Insurers limiting doctors, hospitals in health insurance market

[PoliticAverse]

Last edited Sun Sep 15, 2013, 02:33 PM - Edit history (1)

Insurers in California's new health insurance exchange are holding down premiums by limiting choices, raising concerns that patients will struggle to get care.

The doctor can't see you now.

Consumers may hear that a lot more often after getting health insurance under President Obama's Affordable Care Act.

To hold down premiums, major insurers in California have sharply limited the number of doctors and hospitals available to patients in the state's new health insurance market opening Oct. 1.

Read the rest at: http://www.latimes.com/business/la-fi-insure-doctor-networks-20130915,0,2814725.story

Single page (no ads version): http://www.latimes.com/business/la-fi-insure-doctor-networks-20130915,0,3866885,print.story

[Adsos Letter]

1. Interesting. I wonder how Kaiser will fare in all of this? n/t

[Sirveri]

2. Kaiser will have higher rates because they don't allow bottlenecking like this.

Once you're in network, you have access to any and every doctor in their network. Then again it's still Kaiser, so who knows if that's a good thing...

[Merlot]

3. You know what really limits care? Not having ANY insurance.

[antiquie]

4. True ^ this.

[truedelphi]

5. Also one of my big concerns -

I noticed that Anthem is one of three choices we get as far as insurers. (The other two being Kaiser Permanente and Blue Cross or Blue Shield.)

Anthem was also the party responsible for the dental insurance provisions for anyone relying on MediCal. And it was a total win/win FOR THEM, in terms of my being reimbursed.

To get dental surgery, I had to see a dentist locally for the rec to a surgeon.

Then I had to pay upfront for the surgery, out of pocket. Anthem had already told me the doctor's office would submit a claim. But the surgeon's office said I had to, and when I tried to get the bill handed off to Anthem, they said it had to come from the surgeon's office, so I never got reimbursed. I had no fight in me, as the surgery took that away for some weeks.

I can just see them pulling stunts like that left and right.

I hope the state has a referee system in place - and that would be one busy office if they do set one up.