My saga to find a dr. to accept my Obamacare Blue Cross Insurance

[Honeycombe8]

I posted a prior post a while back about my troubles for several years in finding a dr. to take my Obamacare insurance. And it continued in my new location, in a different state.

Well....I found one! Yay! I will have my first exam since 2013! I'll get a mammogram for the first time since 2013!

It was important to me, since it looks like Obamacare may be going away. This will be my last year with Obamacare...I'm not too far from getting Medicare, so I'm going to hang in there & wait for that. I can't afford the ACA w/o a subsidy, so....

In the meantime, I've found a dr. not far from me! Yay! (I can't express how excited I am. I've spent hours on the phone over the years, on hold and listening to rejection after rejection. I was surprised when I found one who said YES!)

[Eliot Rosewater]

1. I dont understand this at all, Obamacare policies and employer based are all the same as in what

they cover.

This makes no sense.

[SalviaBlue]

4. Insurance companies reimburse differently for ACA versus private policies.

[Eliot Rosewater]

7. Time for national healthcare and free medical school for those who participate in the system.

Any hospital or dr refusing to take it not eligible for the education.

Solves everything.

[SalviaBlue]

53. I agree!

[ehrnst]

78. Yes, but getting there is the issue. And no healthcare is "free"

Because health professionals and those who teach them are not doing it as volunteers. You have to pay them, and you have to pay them in a manner that would make the very difficult process of becoming, and being a doctor worth it for them. You pay people what there job is worth, and our health is worth a lot.

It's much easier to hold costs down over decades then it is to retrofit low costs into an existing high cost system.

It's like saying that putting hydrogen fuel cells on all cars, businesses and residents will slow global warming faster than anything - because it would. But the costs and infrastructure to keep those cells fueled, retrofit vehicles and homes - not to mention the impact on the economy of people who would be unemployed as a result, would require an incremental approach.

The ACA is the closest we've come to national healthcare.

[Eliot Rosewater]

81. Yes, we dont disagree, but we do have to recognize that our system has allowed for SOME

physicians (not most by any means), pharmaceutical companies and of course hospitals to make enormous profits off of you and me.

It isnt like that anywhere else, not anywhere, not anywhere of any note or size.

A heart surgeon making $5 million a year makes sense in light of a MLB catcher making $10 million I guess, but we dont need baseball to survive.

So as a society we have to make compromises, all of us including the best doctors and so on.

ACA is the single greatest accomplishment by a president since Medicare via Johnson and Social Security before that via FDR.

Obama is one of the 3 best presidents of all time, and Hillary would have been also or top 5.

And that is all true at the same time we have a broken healthcare system that only works really well for some of us.

Like I said, you make medical school, nursing school all tuition free and everyone who partakes agrees to work in the national healthcare system. Get rid of for profit hospitals except for rich people who want private rooms and spas.

Doctors and teachers will still make plenty of money but maybe the heart surgeon makes $2 million a year instead of 5, something like that.

The alternative is an ACA with a republican president doing everything he can to destroy it because of the skin color of Obama etc.

[ehrnst]

82. We agree on many things.

But nothing in the healthcare system is free, not even teachers.

The money to pay someone, someone good, to teach, and the money to pay someone, someone good, to be a physician has to come from somewhere.

And lowering pay is much more difficult than keeping it at a lower rate to start with. The process of "getting rid" of for profit hospitals is very expensive and complicated, because it's a retrofit, and not baked into the system to begin with.

I feel that this is often oversimplified, and will lead to falsely raised expectations - like when Obama said, "You can keep your doctor." That set back support for the ACA, unfortunately.

If we manage expectations to what is possible, then we don't get so much of the vilification of leaders who are up front and honest about it - like Hillary was when she said Single Payer, as it was promoted, "isn't going to happen."

[Eliot Rosewater]

83. Tuition free would be really easy to do if we created a system that removed the profit

that exists now for insurers and hospital owners.

Tuition free is common most places but America.

I get the vilification issue, believe me, you know I do.


BUT it was Hillary herself

who CREATED the national healthcare idea in the first place. She was going to take us there, in time, and it would have taken time.

I dont trust certain "other" politicians who say we can do it overnight or who will try too much too soon. I trust people like Hillary and Barack to do it the only way it can be done in a country like ours.

[ehrnst]

86. "If we created a system that removed the profit that exists now"

That's the part that hasn't been explained adequately.

The removing the profit part.

And this is HRC's plan as of last year:

https://www.hillaryclinton.com/issues/health-care/

It changed considerably from 1993 due to lessons she learned the first time around. It includes a public option, and allowing people to buy into medicare earlier, but no other plans for a socialized health care push.

[burnbaby]

79. I'm with you

been saying that for years. Seems like a win win. Politicians should run on that idea and I'm not sure why they haven't

[ehrnst]

80. Because it isn't as simple as it seems.

As we've told Don the Con, healthcare reform is complicated.

If it was simple and affordable to implement, and was such a win-win, it would have been done already.

[Eliot Rosewater]

85. Absolutely and the FIRST person to try it was HILLARY herself

I wish certain people around here would educate themselves about this...

The problem is people like you and me cant discuss this the way we want to because it is used against us, used against well meaning democrats who KNOW it cant be done with the click of a couple fingers.

[ehrnst]

87. I get that - and that was 1993, and she learned some lessons from that.

Which led to a very different vision for 2016.

[Eliot Rosewater]

84. If I made this sound simple I didnt mean to, I am just lazy when I post sometimes

HILLARY started this idea, not me, not you, not Bernie, HILLARY...

And she was beaten over the head with it for decades.

[ehrnst]

88. No matter who started the idea, a socialized medical system

like the one we have for servicemembers isn't going to happen in under several decades.

That's what the non-partisan, self funded think tanks on health policy say.

Maybe I'm not making myself clear - I loved the care that I had in the UK when I lived there. I hadn't been able to afford it here, and wish I could get it here.

I would love for it to be possible. I don't care who pushes it, I look at what health policy analysts with no skin in the game have to say.

And they say single payer is nowhere as simple as it has been presented. It sounds simple if you don't look closely at what turning that huge ship on a dime would involve. And "a dime" is under 20 years - and we've seen what has happened to the ACA in just 8 months of a new administration.

This is why anyone talking about "simple solutions" to very complicated issues makes me nervous.

[still_one]

59. That is true, and also the same reasoning some doctors won't accept Medicare or Medicare for

payment in full

Almost all Major hospitals and university hospitals and the doctors associated with those institutions you should have no problem, and if it is a medical emergency patient dumping is illegal

[AncientGeezer]

6. Not true.....can be very different coverages.

An ACA Bronze isn't going to cover like a GE employee plan.

[Eliot Rosewater]

8. Coverage? No , coverage is the same, deductibles, copays and the way the dr is paid is

different, not coverage.

The main thrust of ACA other than subsidies was to make all healthcare or health insurance the same as in no more shit policies.

Trump is destroying that now.

[AncientGeezer]

20. Please...Sir...coverage(what is covered) can be vastly different.

An example...my Mom's survivor spouse GE ins. covers IN FULL ambulance transport and residential OT/PT....my bronze ACA.....not even close to same coverage.
2 yrs ago she had to be transported by helicopter and lifted to Albany..PIF..I can't get on a helicopter for a tourist trip to Albany.....without being on the hook for full price.

[Eliot Rosewater]

21. Deductibles are different and copays. All health insurance in America is ACA, fact.

All necessary and preventive care is the same coverage by law.

[tymorial]

30. You are confusing coverage and out of pocket costs.

[AncientGeezer]

63. No I'm not.

My Mom has an employee based policy that "covers" things my ACA policy doesn't.
Not a hard concept to grasp.

[tymorial]

65. Other posters have tried to explain the difference to you

I'm not going to argue with you. Believe what you will

[AncientGeezer]

72. It's not a belief....it's a fact. "Coverage" has a definition.

[Honeycombe8]

13. Do you have a private ACA policy (one of the metals)? nt

[Eliot Rosewater]

15. No, employer based.

Apparently the reimbursement is different, not the coverage, i know the coverage is the same, that is the law.

The answer is single payer.

But we cant have nice things.

[Honeycombe8]

17. Employer provided ins. is not Obamacare.

Obamacare is an individual policy bought on the exchange (subsidies). It has special coverages and rules. And more limited providers.

[Eliot Rosewater]

18. Wrong, with all due respect. ALL health insurance in America is Obamacare, what is

different is the subsidies and the way ACA policies reimburse.

Which was the whole point of the ACA, to standardize all insurance and get rid of the bad stuff.

What I didnt remember until today was the way they do reimbursement is different and many doctors are used to the higher level of pay.

ALL health insurance in this country is subject to ACA as to coverage.

I suppose there might be some elective stuff covered on one and not the other but nothing as to necessary and preventive healthcare.

[Honeycombe8]

23. Not in the vernacular. "Obamacare" is the NEW thing: Individual mandated policies...

usually bought on the exchange (subsidies).

Providers don't refer to employer-provided insurance as "Obamacare."

The rate of pay is lower, and the manner of pay is different, and ins. cos. aren't allowed to cancel a policy for months even if the insured doesn't pay the premium (meaning doctors may get stiffed on a bill).

All the coverage is the same...that's not the problem providers have with Obamacare. It's the payments to THEM.

[Eliot Rosewater]

24. Correct, all the coverage is the same and many doctors and hospitals have gotten used to a rather

generous system of pay from insurers depending on the policy.

Which is why the entire system has to be taken over bottom to the top.

Most countries doctors dont make the kind of money they make here for specialties, and while I havent researched that I can say it with confidence.

[tymorial]

31. Correct

There seems to be some confusion between out of pocket costs and services covered by insurance... not to mention a misunderstanding of ACA rules.

[Demsrule86]

36. It covers the same essential benefits as Obamacare...I never got well care under hubs old plan...

until Obamacare...I pray we keep it or health care is done...and if you think the GOP will leave you in peace with medicare thing again.

[Honeycombe8]

47. Oh, yes...I know they're gunning for Medicare. But at least I'll get a good chance ...

to have some health care (I have to pay for it, but at reduced prices, and I know the cost, altho it'll probably go up some).

My cost of medicare will be about half of the exchange purchased ADA individual policies I've had.

[Demsrule86]

55. I hope that happens...the GOP are looking to privatize it and kill it.

[Honeycombe8]

58. Yes, I know. They've been working on it for decades. I fear that this time they will...

do something to damage it so that it "withers on the vine," as Gingrich once said.

That's what they're trying to do to Obamacare...damage it so that it withers on the vine.

I'm also worried about Social Security.

[Ms. Toad]

38. There is no such thing as Obamacare. That was a derrogatory term created by Republican

All plans currently available (aside from a few grandfathered plans) are ACA plans. Both employer and exchange plans are part of the ACA. If the ACA vanishes - my daughter's employer-based plan vanishes.

If providers are limited, it is because of the package the insurer negotiated - NOT - whether your policy was acquired through an employer of the exchanges. The metals are rough designations of the minimum package a plan with that label covers.

The special rules associated with the exchanges have to do with open enrollment periods and cost-sharing subsidies (including the metal labels - which are linked to the subsidies). The reality of Trump monkeying with the cost sharing subsidies has caused instabilities in the marketplace that impact the stability of employer-based plans less (since the employer-based plans are not mandated to provide cost-sharing subsidies).

And, as has always been true, access to affordable health insurance has always been easoer through a large employer who has the muscle to negotiate a better deal. That doesn't mean it is an inherently different beast. It's all in negotiating power.

[Honeycombe8]

40. Originally it was. Then Obama himself claimed the name, saying he's proud to call it Obamacare.

After that, it became the common way to refer to the ACA, and in particular, the individual policies of the ACA (esp the ones bought on the exchange, which was a new thing brought by the ACA, different from all the other policies that pre-dated the ACA).

[Ms. Toad]

46. My spouse was proud to claim the black sheep award for our family

based on who had pissed of the parents worse. My spouse's sin? Being gay. I hid the sheep where it will never see the light of day.

Doesn't matter how you try to wash out the stench, it's still a derrogatory term.

[Honeycombe8]

49. Not to me or any of the Democrats who use the term. I think you're behind the game on the term.

It STARTED that way, the Repubs thinking heh heh heh, we'll call it "Obamacare," and he'll be stuck owning that POS. But it turned out to be a very popular bill, and Obama claimed the name, and it stuck among people of different political persuasions. "I don't mind the name, because I really do care."

And..

But it was hard not to notice the ubiquity of the “Obamacare” label, and in an interesting move, the president’s re-election team has decided to embrace it with both arms. David Axelrod sent an email to supporters this afternoon with a subject line that read, “I like Obamacare.” The letter said:

I like Obamacare. I’m proud of it – and you should be, too.

Here’s why: Because it works. So if you’re with me, say it: “I like Obamacare.”

Obamacare means never having to worry about getting sick and running up against a lifetime cap on insurance coverage. It gives parents the comfort of knowing their kids can stay on their insurance until they’re 26, and that a “pre-existing condition” like an ear infection will never compromise their child’s coverage.

It’s about ending the practice of letting insurance companies charge women 50 percent more – just because they’re women.

And Obamacare can save seniors hundreds of dollars a year on prescription drugs – and gives them access to preventive care that is saving their lives.

The email also refers supporters to a new “I Like Obamacare” website.

[Ms. Toad]

52. My answer still stands.

And given the way you are using it, I'm surprised you are claiming it has been rehabilitated.

You' ve been trashing it quite a bit through at least two threads - calling one part of the ACA out separately, insisting that there are different rules for the part you call Obamacare (there' aren't aside from the subsidies), treating it as something other than the insurance plan that it is, and complaining that no one will take it because it's different.

[Honeycombe8]

56. President Obama disagrees with you. My reference stands. I have not been "trashing" it.

Question is...why are you offended that someone had a problem with it? Do you think that bill, or any bill, works for everyone or is perfect?

You say that I "insisting that there are different rules for the part you call Obamacare (there' aren't aside from the subsidies)." You are wrong. Please don't try to discuss things you don't understand fully.

I've been buying it every year since 2014 and have spent well over 100 hours studying policies and rates and coverages and provisions. I have a good grasp of how it works. YES...it has different rules. Any time you use someone else's money to pay for something, there will ALWAYS be different rules. (Example: Medicaid. It has different rules, too.)

One rule is...what can an insurance co. do when an insured or entity it has contracted with failed to pay a premium? Answer: It can cancel the policy immediately, in accordance with its stated policies and procedures...UNLESS you bought a policy through the exchange. In that case, the ins. co. cannot cancel it for three months. BUT the ins. co. can refuse to pay for any claims turned in after the date the policy was paid up through. This would stiff any providers who had provided treatment.

And THAT is one reason that providers are picky about taking the exchange-purchased individual insurance policies.

And YES...I called over 20 or so providers in Dallas, TX ( a mecca of medical provider), from the "network provider list," and did not find one doctor who'd take it within a reasonable distance of me. I finally found one in a suburb...I found him on my own through Google searches (not using the provider list). He was about 2 hours away; I didn't go to him, because by then I was moving. The only other two I found were not doctors: I found a nursing assistant (who required me to pay upfront $100 for initial exam, despite that being against the law), and a Medicaid Clinic that would have taken me over an hour to get to. The Medicaid Clinic ALSO required a "meet and greet" and "orientation" meeting for a fee, before going there.

So yeah, I know what I'm talking about.

Do you have any other questions? I'll be glad to tell you anything you want to know about Obamacare. I've done a lot of research on it, and of course, have experienced it firsthand for four years.

[Ms. Toad]

60. I've spent a good deal more than that time with the ACA.

I have a daughter with $60-100,000 in billed medical expenses every year. Access to insurance/health care (starting with COBRA, through HIPAA, and most recently the ACA) has to be my business, becuase othewise she will die.

[ehrnst]

89. No, Obamacare is not a policy. It is a law, and it does cover employer provided insurance.

In a WHOLE lot of ways.

There is an employer mandate:

The employer mandate requires employers meeting certain criteria to provide health insurance to their workers. The mandate applies to employers with more than 50 employees that do not offer health insurance to their full-time workers.

Preventive Services Without Cost-Sharing
The ACA requires all new health plans, including those sponsored by employers, to cover recommended preventive services without cost-sharing, bringing new benefits to 71 million Americans. That means individuals can get the screenings, immunizations, and annual check-ups that can catch illness early or prevent it altogether without worrying about meeting a costly deductible or co-payment. With that peace of mind, it’s no wonder it’s one of the most popular provisions of the ACA. Women employees can also access affordable contraception, making available a wider variety of contraceptive choices and increasing use of long-term contraceptive methods.

Pre-Existing Condition Exclusions

Under the ACA, employers cannot impose a waiting period for coverage of a pre-existing condition. Prior to the ACA, individuals who became eligible for an employer plan—for example, once hired for a new job—might have to wait up to 12 months for the plan to cover pre-existing health conditions. You could “buy down” that waiting period with months of coverage under another plan, so long as it was the right kind of plan and you didn’t go without coverage for 63 days or more. But if you lost your job, couldn’t afford COBRA, went a few months without coverage and then were lucky enough to get another job with benefits, you might find the care you needed wasn’t covered under your plan for an entire year.

Dependent Coverage To Age 26

The ACA requires all health plans, including those sponsored by large employers, to cover dependents up to age 26. Prior to the ACA, one of the fastest growing groups of uninsured was young adults — not because they turned down coverage offered to them, but because they were less likely to have access to employer-based plans or other coverage. The result has been a dramatic increase in the number of insured young adults, particularly among those with employer-sponsored coverage. This ACA requirement is one provision President-elect Trump and many anti-ACA legislators have pledged to retain.

http://healthaffairs.org/blog/2017/01/11/get-health-insurance-through-your-employer-aca-repeal-will-affect-you-too/

[brokephibroke]

2. Blue Cross is widely accepted

It's pretty hard to find a doc who doesn't accept it.

[SalviaBlue]

3. In CA Blue Cross (Anthem) through the ACA marketplace

is not the same as an Anthem policy purchased outside of the marketplace.

I was on ACA originally and could not find a doctor in the network. Every Dr. I called that was listed on the network list was not actually accepting ACA policies. I finally received a refund from ACA and bought a private Anthem plan and had many choices of in network Drs.

I was told by the Drs. office that the insurance companies reimburse the Drs. differently for ACA Silver Plan versus Private Silver Plan.

[Eliot Rosewater]

10. This is sadly true, while WHAT is covered is the same, how it is paid is different which is why

we need a single payer.

When you first posted this I had forgotten about the fee-for-value payment models

[Honeycombe8]

19. This is what I found. But they wouldn't refund me. I just paid and didn't have access to care.

The insured can't change the insurance contract, because the contract is between the govt and ins. co.

I moved but couldn't get the first policy canceled. I did everything properly, notifying ins co and govt, changing address. Blue Cross never did cancel that first policy and kept billing me and the govt.

I have changed addresses again. Blue Cross will not change my address, even tho I changed it with the govt and notified Blue Cross. They still send mail to my old address, which is forwarded, and have my old address on my account.

[Eliot Rosewater]

22. More reason to make blue cross and blue shield and the rest of them a thing of the past.

[Honeycombe8]

25. Well, it's too late for me. nt

[Eliot Rosewater]

26. How is it too late?

What are your exact needs and situation?

[Demsrule86]

37. My daughter in Ohio was on Blue via the ACA.

And any policy you buy has to cover the same thing as the ACA...it is all the same. There are different plans...you check before you sign up who take the plan.

[sheshe2]

57. ACA covered me.

Unemployed and on unemployment insurance. Could not afford Cobra. It was a life savor. It was a great plan through Tufts.

More about ACA...



https://www.healthinsurance.org/obamacare/off-exchange-plans/

[Phentex]

5. Depends on the plan....

http://www.myajc.com/news/state--regional-govt--politics/blue-cross-pulls-back-georgia-coverage/9ri1oiB4xcfp4pEXyjSr0N/

It will stay in rural areas where there is no other choice. But it is leaving the metro Atlanta area.

[kacekwl]

12. Untrue, there are many blue cross plans , too many to count.

Tried to get flu shot last month and was not covered. Blue cross Illinois, blue cross blue shield, blue cross silver, blue cross hmo,ppo it goes on and on.

[Eliot Rosewater]

27. Either flu shots are considered preventive by ACA or they are not, pretty sure they are and if

they are the law requires all carry that coverage.



Flu and other vaccines are required to be covered by your health insurance without charging a copayment or coinsurance



whoever said they are not covered being lied to by someone

By law that flu shot is not only covered but you pay nothing, fact.

[kacekwl]

34. I'm going to try elsewhere so

Hopefully you are correct. Thanks.

[Eliot Rosewater]

35. I am , find a pharmacy that gives the shots that takes your card.

[Honeycombe8]

61. I couldn't get an answer to that question from Blue Cross, so I didn't get one.

I didn't actually try to get one and present my ins. card (at the drugstore or wherever). They may know. I need to ask.

But I did call Blue Cross, and she said that because I have an HMO, I can't get a flu shot at a drugstore or somewhere. I have to go to my primary care provider for everything, or have him refer me. She wasn't sure if it was preventive. That sounded ridiculous, so I don't know. The reps don't always know much.

It may depend on whether you have a PPO or HMO. All the policies sold in this state are HMOs, so....we pretty much have to go to the one doctor for everything.

[Demsrule86]

39. Blue cross makes you pay upfront if you have not met your deductible but if you file a claim, they

send you a check.

[Eliot Rosewater]

41. Not for preventive care which this is, by law there is no copay or deductible.

Trump will do away with that the instant he can because it is a good thing, but right now you pay nothing

Same thing for colonoscopies and mammograms, if necessary for preventive care

[brokephibroke]

33. I have Blue of CA

It was free.

We need single payer.

[Demsrule86]

42. I want a unicorn and have as much chance of getting that as getting single payer anytime soon...The

Choice is not the ACA or Single Payer...it is the ACA or nothing for years and years.

[brokephibroke]

48. Polka dot unicorn?

I'm afraid you are correct. America is anchored down with conservatives.

[Demsrule86]

50. I don't say this with happiness...but because just as you say...we are anchored by conservatives.

Pink polka dots are my fav...

[Honeycombe8]

62. What is that? Is it CA single payer? Do the doctors like it and take it? nt

[LeftyMom]

67. Every plan is required to cover flu shots with no copay.

You may be limited in where you can receive it. You should call and ask for clarification or check their website.

Last year I was required to get my flu shot from my primary care office to be covered. This year the same plan allowed me to get it at a retail pharmacy, which meant I was able to get it much earlier.

[Honeycombe8]

14. Apparently not the case. I couldn't find a dr for years who would take mine.

Do you have a private ACA policy bought on the exchange? What city and state do you live in?

[brokephibroke]

32. Until 10/1 I had an ACA plan from Cigna - silver

Had no trouble at all finding doctors, I kept the one I have had for years on various plans. I live in the Longmont, CO area.

Now i have a blue of California plan provided by an employer - all my docs take it.

It must be the state.

Btw, due to all this GOP health care BS I decided to stop being self employed and took a job. The ACA was great for those who wanted to quit working for a corp and enjoy the freedoms of working for oneself.

[Bradshaw3]

44. not true. BCBS is not just one plan

I have BCBS in Az through the ACA and they have different types of plans. Most doctors in my area do not take my plan.

[treestar]

9. I didn't have a problem

the doctor I already went to accepted it. Maybe because it's a blue state, or small.

[Eliot Rosewater]

11. Free medical school if you agree to participate in AmericaCare , the new single payer

system where for profit hospitals exist to treat only those with private insurance.


This makes sense and is good for Walmart Greeters and auto mechanics and secretaries and Uber drivers so expect them to say no, sigh

[Honeycombe8]

16. That was not the case for me, unfortunately.

Did you get a subsidy? This is what the providers call Obamacare.

[treestar]

28. Yes. Nobody referred to that.

I have been to the Dr. a lot since then - preventive in nature. I just pay the copay. Really has worked well for me anyway. Maybe it is different by the state, though. This state is blue (DE), and would want it to work as our Biden said it's a big fuckin' deal, LOL.

[Honeycombe8]

29. May be the difference. I've been in 2 red states. The ins cos have been paid...

over $35,000 for 2014 - 2017 policies for me. Amount of claims: $0.

But to be fair, I became so despondent over the situation that I didn't call much after a while. I couldn't take the repeated rejection. I got pretty depressed over it. Even if I'd found a dr., my deductible was $6,000, so I would have had to pay out of pocket except for a preventive exam. (this year I got a low deductible.)

All Blue Cross during those years except for 1/2 year United Healthcare (the first good policy I had)...but they withdrew from the state, so had to go back to BC.

Oh, well. It's over for me this year. I can't get it after this year, I think. But not long until I can get Medicare (yay!).

[Demsrule86]

45. Why can't you get it after this year?

[Honeycombe8]

69. Oh...I can't afford it..the subsidies are up in the air.

I can't take a risk that the subsidies won't be there. It's WAY expensive (my current one, an HMO silver, is over $950/month). I could drop it down to a bronze, but those have high deductibles, and would still be probably $900/month. I'm healthy but older.

Plus I'm not sure what my income next year will be...I have to estimate. It's always tricky, so I don't want to do that again.

Psychologically I can't deal with it any more. The doctors, the cost, the worry, the subsidy. It hasn't worked for me. I do understand that it's worked well for others.

Just got a letter from Blue Cross that says "Be prepared...rates are going up in 2018." UP? For me? BC has gotten over $35,000 for my insurance. Claims turned in: $0. But my premium is going up.

[Demsrule86]

43. That is just not true...

What state are you in.

[Mediumsizedhand]

51. I have not had any trouble at all. I have to wonder about your states. Two states myself.

Yea, you have a doctor. That is the good thing.

[Honeycombe8]

64. Texas and Louisiana. Two red states. Big city...small city.

Part of the issue was that the policies were/are HMOs, I think. Doctors don't like HMOs generally; they don't pay.

[Mediumsizedhand]

70. I was in one of those states and had no problem at all. I bought the higher end one.

On silver. It was a particular hospital and all their medical extention and doctors. The other, I got in the second year didn't have my doctors, but it was thru the other hospital and if I needed I could have easily found the doctor I needed. I really do not even a little get, your challenge. I am in another state. Did the policy that was a tad higher and got the first two doctors I called. Dermatologist and internist.

[Honeycombe8]

74. Did you buy through the exchange? And have an HMO?

I can't go to a dermatologist, since I have an HMO (unless a PCP refers me). Blue Cross sells only HMOs in Louisiana, where I am right now. So I'm guessing you have a PPO. They have larger provider lists.

There were PPOs in Dallas, but I had a bronze HMO, since that's all I could afford. (I'm older, so my premiums are very high.)

The provider lists were so wrong as to be useless. This claim is actually part of a lawsuit against Blue Cross, btw. I know it's hard to believe. But the provider list was clearly false. Not even close to being accurate.

It wasn't me. I wasn't "calling wrong," or failing to use the provider list, or "asking wrong." I can only relate my experience. I was truly shocked. I couldn't believe it. I was shut out of the general doctor group in Dallas because of my policy.

I will say that once I started getting the rejections, I did get very depressed about it, and didn't want to call any more. I just couldn't handle it. Some of them were not that nice...one said, "Oh, we don't take THAT."

One place that would take my insurance was a Medicaid Clinic. A Medicaid Clinic for a policy that was costing almost $900 a month? They were also not nice. But it was too far away, time wise, for me to go there, anyway.

[Mediumsizedhand]

75. I better understand. I had the Bluecross HMO before I did ACA.

Useless. Fuckin useless. I did not do BCBS thru ACA. What I had was bad. By the time I got on ACA, BCBS was out. Well, I think the first year they were there but they charged a lot for not a lot. I picked a different insurance for my area. It was directly connect to the hospital and outreach.

I wish you had better luck with it but I was so turned off with BCBS prior to enrollment, I stayed well away. I have had a very positive experience.

At 32k a year for the first year, I was at 156. a month and had all my work ups. Blood tests, prescriptions, a lung scan. I totally had insurance paying more out than what I paid in. Even on the skin cancer surgery, the insurance picked up some.

I am really sorry you did not have a like experience. Again, I love my ACA, and am bothered they are messing with it.

Second year, it increased to 180. a month for single coverage, the not as prominent company. I didn't use it and moved. It did increase in cost the second year, 2017. But I understand it was stabilizing. Trump has taken that away.

This one in a blue state was accepted the first two doctors I called. 25 doctor visit and covered perscription at 7 per perscription.

I cannot complain.

[Honeycombe8]

77. Wow. That sounds great. You are younger so can afford more...

I'm older. The premiums skyrocket at a certain age, even if you're healthy, like I am lucky to be.

BCBS cost less than the others I looked at in Dallas, so it's odd it was the opposite for you. Aetna, Cigna, Humana cost even more for less. (I think Aetna and Cigna withdrew later, tho.)

In la. there are only 2 cos. that sell it: BCBS and something called Vantage. Vantage costs even more for less, so I went with BCBS. Not much choice. But I did get a silver level this time. Still an HMO because that's all they sell.

So I'm excited I found a doctor nearby who will take this insurance. She's very young, which concerns me. But I'm lucky she'll take my ins.

[Mediumsizedhand]

71. I personally, love ACA. it has allowed me to do all my work ups, and get a plan as I get older.

I am really bothered that Trump is missing with it because it is a life saver for me.

[Merlot]

54. Your insurance plan has a list of providers in your area

You call them.

[Honeycombe8]

68. Of COURSE I started w/the provider lists.

Of course I know all about provider lists, having used them for decades.

[LeftyMom]

66. My saga to find a dr to accept my ACA plan. I made a phone call. They gave me a list.

When I wanted a GP they just gave me doctors accepting their plan and new patients in my zip code (over a dozen,) when I need a specialist they give me a list in my city or my GP's office makes the arrangements and just calls me when something is scheduled.

I do find the delay in getting specialist referrals or tests approved annoying, it's taken as long as two weeks.

But several years to find a GP and a mammo? In unspecified location and unspecified location with vaguely identified plan (that's somehow the same in two states and over several years even though you hate it?) Not really buying it.

[Not Ruth]

73. You have been paying for healthcare for 4 years without being able to get a doctor?

Horrible, this is not how the system should work.

[LenaBaby61]

76. Good for you ...

Honeycombe8