General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsHave a question about Obamacare, I needed a new GP, but I delayed, mostly out of laziness...
until today. So I called the nearest medical office to me, on the off chance they are taking new patients. They were, seemed friendly, and then I asked if they took my insurance, wouldn't do any good if I'm out of network, they asked if it was "through obamacare or employer", mine is through employer, didn't really expect the question, and just said so. They then said that they do.
I wonder, if I said it was through the exchange, could they be allowed to refuse me, even though its the same insurance company? In addition, would they be able to figure out if it was an exchange plan if I lied?
randys1
(16,286 posts)thru ACA.
Because it is just a policy like any other.
Sounds like some deeply racist assholes who want to tell people they wont see them if they have Obamacare, you should report them to some government entity.
PoliticAverse
(26,366 posts)that are sold only on the health exchanges. It is often the case that those policies pay
doctors less than insurance policies obtained through employers. In addition the
list of doctors and medical facilities "in network" likely will differ.
randys1
(16,286 posts)There have been enough posts about this that you should know better by now.
'Deeply racist assholes' is your answer for everything.
randys1
(16,286 posts)Nye Bevan
(25,406 posts)And your answer in post 1 is so embarrassingly wrong that you really should edit or self-delete it.
cwydro
(51,308 posts)You make a nasty inference about a poster who simply pointed out you don't have all the facts?
And you don't have all the facts.
randys1
(16,286 posts)alc
(1,151 posts)In my last full time job everyone in the country had the same plan from a big insurer (actually we all chose one of 3 plans). But the specifics depending on the state we lived in. Doctors had to call and find out exactly what was covered for me, not my plan, and what the reimbursement rate was based on all the numbers on my card. Different states had different reimbursement rates so more than the policy number mattered.
I'm covered by my wife's company now. And even though it's the same insurer and base policy that other companies can get, the deductibles are based on how much the entire company used insurance last year. They were told the deductibles went up a year ago because so many babies were born the previous year and costs were higher than expected. So I think they can know where the insurance comes from (or at least that the reimbursement isn't the same as the ACA plan)
Travis_0004
(5,417 posts)Like the place isn't in network on any obamacare policies, so its a very reasonable answer.
Nye Bevan
(25,406 posts)Anthem, for example, sells different plans on and off the Obamacare exchanges. The Obamacare plans are eligible for subsidies but generally have narrower networks, so a doctor may be in the network for an off-exchange plan but not for an exchange plan. And the doctor's office will know from your policies "group number" what kind of plan you are in.
My kids' allergists office has a sign up stating that they do not accept any ACA exchange policies or Medicare Advantage policies (they do, however, accept regular Medicare).
Shandris
(3,447 posts)Just guessing, I'm going to toss out payoff rates? I remember long, long ago in a different lifetime when I dealt with medical stuffs, the payoff rate was the biggest complaint (this was not in regards to Medicare/Medicaid or even the government, just the common complaint).
It's interesting that you mention that 'narrower network' thing, though. I've recently read an article that suggested that anyone on Advantage plans look to the ACA plans because they would risk having narrow networks if they didn't. Which seems...off. But I don't profess to understand any of this clearly, so just take it as some minor grousing and not a formal complaint.
Nye Bevan
(25,406 posts)This is a busy, thriving practice. They have no shortage of patients in off-exchange plans and regular Medicare, so there is no need for them to accept the lower reimbursements of ACA and Advantage plans.