<p>Just looked it up. The doctor does not take medi-cal. He does take people with no insurance and takes finances into account. </p>
<p>I can’t blame him for not taking MediCal, but if he did, he could find plenty of patients.</p>
<p>I feel sorry for the solo practice GP. Everyone is going to the multi-specialty groups where you have doctors in all specialties in house.
Medi-Cal payout to GP doesn’t cover overhead, the more Medi-Cal patients he sees, the more money he loses. Other doctors can afford seeing a limited number of Medic-Cal patients because there are more privately insured patients to balance his books.</p>
<p>Cbreeze, if the office is empty, isn’t some pay better than zero? For GPs in 2014, MediCal reimbursements were increased. </p>
<p>I dont know what the variable cost is of seeing a patient. If the employees are being paid, is it better to see low paying patients than no paying patients? </p>
<p>I was told Medi-Cal only pays about $40-$50 for an average visit to GPs.Even with the increase, it can’t be much more. It also depends how the physician wants to run his office and his average overhead cost (use of equipment and supplies, billing, insurance, licenses etc) per patient. Since your wife’s GP is in his 60’s, retirement is near and he doesn’t need nor want more headaches.
It’s like my plumber tells me he has to charge >$100 per visit and more if he has to use his heavy duty blade for snaking a clean out because the blade is expensive.</p>
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<p>I don’t feel sorry for a solo GP for that reason, any more than I feel sorry for the buggy whip manufacturer or anyone else who is trying to sell things that people don’t want to buy. It’s not like the doctor can’t find a job somewhere and make a good living-- they just can’t make a living selling something people don’t want.</p>
<p>CF, expressing compassion towards this doctor who is obviously helping dstark’s wife, is not going to kill you.</p>
<p>My wife really liked the doctor. He was helpful.</p>
<p>My wife needed a blood test for her upcoming cataract surgery. Looked at Anthem’s website and found Hunter Lab. She went to Hunter Lab. There was a different lab instead of Hunter because Hunter hasnt existed for a year. It is a good thing Anthem updates its in network facilities on a weekly basis.</p>
<p>Our insurer is BCBS PPO instead of Kaiser HMO. We switched just before we got married because I had just had a medical malpractice case and deposed all the OB/GYNs at Kaiser. About 80% of our state is BCBS and nearly all the non-Kaiser docs are participating & preferred as are most of the pharmacies & med centers. It has been a bit of a challenge when I travel, but I am usually able to get appropriate coverage for everything we need, though I have had to argue at times. Our BCBS premiums are lower than Kaisers and providers pretty good coverage. The healthcare providers are unhappy because often they need to submit additional information (more hassles for them) to get claims covered that should normally have been covered without the excess paperwork. They also reimburse poorly–close to Medicare or below, I believe. They lag in paying claims and make providers jump thru a lot of hoops.</p>
<p>I am grateful that I have gotten most of our care provided without undue hassle, though I was assigned personal reps at insurer for several years because I had had so many problems getting claims paid. Haven’t had problems in several years now.</p>
<p>HImom, I remember how relieved I was to find a Kaiser clinic in Kona when I had a toe infection while visiting. It was a small clinic by CA standards. I had a feeling they were not the dominant providers on the island.</p>
<p>dstark, the phantom lab on the insurers web site is certainly disturbing. The LA Times reporter proposed that Californians come up with an accurate list by “crowd sourcing” the information. Discouraging that something as important as an accurate provider list is not given higher priority, either by insurers or regulators.
<a href=“Can I keep my doctor with Obamacare? There's a database for that, thanks to the LA Times - Columbia Journalism Review”>Can I keep my doctor with Obamacare? There's a database for that, thanks to the LA Times - Columbia Journalism Review;
<p>Momsquad, interesting. </p>
<p>After talking to a doctor’s office which said they take all plans except anthem’s, I checked Blue Shield’s network and it looks like all my family’s doctors take Blue Shield’s plans. I told my wife. She said we are going to Kaiser. She is the boss.</p>
<p>Himom, I am glad it is working out for you.</p>
<p>Re: the doctor who does not take MediCal and is not busy</p>
<p>It was mentioned that this doctor is older. Perhaps that means that he is not paying off startup costs for his practice, and any medical school debt (presumably much less than now) is long gone. So he may not have to fill every appointment slot to make a decent living. It may also be that he is retiring gradually, taking on a lower patient load for now.</p>
<p>Yes, our monthly premium is $277.31 family plan paid by us and $831.94 paid by former employer. H also pays for Medicare B. We have no deductible and our Rx coverage exceeds Medicare D, so we opt out of D. When I get to be 65, I will also pay for Medicare B and get A “free” because I have enough quarters. </p>
<p>We are grateful to have good coverage and H rarely has any copay with his primary and 2dary, except for Rx. </p>
<p>Those are great costs. </p>
<p>Yes. Even with some serious chronic health issues, we’ve only reached the annual max of $2500/person plus Rx copays thrice so far, 2x for me and once did D. Luckily we’ve all been able to avoid hospitals, which helps a lot. </p>
<p>The Rx plan has a decent formulary and our copays aren’t outrageous. We are very grateful, especially that our kids are covered until they age out at 26. </p>
<p><a href=“More Plans Setting Spending Limits For Some Medical Services | KFF Health News”>http://kaiserhealthnews.org/news/more-plans-setting-spending-limits-for-some-medical-services/</a></p>
<p>This just puts more onus on patients. If a hospital is in network, it should have to abide by the contract price agreed to by insurer and not potentially expose patient to higher charges. That is why we buy insurance after all, not to have to go around comparing prices at all the in network providers!</p>
<p>Yes. I think that is an added burden for patients.</p>
<p>To date, my federal employee plan has not foisted this onerous clause and term on its insureds. I hate all this cost and responsibility shifting. It’s wrong and repugnant, no matter how the insurer spins it!</p>