scrubbedexpat099

That is not the case as I previously stated.

penguinbar

You don't need a SSN to get health insurance. My husband was put on my policy before he had one and I have Blue Cross.

notshipman

Well obamacare may give people insurance to those who never previously had it and new migrants/elderly etc etc but having spoken to many doctors in the US they say these plans the people get are not financially viable for them to take so they simply wont accept them.

Its all very well to have the headline 'x people now have medical insurance' but if the docs etc wont accept them then what exactly is the use?!

scrubbedexpat099

Some Doctors will, may not be the best ones at the best hospitals.

There was pressure to keep cots down and rather than look at the inherent waste they went the more practical route of limiting the network.

penguinbar

In New York the plans are terrible and not cheap. If I took the cheapest plan for my husband and myself it would be over $700 a month and the co pay is a percentage of the doctor bill.We make too much to get any subsidies. They are all HMO's on the NY exchange and it's mainly Emblem which non of my doctors take. This is with a $5000 deductable.

scrubbedexpat091

I am just curious as to how the doctor would know if its say something through the exchange or through an employer?

For where I would be living in California, all the usual companies are included on the exchanges, none are obscure companies.

Sharp and Kaiser for instance are both included and both operate several of the hospitals in the area, so your still gonna get good hospital care.

Like I said, just curious is all.

Duncan Roberts

As far as I know there is no difference in the contracted rates between an employer plan or a personal plan via the same insurance company. If they claim the reimbursement is too low it would mean its too low for any plan issued by the same insurance company. I call BS or misunderstanding on this one.

SanDiegogirl

Maybe your husband was in the country on the relevant visa which afforded him legal and permanent status - the OP, unless he gets his AOS before February, which is when his B1/B2 visa runs out, won't be.

There are posts on this forum from people who say that insurance companies won't give them a policy until they have been in the country for 6 months - I don't see how they would provide a policy to someone who does not have a visa for permanent resident yet.

Everytime I have applied for an individual policy I have been asked for my SSN.

Michael

Some PPOs and HMOs in some states reduced the list of doctors and hospitals that were in network for ACA plans. It appears that most California plans were not allowed to do that.

The restructuring may have been done to reduce costs and increase profits or it could have possibly been a scheme to try to make ACA fail.

scrubbedexpat099

AS I mentioned he just needs to have filed for Adjustment to qualify, which he has.

Insurers through the Exchange can not exclude based on your residency period, you either qualify or you do not.

They just use the SSN as a convenient tracking number, it is a Social Security Number, not a private insurance number.

scrubbedexpat099

I was under the impression in Colorado that the ACA plans were separately negotiated and rated more akin to medicaid reimbursement.

A lot of the details seem to be hidden and will no doubt come out in time.

I am pretty certain that if you have different policies with the same insurer, one ACA and one not, there will be different returns to the Doctor for doing the same treatment.

notshipman

agree with boiler and disagree with duncan from the medics i have spoken to in the US the plans are very different according to whether aca or not even from the same company. this makes sense given the type of people you are now insuring i.e those with existing conditions, lots of unknown pathology compared to those getting regular checks and physicals etc

so naturally the aca plans will be less desirable with worse benefits higher deductibles but it looks good because those folks now have 'insurance' even though it is likely just a useless bit of paper. the docs wont take them on as the reimbursement will be less as the plans are crap as the insurers arent going to take a hit on these folk out of sympathy. the docs wont want these high risk low reimbursement people and because they are mostly independent they dont have to either etc

thats one thing noone really considered with aca the fact that the providers have no obligation to accept these plans that are likely to be substandard given the population they are now covering etc

Michael

That's a good theory but over the last 10 years, more and more private plans were high deductible plans and when insurance companies had to pay, it was always a hassle sometimes telling the doctor that a procedure was covered and then later saying it wasn't. Then they canceled people or put them on a very high deductible with high co-pays and unlimited out of pocket expenses when they got sick and the treating physician was screwed more.

notshipman

See your point but the US docs seem pretty savvy. I very much doubt when you stop paying they would continue to see you gratis as they are a business not a charity. End of the day high co-pays and deductibles screw the patient not the doctor as they can choose to move on to people with better plans and reimbursements.

The US docs tell me a lot of the ACA plans are sub-medicaid reimbursement so naturally they aint gonna bother especially when a lot of patients with ACA will be high risk.

scrubbedexpat099

So why are Doctors relatively savy when it comes to this, but not so seemingly when it comes to the big picture of getting the best for the overall populace?

They then seem to want to ignore the biggy completely.