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Re: “The Insurance Leech

But the issue is more complicated for individual insureds, at least for me. I'm self employed, and with no dependents. I did not want to buy a plan on the exchange because I read many doctors were not signing the contracts with Blue Cross or Blue Shield to accept that insurance. I contacted Blue Cross and asked them what individual policies were available that had contracts with my doctors, and would continue to contract with after the ACA went into effect. Basically, purchasing in individual private plan. I was told my doctors were covered. So on 12/23 I purchased a specific private plan. By 1/15/14, I learned that Blue Cross decided that it was going to require all doctors accepting my plan to sign the same contract for reimbursement it was requiring doctors who accepted the exchange plans. The result for me: I bought a private plan to ensure coverage and ended up with the private plan, without coverage because my doctors were not signing the ACA plan contracts Blue Cross required. Until the dates to switch insurance opens up, I am now paying almost $400 a month for premiums, and having to get care from "out of network" doctors and I am paying the full boat on all bills. The consequences of the ACA is to give more power to the insurance companies, and add more people to the insurance rolls and Medi Cal. Me? Self employed, middle class.... I'm screwed.Thank you NCJ and Dr Dalton for covering these insurance issues.

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Posted by Areal Voter on 06/21/2014 at 10:34 PM

Re: “The Insurance Leech

You folks need to remember those providers accept regular Anthem/ Blue Cross claims, or that's my understanding. They just don't accept plans bought under the ACA.

I actually called Redwood Family Practice some time ago after hearing they might not accept A/BC insurance. The gal told me they accepted and submitted all A/BC claims the same way. Whether they would continue to accept the ACA related insurance was dependent on ACA- A/BC reimbursement rates.

I have yet to see my doctor under the ACA plan and it's been some months, so don't know if they've decided whether they'll continue to accept them, or not.

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Posted by Fred Mangels on 06/21/2014 at 10:19 AM

Re: “The Insurance Leech

A big thanks to Dr. Dalton and to the NCJ for these articles. I have the new Anthem Blue Cross insurance and feel duped and outraged by my experiences with this immoral company. The list of "network providers" on their website appears to have absolutely no basis in reality. Every single "network" doctor I've called is not (and never has been) in the network. I am going to great expense and logistical turmoil to have a hip replacement out of Humboldt because there is not a single local orthopedic surgeon in the network. Not one! And now, after going through all the trouble of setting up the surgery elsewhere, I discover that THAT surgeon isn't in the network either! Never mind that he's listed on their website. This means I will have to pay at least double for the procedure. Is this any way to treat people who are already suffering? Yes, I'd agree that the system is broken.

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Posted by Linda Mitchell1 on 06/21/2014 at 10:07 AM

Re: “The Insurance Leech

Thank you Dr Dalton for speaking truth to power; as more and more folks experience the outrageous greed of the Insurance companies, more and more folks will understand the efficiencies and benefits of a single payer system.

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Posted by yopeace on 06/21/2014 at 9:20 AM

Re: “The Insurance Leech

It would be interesting to hear how Dr. Dalton deals with MediCal/MediCare patients and their billing.

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Posted by Fred Mangels on 06/19/2014 at 10:10 AM

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