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    MIA Providers ACA

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    beejean

    Posts : 542
    Join date : 2010-02-20
    Location : Boston area

    MIA Providers ACA

    Post  beejean on Sat 08 Feb 2014, 4:18 pm

    MIA Providers ACA

    What kind of plan is this when 80% of CA doctors don't take the ACA plan, even if they have determined after 6 hours that you enrolled in the insurance plan?

    Also, those insurance underwriters could only find 2 hospitals in the entire state of New Hampshire ? Give us a break.
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    beejean

    Posts : 542
    Join date : 2010-02-20
    Location : Boston area

    Re: MIA Providers ACA

    Post  beejean on Sat 22 Feb 2014, 9:23 pm

    CBS 13 Sonora CA Reports that Doctors Deny man his back surgery since "Covered California" didn't cover Him

    Nick Janes wrote:   For privacy reasons, he couldn’t comment on the specific case, but said in general that consumers should do their research before purchasing plans.

    “I would suggest they contact the plan to make sure what doctors are available to them,” he said.

    Tammy says she finally found an in-network doctor, but the problems don’t end there. We looked him up using the couple’s plan info, and the Blue Cross website shows him as in-network.

    But that same doctor’s officer told Tammy he won’t see patients with insurance from Covered California.

    “It’s like we’re a second-class citizen,” she said. “We can’t get the coverage we need.”

    For Chris, it’s another stop in a long road to the surgery he needs.

    “To this point where it feels like I’m going to be in pain,” he said. “I can’t find nobody to do it.”

    CBS13 wasn’t able to reach the doctor tonight, and a late-hour contact with Blue Cross didn’t get to the bottom of it, so we’re still pushing for answers.  

    http://sacramento.cbslocal.com/2014/02/18/mans-back-surgery-on-hold-as-doctors-deny-covered-california-coverage/

    For the above, how much more do you need to know than that you'll be paying thousands a year for coverage that doesn't cover any treatments because the reimbursement rate is not the hospitals' liking.

    Out here in Massachusetts, while waiting in line at the pharmacy window I overheard that the pharmacist couldn't give a woman her young son's nebulizer medication on the prescription because the pharmacy could not verify that she had any coverage.... Said the cashier: "we're trying to get a hold of someone at the insurance but we can't succeed. " The woman walked out while the pharmacy technician resumed the 25 minute wait in trying to verify.  Sitting up with a sick kid with closed bronchial tubes trying to see if he can get another breath is no joke.  Of course, there's always the oxygen tent in the ER.  This is insurance ?  (I'm pretty sure it was an ACA plan...  the Massachusetts plan has 50,000 valid applications that can't be entered into the Massachusetts website that was created by the same company that created the National website.  The ACA applications are stacked there as laborers in the State Government bewail that they can't get them entered because of the long 3 hour process on the slow website to put in just 1. )
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    DearWife

    Posts : 253
    Join date : 2010-02-17

    Re: MIA Providers ACA

    Post  DearWife on Tue 25 Feb 2014, 9:03 am

    beejean wrote:CBS 13 Sonora CA Reports that Doctors Deny man his back surgery since "Covered California" didn't cover Him

    Nick Janes wrote:   For privacy reasons, he couldn’t comment on the specific case, but said in general that consumers should do their research before purchasing plans.

    “I would suggest they contact the plan to make sure what doctors are available to them,” he said.

    Tammy says she finally found an in-network doctor, but the problems don’t end there. We looked him up using the couple’s plan info, and the Blue Cross website shows him as in-network.

    But that same doctor’s officer told Tammy he won’t see patients with insurance from Covered California.

    “It’s like we’re a second-class citizen,” she said. “We can’t get the coverage we need.”

    For Chris, it’s another stop in a long road to the surgery he needs.

    “To this point where it feels like I’m going to be in pain,” he said. “I can’t find nobody to do it.”

    CBS13 wasn’t able to reach the doctor tonight, and a late-hour contact with Blue Cross didn’t get to the bottom of it, so we’re still pushing for answers.  

    http://sacramento.cbslocal.com/2014/02/18/mans-back-surgery-on-hold-as-doctors-deny-covered-california-coverage/

    For the above, how much more do you need to know than that you'll be paying thousands a year for coverage that doesn't cover any treatments because the reimbursement rate is not the hospitals' liking.

    Out here in Massachusetts, while waiting in line at the pharmacy window I overheard that the pharmacist couldn't give a woman her young son's nebulizer medication on the prescription because the pharmacy could not verify that she had any coverage.... Said the cashier: "we're trying to get a hold of someone at the insurance but we can't succeed. " The woman walked out while the pharmacy technician resumed the 25 minute wait in trying to verify.  Sitting up with a sick kid with closed bronchial tubes trying to see if he can get another breath is no joke.  Of course, there's always the oxygen tent in the ER.  This is insurance ?  (I'm pretty sure it was an ACA plan...  the Massachusetts plan has 50,000 valid applications that can't be entered into the Massachusetts website that was created by the same company that created the National website.  The ACA applications are stacked there as laborers in the State Government bewail that they can't get them entered because of the long 3 hour process on the slow website to put in just 1. )

    Hi beejean.  I tried signing us up for covered California via the website to no avail.  Several times I tried but information was like it was never received.  Instead we opted to pay our health care out of pocket and under a ppo.  Feels much better this way but the bills are already stacking up pretty high.  It's about $380 monthly but changes to it will take effect in April, so not sure if it will become higher or what.  So far we've been getting good coverage, and the good thing about it is that I don't have to always get a referall to see a specialist like it was before.  But not sure what it will be like if one of us has to have surgery.  

    The thing is, the hospitals are supposed to cover patients regardless of being coverned or not because they get a stippened from the government if they are non-profit.  At least that is what I remembered reading about a few hospitals in our area.  Some non-profits hospitals got in trouble for it for over charging patients for items used by nurses and doctors and even medications distributed, and some have been fined for that.  It's basically white collar crimes that have been commited.  Then there are the physicians who work for the big drug companies.  

    The other day I was reading about a doctor who researched into helping people with depression and mental illness using vitamins and nutrients to help with their mood.  Very wise man in my opinion because he was against the use of anti-depressants and mentioned that a good well balanced diet with certain vitamins will help these who suffer.  Oh looks like he passed away in 2009 but here is the video:

    Natural Cure for Depression, Bipolar, ADHD, Schizophrenia..
    http://www.youtube.com/watch?v=X9cg4454mYA

    Think there was a good reason why the herbs of the field were good at the creation of the world Wink Not till the flood was mankind introduced to eating the flesh.  Another reason too why in the New Testament, those new the to the teachings of Christ, were told by the disciples to not eat blood, because the blood is life.  We also know from our sciences that the blood also contains diseases.  Reason why meats are Kosher and wait for the blood to drain from the animals completely before consumption...not a bad idea really.  

    Thanks for sharing beejean.  Hope you and yours have a good rest of the week.  We're expecting some storms or rain, abundance of seagulls started coming inland so was an indicator that maybe they are feeling the barometric pressure dropping.  

    ~DW

    P.S. Oh look Lunar explosion, I guess I'll post that next.
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    beejean

    Posts : 542
    Join date : 2010-02-20
    Location : Boston area

    Re: MIA Providers ACA

    Post  beejean on Wed 26 Feb 2014, 11:50 pm

    Hi DearWife,

    the family here isn't disenfranchised for the health plans either - my husband's working full time and has PPO coverage. My concerns extend to the uncertainty of the economy and what that means for keeping covered.

    based on the dubious nature of the ACA websites and everything, I just base my hopes for continued well-being on God and his grace. I agree with you 100% on that. It seems like mankind has gotten so out of conformity with common sense and has structured everything surrounding going to the doctor with red tape and convoluted processes. - Apple a Day ! Beejean

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