GeoffM

Good luck, OnwardandUpward. It really is a mess. Even Kaiser P who are insurance and provider all-in-one, vastly simplifying things, weren't able to tell me in advance how much a vasectomy would cost me and I had at least three different figures from different people. In the end it would have been a small co-pay but my wife got plugged instead.

Giantaxe

I have United Healthcare insurance and when I search for a provider the website says "Show providers that accept" and the name of my particular insurance plan.

My experience with United Healthcare has been completely positive. But admittedly I don't have an ACA plan but employer-provided group insurance.

scrubbedexpat099

Makes sense that a provider would sign up for plans offering shall we say normal reimbursement but would wish to exclude or limit those offering reduced reimbursement.

Giantaxe

Absolutely. But that is why it's weird that the OP is apparently being shown on the website providers that aren't covered by his insurance.

scrubbedexpat099

I know a Surgeon, he is semi retired now, I remember him saying that he takes some Medicaid etc patients but obviously has to balance them against full payers.

Which makes sense.

OnwardandUpward

I think you're right Boiler, it's something to do with renumeration- the doctors intend to take the 'obamacare' policies ( and Medicaid ) but once they have enough lower paying patients they won't service any more.

And because nominally they are accepting my insurance I don't know until a couple of days before the appointment when someone checks in more detail then refuses it.

Trying to sort it out- unfortunately been sick today! so not feeling like spending hours on the 'phone...

I don't know what the answer is, just hope you're lucky the doctor or specialist you see isn't over-subscribed I suppose- and of course there's no information about that available anywhere, or you could pick one who isn't. Sadly this gastro-enterology doctor was excellent and I am very disappointed not to be able to see him but without the endoscope procedure he can't do any more. The admin says another hospital is coming into the network in the fall but that doesn't help me now. Maybe I'll just have to pay when I want to see doctors I like/ trust.

I am keeping detailed notes and saving all my communications.

But I think it's the whole disjointed messed-up way of organising things to blame to be honest because people are having problems left right and centre wherever they buy their policies. It's just not a joined-up system.

OnwardandUpward

Thanks!

scrubbedexpat099

The other reason they may be reluctant to take Obama patients is the credit risk, one or the other or both.

retzie

Yikes! I'm sorry to hear of further difficulties, O&U. I didn't have any problems using my marketplace policy for specialists in NY (although, I only tried for a minor procedure). Errrr, can you move to a more ACA-co-operative state...?

This is a pretty blatant workaround for the denial of access to healthcare. Indeed, it's even 'better' than the old pre-existing condition excuse, since they still get to take your premiums. I hope there is some sort of federal action to stamp out the selling of policies that can't be used



Jeez, along with all the other current threads about major health insurance difficulties and massively overworked H-1B holders, I hope all the US-aspirants can see a little (big) patch of brown grass on this side of the pond.

jb82

Surely it isn't down to who is taking Obamacare since someone with a wife and kid could get some credit under the ACA whilst earning about $80000 between the family. That isn't peanuts and certainly is little credit risk. I also thought but may be wrong that the doctors etc are seeing the same remuneration obamacare policy patient or not. They are full policies just subsidized via tax credits.

I imagine the actual Obamacare UHC policy is somehow different to the non-Obamacare one through the choice of UHC (or for example to meet the minimum rules of the marketplace)

jjmb

sorry to hear about your health policy woes. I can't help you in that regard but even for those of us with good health insurance, its a worrying trend as a lot of employers are planning to exit the health insurance games over the next few years apparently. Already our options have changed and become more expensive. Seems like Obamacare is going to be boon to the health insurance industry, not its death knell as some were predicting.
As the health issue itself, if you can afford it I would pay for the procedure as an ulcer is not something to leave alone. My grand-father had 2 burst and nearly die. Also it might be something as simple as acid reflux or something else. My acid reflux turned out not to be hiatus hernia but something called Barrett's oesophagus. Treatment is simple,change diet and antacid pills It just needs to be watched via an endoscope every other year.

scrubbedexpat091

Credit risk from what?

bruceba

You may die while you wait for the procedure in Canada.

Zoe Bell

And you're basing that off what exactly?

scrubbedexpat099

I thought they are in California?

As far as the Feds are concerned well it is their product.