Nutmegger

And I have also described how my OH's ACA insurance cover through the CT exchange has been excellent for over a year now. Yes, he had to research, research, research, follow-up, follow-up, follow-up in order to ensure that he had the correct coverage and that our doctors and local pharmacies were in the loop -- but you have to do that with private sector insurance too. Of course there have been teething troubles for the CT exchange, but everyone is learning on the fly here, and the end result has been great. I'm sure some state exchanges are far better than others, especially than those in the states that are fighting the whole concept.

OnwardandUpward

You're totally right. And I am fighting it- as much as one person can in the face of so many.

Hopefully when I see the doctor next week she can use my insurance and help me.

But I had to throw a temper tantrum before anyone would help me, they just kept fobbing me off with doctors who aren't taking patients;
somebody said on one of the threads here that the system is geared up so that people won't use it except in emergency.

What the government doesn't recognise is how many of us are buying it as a last resort with pre-existing and no proper treatment for several years.

That said- I doubt I'll buy it next year via the government, it's been too stressful.

And until I speak to the doctor herself I am still a bit skeptical- even though the admin assured me I am covered and have an appointment- we had a conversation 6 months ago where she told me she wasn't going to accept patients via the exchange.

She's the best doctor I've had in my life so I will be very happy if she can treat me.

She's an immigrant like me, only from China.

Giantaxe

Clearly you need to message the Nobel Prize committee and see whether they can sort out your insurance.

OnwardandUpward

don't know who I got through to in the end @Giantaxe- though the first rep I spoke to yesterday told me 'don't call it Obamacare- that's not the name'! I said 'ma'am every doctor I've called the office staff it's the first question- is it Obamacare?'

Was a very long weird day. And I actually do think the president should have addressed this- not me personally, but the large numbers of people who are having similar problems, apparently Texas and California are the two states having big issues accessing doctors.

Anyway I think it's sorted now.

I just don't see why when you buy a product it should entail throwing a tantrum and threatening complaints.

I think I will have to be very careful with this policy because as it says on the card 'does not mean you are covered'.

scrubbedexpat097

All insurance cards say that.

You can pay for a month or two get a card and then stop paying, making your insurance void. People try to use cards when they haven't paid the premiums. I expect they think showing a card with their name on it is all they need but those pesky doctors office workers tend to call and verify...happens all the time, even before "Obamacare"

OnwardandUpward

I'll feel better once I've spoken to the doctor to be honest, because I know just because I've made it into a complaint the doctor can't be forced to take my insurance.

You are totally correct though @Sugarmooma, that's why the doctors aren't taking the lower level tiers of subsidised insurance, the new law says that the doctors have to provide coverage for 90 days when there's no guarantee that anyone will pay them after the first month.

Whoever thought all this up must be very out of touch- who's going to run a business where they can't guarantee payment?

Especially when policies are being sold as 'affordable care' with $6000 deductables that most Americans don't have?

scrubbedexpat099

Now I am lost.

scrubbedexpat097

+1

OnwardandUpward

The insurance company thinks that because they have a doctor on their list that means they have to see me; well the first six doctor offices were on their list and said no.

And this doctor was not on offer until I complained. She would have been my first choice if she was on United Healthcare list of PCPs.

But like I say- she told me 6 months ago she only takes private insurance/employee insurance.

I'm hoping she'll be able to use my insurance though.

Frankly I don't know where else to go with this, but I do know that it's far more common than is being reported in the media in the US- that people are buying insurance and not being able to access a doctor.

scrubbedexpat097

So if you call and they say they are accepting new patients and then you say you have UHC insurance and they accept UHC why do you have to say it is Obamacare? That bit I don't understand..

OnwardandUpward

maybe it's a texas issue Sugarmooma, the people here are on the whole against the concept of 'Obamacare'. And if you call a doctor office- it's the first question they ask about what insurance you have.

And I can totally understand that if I had bought a lower level policy and the doctor might end up treating me for free- I bought Platinum for that reason.

I actually think that there are fixes for all this- people like me could pay all my premium up front for example, then there would be no question about coverage. I paid, I bought an insurance product, I'm covered.

scrubbedexpat099

Platinum means you bought a policy with a lower deductible.

OnwardandUpward

but apparently the doctor issues are with high deductible policies because the law now says they have to treat a patient for 90 days when that patient defaulted on paying their health policy. The insurance companies are responsible for the first month but the doctors are responsible for 90 days.

It's called 'grace period' for not paying up. It doesn't mean the person isn't responsible for those debts- just that the insurance company won't cover them.

But a lot of people have bought the high deductible policies without realising when they get sick- the first $6K is on them.

Not everyone has $6K, and the doctors know that.

Most expats probably do, so maybe I am talking to people who don't understand what I mean- but none of my American friends have $6000.

scrubbedexpat099

Effectively the risk period is 60 days and it gets really complicated

The main issue I have heard is the reduced rate of payment. A lot of employers have moved to high deductible plans so that aspect is not just a ACA issue.

It is a screwed up system and not a lot has changed.

OnwardandUpward

No it's not changed for the better@Boiler- I've lived here since 2001 and we had great coverage at first, in fact you could afford to self pay and opt out of the insurance game if you were lucky and didn't have an accident/emergency etc.

Year on year things have got worse. Coverage across the board is worse. That's what most people I know are saying.

But I live in the general community- most people I know now aren't expats. And the expats I do know tend to have great insurance- so I think some people here just don't know what I'm talking about. And I know it's hard to get your head 'round! The law should be the law

I know I'm probably being too political for this forum- but that's what ACA was supposed to do. We were all going to have access to a website one stop shop and be able to buy health insurance. Compare policies. Consumer experience like we get if we want car insurance.

But people will complain if they're sold something commercially which isn't fit for purpose, I think that's my big issue with our president- he doesn't acknowledge that the government is selling something that's messed up- for whatever reasons. Or excuses. They're a business when they start selling a product. Especially when people are going to be fined/taxed for not buying it!

Anyway, I think I am ok. We'll see next week.