Attempting to understand Obamacare
March 24, 2014
My first visit to the Covered California official Obama care website a few weeks back looked promising, so I decided to meet with an insurance specialist to see if the AHCA (Affordable Health Care Act) would help my family reduce medical expenses.
With a specialist, my wife and I compared our current Blue Cross Anthem plan to the Obama plan called SILVER, and upon first glance, I was encouraged.
My monthly premium would fall by about $200 and my out of pocket would also be reduced, so we started searching for our current doctors to see if they accepted the plan.
That's where the problems started. Not one of our doctors, neither my wife's nor mine, would accept ACHA. In fact, in Nevada County, there were only about two dozen or so who were listed as "within the network" on the site.
We called a few to see if they would take new patients. Unfortunately, none we called would. The only one we found that might consider us was charging a $1,500 membership fee. Although I did not know the reason this particular doctor was charging such a fee, I anticipate that we will see more doctors charging membership fees such as this to thin out the ranks of attending patients or help recover some of the costs incurred by Obamacare.
Even if I wanted to change doctors (which I don't), there wasn't a doctor in my county who would take new patients under Obamacare that I or my insurance agent could find, nor were any of the specialists that I had gone to in the past few years listed on the website as accepting the AHCA.
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This meant that if I had signed up for the plan, my only option would have been to go to the hospital for every doctor's-office visit I required, as would my wife. Obviously this is not time effective for me and certainly not cost effective for national health care or its balance sheet.
I don't know how far I would have to travel to find a doctor that accepts Obamacare (and would also take new patients) but within a 30-mile range, we found none.
My insurance specialist told me that as he understood it, if I had to go to a specialist, the specialist might be "out of the network," meaning I would pay full price for their services and my out-of-pocket deductible would skyrocket to over $10,000.
On my current plan, I get a negotiated rate. On the new plan, the way it was explained to me was that I would pay full price, which would probably be exorbitant.
At least on my current plan, I have never seen a doctor who wouldn't accept my Anthem Blue Cross, and all the specialists I have seen over the years have also accepted it.
Using the AHCA, on the other hand, we couldn't find a doctor here who would accept new patients and the plan together, so it leads me to ask, what good is it?
My insurance specialist told me that the list of doctors accepting Obamacare was getting smaller by the day, and today's visit resulted in us leaving our specialist as we found him — shaking his head as to how this whole thing is supposed to function.
He had warned us that the plan was onerous to doctors and he had to continually turn away potential customers, due the simple fact you cannot find a new doctor who will accept Obamacare if your current doctor won't.
During my recent radio show, I took listeners' calls regarding their experiences with the ACHA, and the majority of callers happiest with the plans had signed up early and were getting all or part of their premiums paid by the government. The rest of the callers seemed dissatisfied with the way the ACHA is shaking out.
After my experience, Obamacare is, at least from my standpoint, a mess at this time. I can't find a doctor;l none of the specialists I might use accept it; few people are signing up to average out its eventual cost; and many of my friends are losing coverage or finding their new coverage much higher in price.
Despite what Washington tells me, it's not working for my family, not even a little bit. I only hope it gets better sometime in the future.
If you had any experience with signing up for Obamacare, I would like to hear about it. Send me an email at Moneymatters@kvmr.org.
This article expresses the opinions of Marc Cuniberti. He hosts "Money Matters" on KVMR FM 89.5 and 105.1 FM at noon Thursdays. His website is http://www.moneymanagementradio.co