit card on me, but one shouldn’t need to have a credit card to go to the doctor.</p>
<p>GP could have gone to the post office at anytime before April 15th and mailed in his estimated taxes. That he waited until practically the last minute and had to stand on a long line and wait is his fault. Personal responsibility and all. </p>
I tend to believe there could be a problem with medicaid coverage irrespective whether the writer made up the 96 number. I would be shocked if it was exchange plan since the insurance plans do provide a list of doctors and one can always call the insurance company to ask to cover out of network if they have no doctors willing to take on new patients.</p>
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