Another very strange Affordable Care Act rule

[catherine]

I agree with peggy--most of the situations are just normal things that people run into. Maybe in this case they should have called the maternity benefits "inpatient services" or whatever.

When the services are bundled I have no problem. Of course I expect that the person who signed up right after me might have completely different needs than I do. But it's ridiculous to make something a mandatory add-on cost, when you don't need to add it on!! And ANM is right--the website shouldn't make things worse.

(and I do have to admit that peggy is also right in that men's "lifestyle" needs are taken more seriously than women's in healthcare. I had a male colleague tell me that BC shouldn't be covered, but Viagra should because of the damage erectile dysfuntion is to male self-esteem.)

[peggy]

Catherine, it's not exactly the ACA fault if you want to buy outside the exchange. If you buy through the exchange you won't have to buy this coverage. That actually kind of makes the ACA working IN your favor, doesn't it. Have you looked at the policies in the exchange? Your better prices just might be there. Plus you won't have to buy this extra dental insurance.
I agree, dental insurance is kind of a non starter for me. I have it only because it's included in our insurance, and I use it for check ups but when I could have really used some coverage with a root canal this past winter (yeah, this whole year has pretty much sucked for me) it didn't really cover much.
6 of one half a dozen of another.

[catherine]

Catherine, it's not exactly the ACA fault if you want to buy outside the exchange. If you buy through the exchange you won't have to buy this coverage. That actually kind of makes the ACA working IN your favor, doesn't it. Have you looked at the policies in the exchange? Your better prices just might be there. Plus you won't have to buy this extra dental insurance.
I agree, dental insurance is kind of a non starter for me. I have it only because it's included in our insurance, and I use it for check ups but when I could have really used some coverage with a root canal this past winter (yeah, this whole year has pretty much sucked for me) it didn't really cover much.
6 of one half a dozen of another.

Maybe I'm throwing blame at the ACA when the insurance companies are just trying to squeeze out some extra pennies in a completely stupid fashion, but as I've said before, the whole insurance thing has to just be torn down and we need to start over. Whether Obama is to blame, or my insurance company--who cares. As long as the government and private insurance companies are bedfellows, we're sc***ed. It's all messed up. I do think people have a right to healthcare and shouldn't be penalized with their lives just because they have less money. I truly believe that. But I'm discouraged by my own personal experience with Obamacare. Do I want it to go away? No. I want it to get better.

PS. I tried to get back on the healthcare.gov site so I could evaluate my options, and I had an issue with getting a password because they obliterated my first one, and I didn't have time or patience to get another password, so I just went with the easiest route: ehealthinsurance.com. But in my earlier experiences, prices were the same. The exchanges don't do me any good.

[peggy]

Oh I totally agree. We should have universal health care like every other progressive modern society. Then we could stop this piece meal approach and get on with it! Everyone gets health care, period.

[gimmethesimplelife]

Maybe I'm throwing blame at the ACA when the insurance companies are just trying to squeeze out some extra pennies in a completely stupid fashion, but as I've said before, the whole insurance thing has to just be torn down and we need to start over. Whether Obama is to blame, or my insurance company--who cares. As long as the government and private insurance companies are bedfellows, we're sc***ed. It's all messed up. I do think people have a right to healthcare and shouldn't be penalized with their lives just because they have less money. I truly believe that. But I'm discouraged by my own personal experience with Obamacare. Do I want it to go away? No. I want it to get better.

PS. I tried to get back on the healthcare.gov site so I could evaluate my options, and I had an issue with getting a password because they obliterated my first one, and I didn't have time or patience to get another password, so I just went with the easiest route: ehealthinsurance.com. But in my earlier experiences, prices were the same. The exchanges don't do me any good.

Agreed 100%. Rob

[gimmethesimplelife]

Oh I totally agree. We should have universal health care like every other progressive modern society. Then we could stop this piece meal approach and get on with it! Everyone gets health care, period.

Agreed 100% and then some! Rob

[gimmethesimplelife]

Something that I am hearing about ObamaCare, though I have not experienced due to most everyone I know being on Medicaid since it was expanded in Arizona - is that doctors are starting not to accept people who have purchased insurance through the exchanges since they are not getting reimbursed enough to take these patients. Is this true, or is this an urban legend? I honestly don't know and it seems that there are posters here who might know due to being Medicaid ineligible due to income. I've also heard that networks are becoming very narrow and that there are very few doctors on these plans and if you live in rural Arizona - where I'd like to live - you need to be wiling to travel to see a doctor. Not good if this is true, what are you supposed to do in a case of life or death? I've got Mexico to fall back on and I'm also very lucky to have Medicaid - I realize this - but say I made more money and lived in the rural Midwest, then what do I do? Mexico is too far away and if the doctor involves travel due to narrow networks - see my point? I'm one of the lucky ones - truly I realize this - but as IL said, and I now agree with her, there are winners and losers here with ObamaCare. I'm seeing that now. It's not fair and it's not right......My flip response is that all Americans need to have a few thousand dollars saved for airfare to another country with sanely priced healthcare - but honestly, in this economy that's not realistic for many people. And I still feel very much locked into place - I still have that fear of leaving for somewhere further away from the Mexican border, just in case. My prognosis is that I'm better off as far as health care goes now personally, but I don't believe this holds true for all. Not by a longshot. Rob

[peggy]

Something that I am hearing about ObamaCare, though I have not experienced due to most everyone I know being on Medicaid since it was expanded in Arizona - is that doctors are starting not to accept people who have purchased insurance through the exchanges since they are not getting reimbursed enough to take these patients. Is this true, or is this an urban legend? I honestly don't know and it seems that there are posters here who might know due to being Medicaid ineligible due to income. I've also heard that networks are becoming very narrow and that there are very few doctors on these plans and if you live in rural Arizona - where I'd like to live - you need to be wiling to travel to see a doctor. Not good if this is true, what are you supposed to do in a case of life or death? I've got Mexico to fall back on and I'm also very lucky to have Medicaid - I realize this - but say I made more money and lived in the rural Midwest, then what do I do? Mexico is too far away and if the doctor involves travel due to narrow networks - see my point? I'm one of the lucky ones - truly I realize this - but as IL said, and I now agree with her, there are winners and losers here with ObamaCare. I'm seeing that now. It's not fair and it's not right......My flip response is that all Americans need to have a few thousand dollars saved for airfare to another country with sanely priced healthcare - but honestly, in this economy that's not realistic for many people. And I still feel very much locked into place - I still have that fear of leaving for somewhere further away from the Mexican border, just in case. My prognosis is that I'm better off as far as health care goes now personally, but I don't believe this holds true for all. Not by a longshot. Rob

Rob Rob Rob! What are we going to do with you! LOL
You really need to stop listening to rumors and people who just want to scare you.

Number 1, (a bit from another thread) All cops aren't bad. Really, they're not. In fact, I'd venture to guess MOST are pretty good, and show remarkable restraint considering what they face on a daily basis. Personally I'm surprised every cop doesn't come to believe everyone is a bad person up to no good. Just think of who they encounter everyday. Drunks, thugs, child abusers, etc... Cops are there to deal with the worst of society, or the best at their worst. EVERYONE they deal with is having a bad day, for starters...

Now, for the medical rumors, let me say it again. The government did NOT take over health care, or the insurance companies. Obama does NOT own, run, direct, or otherwise fiddle in the insurance companies. Obamacare is simply a set of rules and regulations insurance companies must follow to do business in this country, the main rule being 'You cannot screw your customers." Not that they don't still try, and clever companies will always find a way to screw you, but..I digress. Anyway, other businesses are regulated so all this uproar about this regulation is simply because a democrat did it...and a black one at that! But again, I digress.
Anyway, if doctors who treat people who bought through the exchange are not getting their money fast enough, it is THE INSURANCE COMPANIES who aren't paying. This is because, these are simply plans bought through the exchange from the same insurance companies who sold them before the exchange. Blame the insurance company. Obama doesn't own them, Obamacare doesn't own or run them, no one is responsible here EXCEPT the insurance company.
The exchange isn't welfare, or medicare/Medicaid. Sure, those getting subsidies do buy through the exchange, but they don't make the whole of the exchange.

Let me explain it this way. When you work for a large corporation, that company buys insurance for their employees by the power of numbers. It is GROUP insurance and just like a food co-op they get a better deal because of the large pool of people/customers. The exchange is like that. It's a co-op. Instead of food it's insurance and anyone can buy into that co-op.
Now, knowing this was going to be a huge pool of people/customers, a win for insurance business, they said we will give you access to this big pool of people, but you must follow some rules to gain this customer base. Most insurance companies, being in it for profit, saw the benefit of this and agreed to follow these rules.

So there you have it. No hokus-pokus, no government take over, no evil liberal plot to deny you your freedom/guns/bibles/whatever. It's just the government finally putting some rules and regulations on an unregulated industry that took huge advantage of many people.

[iris lilies]

Rob Rob Rob! What are we going to do with you! LOL
You really need to stop listening to rumors and people who just want to scare you.

Number 1, (a bit from another thread) All cops aren't bad. Really, they're not. In fact, I'd venture to guess MOST are pretty good, and show remarkable restraint considering what they face on a daily basis. Personally I'm surprised every cop doesn't come to believe everyone is a bad person up to no good. Just think of who they encounter everyday. Drunks, thugs, child abusers, etc... Cops are there to deal with the worst of society, or the best at their worst. EVERYONE they deal with is having a bad day, for starters...

Now, for the medical rumors, let me say it again. The government did NOT take over health care, or the insurance companies. Obama does NOT own, run, direct, or otherwise fiddle in the insurance companies. Obamacare is simply a set of rules and regulations insurance companies must follow to do business in this country, the main rule being 'You cannot screw your customers." Not that they don't still try, and clever companies will always find a way to screw you, but..I digress. Anyway, other businesses are regulated so all this uproar about this regulation is simply because a democrat did it...and a black one at that! But again, I digress.
Anyway, if doctors who treat people who bought through the exchange are not getting their money fast enough, it is THE INSURANCE COMPANIES who aren't paying. This is because, these are simply plans bought through the exchange from the same insurance companies who sold them before the exchange. Blame the insurance company. Obama doesn't own them, Obamacare doesn't own or run them, no one is responsible here EXCEPT the insurance company.
The exchange isn't welfare, or medicare/Medicaid. Sure, those getting subsidies do buy through the exchange, but they don't make the whole of the exchange.

Let me explain it this way. When you work for a large corporation, that company buys insurance for their employees by the power of numbers. It is GROUP insurance and just like a food co-op they get a better deal because of the large pool of people/customers. The exchange is like that. It's a co-op. Instead of food it's insurance and anyone can buy into that co-op.
Now, knowing this was going to be a huge pool of people/customers, a win for insurance business, they said we will give you access to this big pool of people, but you must follow some rules to gain this customer base. Most insurance companies, being in it for profit, saw the benefit of this and agreed to follow these rules.

So there you have it. No hokus-pokus, no government take over, no evil liberal plot to deny you your freedom/guns/bibles/whatever. It's just the government finally putting some rules and regulations on an unregulated industry that took huge advantage of many people.

that is a lot of, ummm, information.

But Rob asked if is is true that "doctors are starting not to accept people who have purchased insurance through the exchanges" due to not enough reimbursement, saying nothing about timeliness of reimbursement.

And the answer to that is yes. Yes, that is happeneing. Physicians have chosen not to accept exchange based insurance coverage.

[gimmethesimplelife]

that is a lot of, ummm, information.

But Rob asked if is is true that "doctors are starting not to accept people who have purchased insurance through the exchanges" due to not enough reimbursement, saying nothing about timeliness of reimbursement.

And the answer to that is yes. Yes, that is happeneing. Physicians have chosen not to accept exchange based insurance coverage.

IL, I'm glad you saw my post. I'm agreeing with your post from some time back that there are winners and losers in healthcare since ObamaCare took effect. And I have read that doctors are not accepting patients with exchange based coverage. If this is true, it really defeats the purpose, doesn't it? Rob