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My Obamacare Ordeal!

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  • My Obamacare Ordeal!

    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!

  • #2
    I wouldn't judge someone without meeting them first.

    Guy at the clinic next door can barely speak english. Born in Africa (honestly not sure which country there) but spent time in Belgium and schooled in England. Awful accent all over the place ... but he's knowledgeable as hell - even about spinal cord injury. My own doctor that I've had for more than twenty years .. not so much .. and he has an excellent practice in a well-to-do area with other well respected physicians. pfft!
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

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    • #3
      You know what they call a doctor that graduated with the lowest GPA from whatever school they went to, right? Doctor. Given the option, if any, why are you doing an HMO? You know that the doctor who is assigned to be the gatekeeper to medical access is financially penalized for 'excessive' care as determined by some insurance bean counter creating a conflict of interest. Might be better to see if you can get a PPO option and just go wherever as the need arises.

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      • #4
        Wow, for my family premiums would be $2494 a month for that plan. After laying out ~$18,000 a year in premiums, another $6,000 in deductibles ($1,500 per, non-embedded!), I'd still be liable for another $6,000 in co-insurance/pays until I hit the $12,000 OOP max per year limit. Hmmmmm...lemme think...is that good insurance? Guaranteed $18,000 annual loss, possible $30,000 if I actually use it. Hmmmmm....tough decision. NOT.
        "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

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        • #5
          You sound like an evil tea party guy. Obamacare is awesome, just ask...uhh, someone! I forget, is this access to medical care or a scheme to give money to an insurance carrier under threat of sanction?

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          • #6
            Re: "Might be better to see if you can get a PPO option and just go wherever as the need arises".[/QUOTE]

            Florida and Texas have pretty much eliminated the ACA PPO option.

            They've come up with the EPO, which rhymes with PPO if that counts.

            "An Exclusive Provider Organization (EPO) only covers care within its network of providers and asks patients to pay through premiums and co-pays, much like an HMO. But unlike HMOs, EPOs allow you to see in-network specialists without a referral. What?s the catch? An EPO?s network is typically smaller than that offered by an HMO or PPO."

            So, a smaller network than an HMO but you don't have to go through a Primary Care Provider to see a in-network specialist.

            Folks in Illinois still have the ACA option for a Blue Cross Multi-State PPO.

            TheRainman: If you keep the HMO and are planning out of state travel, make sure you notify your HMO Primary Care Provider in writing in advance of the visit.

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            • #7
              Haha, EPO. I guess that's one way of saying they cant get any providers to participate in that pay structure.

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              • #8
                dumd question why are you not on medi care

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                • #9
                  Originally posted by lynnifer View Post
                  I wouldn't judge someone without meeting them first.

                  Guy at the clinic next door can barely speak english. Born in Africa (honestly not sure which country there) but spent time in Belgium and schooled in England. Awful accent all over the place ... but he's knowledgeable as hell - even about spinal cord injury. My own doctor that I've had for more than twenty years .. not so much .. and he has an excellent practice in a well-to-do area with other well respected physicians. pfft!
                  I would feel a lot better if this doctor was schooled in England!

                  Comment


                  • #10
                    It's odd that a lot of those folk come to Canada and our folk migrate to the States, in medicine.
                    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

                    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

                    Comment


                    • #11
                      Since I am on Medicare I have no clue how the ACA actually works. I do think there have been some folks who have signed up, paid a few months premiums, got some physical problem fixed and then dropped their premiums. This shows up in everyone's premiums, and is fraud.

                      Any HMO or any of those so called "Advantage plans" defraud the general public as well. The way I read the ACA should work as originally intended would be very close to a one payer system. But enough words got changed to suit some of the conservatives to get enough votes to pass it, screwed the pooch.

                      Rainman perhaps you should reassess your plan. Until I get notified that the plan (Medigap) I have currently I will continue it until I die. Yes the premiums have increased a bit But consider I pay about $5000 for all my health insurance out of my pocket, that is my co-pay Medicare, plus the Medi-Gap insurance, and prescription plans everything, with no additional out of pocket co-pays after the fact.

                      I have in my lifetime seen high priced doctors who I would not let them attend to my dog. Then there are those who live to be doctors, I have met both. Where they go to school makes no difference, but a doctor is like a mechanic, one who can fix stuff (people) even without every modern convenience or gadget known to man, is priceless. Old, young, they are available, you just have to search them out. Exactly what do you consider a reject type doctor? Some folks go to South East Asia to get operations and physically repaired why? Do you think those doctors just took up their practice without some realistic medical education?

                      Good luck with your adventure in studying health care insurance plans.

                      Comment


                      • #12
                        Originally posted by lynnifer View Post
                        It's odd that a lot of those folk come to Canada and our folk migrate to the States, in medicine.
                        We have the best medical care in the world, you just have to pay for it. I go to Mayo in Rochester, the SCI department there is amazing.

                        Comment


                        • #13
                          Originally posted by Bob Sullivan View Post
                          Since I am on Medicare I have no clue how the ACA actually works. I do think there have been some folks who have signed up, paid a few months premiums, got some physical problem fixed and then dropped their premiums. This shows up in everyone's premiums, and is fraud.

                          Any HMO or any of those so called "Advantage plans" defraud the general public as well. The way I read the ACA should work as originally intended would be very close to a one payer system. But enough words got changed to suit some of the conservatives to get enough votes to pass it, screwed the pooch.

                          Rainman perhaps you should reassess your plan. Until I get notified that the plan (Medigap) I have currently I will continue it until I die. Yes the premiums have increased a bit But consider I pay about $5000 for all my health insurance out of my pocket, that is my co-pay Medicare, plus the Medi-Gap insurance, and prescription plans everything, with no additional out of pocket co-pays after the fact.

                          I have in my lifetime seen high priced doctors who I would not let them attend to my dog. Then there are those who live to be doctors, I have met both. Where they go to school makes no difference, but a doctor is like a mechanic, one who can fix stuff (people) even without every modern convenience or gadget known to man, is priceless. Old, young, they are available, you just have to search them out. Exactly what do you consider a reject type doctor? Some folks go to South East Asia to get operations and physically repaired why? Do you think those doctors just took up their practice without some realistic medical education?

                          Good luck with your adventure in studying health care insurance plans.
                          Bob,
                          Lot of good advice, Thanks! I did call the agent from Obamacare, he said all Obamacare policies in Florida are HMO. I am thinking the only real medical help I most likely need this coming year is from a urologist and maybe a podiatrist. And if something else comes up i'll just go to the ER. The hospital nearest to me is in the plan.

                          Called Humana. Their customer service his really good. But, the best they could do was give me a list of doctors. Just a lot of work looking for one from the list.

                          Comment


                          • #14
                            Originally posted by t8burst View Post
                            We have the best medical care in the world, you just have to pay for it. I go to Mayo in Rochester, the SCI department there is amazing.
                            Why can't every hospital work like Mayo? I've been to Rochester and I second the amazing.

                            Comment


                            • #15
                              As far as I can see the whole dam heathcare in this country is a mess. You should be able to go and see any doctor you want like it used to be. Obamacare is the biggest joke ever. In 2017 you won't even find a ins. co. because they all going broke. Obamacare sold use out when he said we would have a public option then sold out to the ins. co..
                              The real joke pass it then see whats in it....Anybody with any common sense knows this plan is so stupid... leadership of the wosre kind. Most folks I no can't afford it with the high copays. Why buy it when you can't afford the first 10,000 out of pocket. I don't know what the answer is but this sure as hell is not the answer.
                              Last Republican debate was about how to build a more stronger military....know body asked how we suppose to pay for it. Even Obama knows its over for his Obamacare. It is going under big time.
                              Art

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