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My Obamacare Ordeal!

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  • #16
    Art,
    Your right about Obamacare going down. It's tough to find a good pcp that takes Obamacare because there all HMO in Florida. I wonder what it would be to find a specialist if needed.

    Tomorrow i'm going to call another agent to see if I can move to a ppo. Cancel that crappy insurance.

    Comment


    • #17
      Humana Ordeal

      Hi Rainman

      I feel ya...I had a tough time this year. Cigna jumped off the exchange, apparently they weren't making a 400% profit. I went through my options (which are less in Florida this year.) I contacted my Urologist and my GP and made SURE they took the insurance I was getting.

      But do remember: your gripe is with Humana, the insurance provider. Leave Obama OUT of it. he's the one that got us the ABILITY to buy insurance in the first place

      Merry Christmas, Peace and love to you and your family


      Originally posted by TheRainman View Post
      So this year I thought I would give Obamacare a try. I am tired of paying 800.00 a month to have a low deductible. So I went to a Obamacare help site. They found me a Humana hmo with a 1500.00 deductible for 591.00 a month. I have to pay full price because of income. No problem with that as long as I get good service and treatment. So the agent that sold me the policy said my pcp and urologist is on the list. They sent me a letter that said I can't use my pcp and assign me someone else. But I can go on their site and request someone else from their list and they will let me know if I can switch. So I checked out the pcp they selected. What a joke. This doctor has been practicing for 30yrs. Graduated from Universidad Central Del Este. You think I want my care from someone that studied at a third world school. Plus very small practice. Only sees Humana patients.

      So I went to their web site. Registered. The site said I will have to wait 5 to 7 business days for verification to surf the site. Now I am scared that their whole list will be of reject type doctors.

      I will update as this ordeal goes. Let me know if anybody else has good or bad experiences. Thanks!

      Comment


      • #18
        I was afraid of the same thing. Then I heard they beat their enrollment projects by 4 million people. Obamacare is going strong, and President Obama will go down in history for this (among many) great achievements.



        Originally posted by TheRainman View Post
        Art,
        Your right about Obamacare going down. It's tough to find a good pcp that takes Obamacare because there all HMO in Florida. I wonder what it would be to find a specialist if needed.

        Tomorrow i'm going to call another agent to see if I can move to a ppo. Cancel that crappy insurance.

        Comment


        • #19
          Anyway, before you buy insurance, isn't making sure your health care providers accept that insurance a matter of personal responsibility? Pull up your boot straps...or whatever the hell people say

          Comment


          • #20
            Dale covered how the numbers don't make any sense to purchase this 'medical care coverage' already. I'm surprised no one is harping yet about the asinine provider costs yet. My last 1/2 hour or so visit was billed over $400 combining doctor/facility fees for renewing a maintenance prescription. And we wonder why the insurance numbers don't make sense.

            Comment


            • #21
              Originally posted by JakeHalsted View Post
              Hi Rainman

              I feel ya...I had a tough time this year. Cigna jumped off the exchange, apparently they weren't making a 400% profit. I went through my options (which are less in Florida this year.) I contacted my Urologist and my GP and made SURE they took the insurance I was getting.

              But do remember: your gripe is with Humana, the insurance provider. Leave Obama OUT of it. he's the one that got us the ABILITY to buy insurance in the first place

              Merry Christmas, Peace and love to you and your family
              Jake,
              The problem is Obamacare in Florida. They only offer HMO's.

              Comment


              • #22
                Originally posted by JakeHalsted View Post
                I was afraid of the same thing. Then I heard they beat their enrollment projects by 4 million people. Obamacare is going strong, and President Obama will go down in history for this (among many) great achievements.
                Their already rolling back penalties for corporations and etc.. Plus 80% of the policies are subsidized. People like me are not buying into Obamacare which pays for everyone else. I was a fool to do so.

                Comment


                • #23
                  Originally posted by JakeHalsted View Post
                  Anyway, before you buy insurance, isn't making sure your health care providers accept that insurance a matter of personal responsibility? Pull up your boot straps...or whatever the hell people say
                  Your 100% right on that. I Trusted the Obamacare agent.

                  Comment


                  • #24
                    4 million more people....were you hear that?....Its just what they want to tell you....its just Propaganda.
                    Art

                    Comment


                    • #25
                      ?

                      I'm not sure what an Agent knows about whether your doctors accept a particular private plan or not.

                      There are EPOs on the Florida exchange.

                      I looked for a PPO from someone other than healthcare.gov. None to be found in Florida on the individual market, except retired government employees.

                      Originally posted by TheRainman View Post
                      Your 100% right on that. I Trusted the Obamacare agent.

                      Comment


                      • #26
                        https://mbaileygroup.com/blog/differ...s-blue-select/

                        all of these were on the exchange this year

                        Comment


                        • #27
                          Any response ? "Only HMOs on the market this year."

                          ????


                          Originally posted by JakeHalsted View Post
                          https://mbaileygroup.com/blog/differ...s-blue-select/

                          all of these were on the exchange this year

                          Comment


                          • #28
                            Originally posted by JakeHalsted View Post
                            Any response ? "Only HMOs on the market this year."

                            ????
                            It varies state by state.

                            "Hempstead found that there will be
                            fewer or no silver-level PPOs in 22 states next year. Federal records show there will be none in Miami and most Florida counties, much of Texas, New Mexico, New York and many counties in Mississippi and South
                            "

                            http://www.npr.org/sections/health-s...-than-for-hmos

                            In Texas:

                            "Following a similar trend that?s happening in many other states, Blue Cross Blue Shield of Texas decided to stop offering their individual PPO plans in 2016, and instead move to an HMO-only model"

                            https://www.healthinsurance.org/texa...ance-exchange/


                            Nothing but HMO in my region of Virginia also. Only two companies bothering to even participate.

                            From the above cited article, none of the PPO plans made money, and the couple staying open increased rates by ~34% in order to try to do so in 2016.
                            Last edited by Oddity; 01-10-2016, 06:18 PM.
                            "I have great faith in fools; self-confidence my friends call it." - Edgar Allen Poe

                            "If you only know your side of an issue, you know nothing." -John Stuart Mill, On Liberty

                            "Even what those with the greatest reputation for knowing it all claim to understand and defend are but opinions..." -Heraclitus, Fragments

                            Comment


                            • #29
                              The Blue Cross plans on floridablue.com include a number of "PPO/EPO" hybrid plans. The Exclusive Provider Organization structure seems more like a HMO with a few PPO features like being able to get some coverage for out of network and out of state care. Looking at the Blue Options plans, their deductible and co-pay when using non-network providers is significantly higher. For SCI, coverage of inpatient and outpatient rehabilitation, DME and whether urinary catheters are considered DME is going to be in the plan's fine print or needs to be discussed directly with a Blue Cross rep.

                              Humana added a pricey, Bronze PPO in the Houston market at the last minute. I think this may end up saving a lot of lives if it's profitable.
                              We have the country's top cancer hospital in our medical center. They were in-network when Blue Cross PPO was available last year but they are out of network for Blue Cross HMO. Patients in the middle of cancer treatment with Blue Cross PPO were getting switched to Blue Cross HMO for 2016 and losing access their treatment team. They would have had to decide whether to change treatment facilities or go bankrupt paying for their own chemo.

                              Comment


                              • #30
                                Originally posted by 2drwhofans View Post
                                The Blue Cross plans on floridablue.com include a number of "PPO/EPO" hybrid plans. The Exclusive Provider Organization structure seems more like a HMO with a few PPO features like being able to get some coverage for out of network and out of state care. Looking at the Blue Options plans, their deductible and co-pay when using non-network providers is significantly higher. For SCI, coverage of inpatient and outpatient rehabilitation, DME and whether urinary catheters are considered DME is going to be in the plan's fine print or needs to be discussed directly with a Blue Cross rep.

                                Humana added a pricey, Bronze PPO in the Houston market at the last minute. I think this may end up saving a lot of lives if it's profitable.
                                We have the country's top cancer hospital in our medical center. They were in-network when Blue Cross PPO was available last year but they are out of network for Blue Cross HMO. Patients in the middle of cancer treatment with Blue Cross PPO were getting switched to Blue Cross HMO for 2016 and losing access their treatment team. They would have had to decide whether to change treatment facilities or go bankrupt paying for their own chemo.
                                Yes, but once you drill down to actually shop, and enter your zipcode, you find that what NPR and healthcare.gov reported is true. Very few counties in FL actually have access to the few PPO plans still available.

                                Changing folks mid-treatment is low. Really low. Of all the dirty ways to save a buck...
                                "I have great faith in fools; self-confidence my friends call it." - Edgar Allen Poe

                                "If you only know your side of an issue, you know nothing." -John Stuart Mill, On Liberty

                                "Even what those with the greatest reputation for knowing it all claim to understand and defend are but opinions..." -Heraclitus, Fragments

                                Comment

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