Monday, June 30, 2014

Be Careful What You Wish For

A friend of mine described life in this way.  

If you pray to God to move mountains, don't be surprised if you open your eyes and see a shovel at your feet.

Be careful what you wish for.

"I thought I had done everything right, and it's been awful," said Jean Buchanan, 56. The Fullerton resident found herself stuck with an $8,000 bill for cancer treatment after receiving conflicting information on whether it was covered.
"How am I going to come up with that much money?"
LA Times

This is not an uncommon for those who purchased Obamacare plans.

Caveat emptor.
"These narrow networks are making a huge difference in terms of affordability," said Mark Morgan, president of Anthem Blue Cross, a unit of industry giant WellPoint Inc. "We found in convincing numbers that people value price above all else."

So you expected to get a Cadillac at Kia prices?


Consider Buchanan, who lost her previous coverage when her insurer dropped out of the individual market last year. She was diagnosed with breast cancer in July, so she opted last fall for a Platinum plan, the highest level of benefits on the state exchange, from Blue Shield.
Buchanan started treatment at UC Irvine Medical Center in the fall, and her oncologist there took her new Blue Shield insurance in January and February. Then the day before her lumpectomy, UC Irvine called to say her insurance wasn't accepted after all.

Not uncommon.

With all the last minute rule changes by HHS many providers had no idea which network they belonged to.

People want to blame the carriers, but when DC changes their mind based on the way the political winds are blowing that day, businesses can't respond on a dime.

Nationwide, about half of all exchange plans feature narrow networks, according to consulting firm McKinsey & Co., which has closely tracked the new insurance market. Those narrow network plans cost up to 17% less on average than plans with broad networks.
In forming tighter networks, insurers tried to persuade doctors and hospitals to accept less money in exchange for a higher volume of Obamacare patients.
Los Angeles pediatrician Danelle Fisher said she couldn't afford the 30% pay cut offered by Blue Shield. She would have received $68 instead of $97 for a routine office visit for a patient with a PPO policy.

And the beat goes on.

Going forward, those with Obamacare plans will find fewer choices, higher premiums, high copay's and more out of pocket.

Welcome to Obamacare.

You wanted it. Now deal with it.
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