General Discussion

Honeycombe8

(37,648 posts)

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

Mon Oct 23, 2017, 09:10 PM

Oct 2017

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.

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My saga to find a dr. to accept my Obamacare Blue Cross Insurance [View all] Honeycombe8 Oct 2017 OP

I dont understand this at all, Obamacare policies and employer based are all the same as in what Eliot Rosewater Oct 2017 #1

Insurance companies reimburse differently for ACA versus private policies. SalviaBlue Oct 2017 #4

Time for national healthcare and free medical school for those who participate in the system. Eliot Rosewater Oct 2017 #7

I agree! SalviaBlue Oct 2017 #53

Yes, but getting there is the issue. And no healthcare is "free" ehrnst Oct 2017 #78

Yes, we dont disagree, but we do have to recognize that our system has allowed for SOME Eliot Rosewater Oct 2017 #81

We agree on many things. ehrnst Oct 2017 #82

Tuition free would be really easy to do if we created a system that removed the profit Eliot Rosewater Oct 2017 #83

"If we created a system that removed the profit that exists now" ehrnst Oct 2017 #86

I'm with you burnbaby Oct 2017 #79

Because it isn't as simple as it seems. ehrnst Oct 2017 #80

Absolutely and the FIRST person to try it was HILLARY herself Eliot Rosewater Oct 2017 #85

I get that - and that was 1993, and she learned some lessons from that. ehrnst Oct 2017 #87

If I made this sound simple I didnt mean to, I am just lazy when I post sometimes Eliot Rosewater Oct 2017 #84

No matter who started the idea, a socialized medical system ehrnst Oct 2017 #88

That is true, and also the same reasoning some doctors won't accept Medicare or Medicare for still_one Oct 2017 #59

Not true.....can be very different coverages. AncientGeezer Oct 2017 #6

Coverage? No , coverage is the same, deductibles, copays and the way the dr is paid is Eliot Rosewater Oct 2017 #8

Please...Sir...coverage(what is covered) can be vastly different. AncientGeezer Oct 2017 #20

Deductibles are different and copays. All health insurance in America is ACA, fact. Eliot Rosewater Oct 2017 #21

You are confusing coverage and out of pocket costs. tymorial Oct 2017 #30

No I'm not. AncientGeezer Oct 2017 #63

Other posters have tried to explain the difference to you tymorial Oct 2017 #65

It's not a belief....it's a fact. "Coverage" has a definition. AncientGeezer Oct 2017 #72

Do you have a private ACA policy (one of the metals)? nt Honeycombe8 Oct 2017 #13

No, employer based. Eliot Rosewater Oct 2017 #15

Employer provided ins. is not Obamacare. Honeycombe8 Oct 2017 #17

Wrong, with all due respect. ALL health insurance in America is Obamacare, what is Eliot Rosewater Oct 2017 #18

Not in the vernacular. "Obamacare" is the NEW thing: Individual mandated policies... Honeycombe8 Oct 2017 #23

Correct, all the coverage is the same and many doctors and hospitals have gotten used to a rather Eliot Rosewater Oct 2017 #24

Correct tymorial Oct 2017 #31

It covers the same essential benefits as Obamacare...I never got well care under hubs old plan... Demsrule86 Oct 2017 #36

Oh, yes...I know they're gunning for Medicare. But at least I'll get a good chance ... Honeycombe8 Oct 2017 #47

I hope that happens...the GOP are looking to privatize it and kill it. Demsrule86 Oct 2017 #55

Yes, I know. They've been working on it for decades. I fear that this time they will... Honeycombe8 Oct 2017 #58

There is no such thing as Obamacare. That was a derrogatory term created by Republican Ms. Toad Oct 2017 #38

Originally it was. Then Obama himself claimed the name, saying he's proud to call it Obamacare. Honeycombe8 Oct 2017 #40

My spouse was proud to claim the black sheep award for our family Ms. Toad Oct 2017 #46

Not to me or any of the Democrats who use the term. I think you're behind the game on the term. Honeycombe8 Oct 2017 #49

My answer still stands. Ms. Toad Oct 2017 #52

President Obama disagrees with you. My reference stands. I have not been "trashing" it. Honeycombe8 Oct 2017 #56

I've spent a good deal more than that time with the ACA. Ms. Toad Oct 2017 #60

No, Obamacare is not a policy. It is a law, and it does cover employer provided insurance. ehrnst Oct 2017 #89

Blue Cross is widely accepted brokephibroke Oct 2017 #2

In CA Blue Cross (Anthem) through the ACA marketplace SalviaBlue Oct 2017 #3

This is sadly true, while WHAT is covered is the same, how it is paid is different which is why Eliot Rosewater Oct 2017 #10

This is what I found. But they wouldn't refund me. I just paid and didn't have access to care. Honeycombe8 Oct 2017 #19

More reason to make blue cross and blue shield and the rest of them a thing of the past. Eliot Rosewater Oct 2017 #22

Well, it's too late for me. nt Honeycombe8 Oct 2017 #25

How is it too late? Eliot Rosewater Oct 2017 #26

My daughter in Ohio was on Blue via the ACA. Demsrule86 Oct 2017 #37

ACA covered me. sheshe2 Oct 2017 #57

Depends on the plan.... Phentex Oct 2017 #5

Untrue, there are many blue cross plans , too many to count. kacekwl Oct 2017 #12

Either flu shots are considered preventive by ACA or they are not, pretty sure they are and if Eliot Rosewater Oct 2017 #27

I'm going to try elsewhere so kacekwl Oct 2017 #34

I am , find a pharmacy that gives the shots that takes your card. Eliot Rosewater Oct 2017 #35

I couldn't get an answer to that question from Blue Cross, so I didn't get one. Honeycombe8 Oct 2017 #61

Blue cross makes you pay upfront if you have not met your deductible but if you file a claim, they Demsrule86 Oct 2017 #39

Not for preventive care which this is, by law there is no copay or deductible. Eliot Rosewater Oct 2017 #41

I have Blue of CA brokephibroke Oct 2017 #33

I want a unicorn and have as much chance of getting that as getting single payer anytime soon...The Demsrule86 Oct 2017 #42

Polka dot unicorn? brokephibroke Oct 2017 #48

I don't say this with happiness...but because just as you say...we are anchored by conservatives. Demsrule86 Oct 2017 #50

What is that? Is it CA single payer? Do the doctors like it and take it? nt Honeycombe8 Oct 2017 #62

Every plan is required to cover flu shots with no copay. LeftyMom Oct 2017 #67

Apparently not the case. I couldn't find a dr for years who would take mine. Honeycombe8 Oct 2017 #14

Until 10/1 I had an ACA plan from Cigna - silver brokephibroke Oct 2017 #32

not true. BCBS is not just one plan Bradshaw3 Oct 2017 #44

I didn't have a problem treestar Oct 2017 #9

Free medical school if you agree to participate in AmericaCare , the new single payer Eliot Rosewater Oct 2017 #11

That was not the case for me, unfortunately. Honeycombe8 Oct 2017 #16

Yes. Nobody referred to that. treestar Oct 2017 #28

May be the difference. I've been in 2 red states. The ins cos have been paid... Honeycombe8 Oct 2017 #29

Why can't you get it after this year? Demsrule86 Oct 2017 #45

Oh...I can't afford it..the subsidies are up in the air. Honeycombe8 Oct 2017 #69

That is just not true... Demsrule86 Oct 2017 #43

I have not had any trouble at all. I have to wonder about your states. Two states myself. Mediumsizedhand Oct 2017 #51

Texas and Louisiana. Two red states. Big city...small city. Honeycombe8 Oct 2017 #64

I was in one of those states and had no problem at all. I bought the higher end one. Mediumsizedhand Oct 2017 #70

Did you buy through the exchange? And have an HMO? Honeycombe8 Oct 2017 #74

I better understand. I had the Bluecross HMO before I did ACA. Mediumsizedhand Oct 2017 #75

Wow. That sounds great. You are younger so can afford more... Honeycombe8 Oct 2017 #77

I personally, love ACA. it has allowed me to do all my work ups, and get a plan as I get older. Mediumsizedhand Oct 2017 #71

Your insurance plan has a list of providers in your area Merlot Oct 2017 #54

Of COURSE I started w/the provider lists. Honeycombe8 Oct 2017 #68

My saga to find a dr to accept my ACA plan. I made a phone call. They gave me a list. LeftyMom Oct 2017 #66

You have been paying for healthcare for 4 years without being able to get a doctor? Not Ruth Oct 2017 #73

Good for you ... LenaBaby61 Oct 2017 #76