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  1. #41
    Posting Addict GloriaInTX's Avatar
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    Quote Originally Posted by KimPossible View Post
    All predictive with little proof or information about specific plans or what is actually going to happen. And in the end, a mini-med program will leave someone with NO coverage if they get sick. Its pretty straight forward and obvious in the writing of said plans.

    You can try to make it sound worse than a mini-med plan but you aren't going to convince me of that.
    Read the full article. There is plenty of information about specific plans and the limitations that these plans are making on providers and hospitals. And it really sounds like the tip of the iceburg. It is silly to imagine that these insurance companies are just going to provide coverage out of the goodness of their hearts at a loss. They are going to find some way to make money one way or another.

    In a new study, the Health Research Institute of PricewaterhouseCoopers, the consulting company, says that “insurers passed over major medical centers” when selecting providers in California, Illinois, Indiana, Kentucky and Tennessee, among other states.

    “Doing so enables health plans to offer lower premiums,” the study said. “But the use of narrow networks may also lead to higher out-of-pocket expenses, especially if a patient has a complex medical problem that’s being treated at a hospital that has been excluded from their health plan.”

    Juan Carlos Davila, an executive vice president of Blue Shield of California, said the network for its exchange plans had 30,000 doctors, or 53 percent of the 57,000 doctors in its broadest commercial network, and 235 hospitals, or 78 percent of the 302 hospitals in its broadest network.

    In New Hampshire, Anthem Blue Cross and Blue Shield, a unit of WellPoint, one of the nation’s largest insurers, has touched off a furor by excluding 10 of the state’s 26 hospitals from the health plans that it will sell through the insurance exchange.
    Peter L. Gosline, the chief executive of Monadnock Community Hospital in Peterborough, N.H., said his hospital had been excluded from the network without any discussions or negotiations.

    “Many consumers will have to drive 30 minutes to an hour to reach other doctors and hospitals,” Mr. Gosline said. “It’s very inconvenient for patients, and at times it’s a hardship.”
    http://www.nytimes.com/2013/09/23/he...anted=all&_r=0
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  2. #42
    Posting Addict KimPossible's Avatar
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    Quote Originally Posted by GloriaInTX View Post
    Read the full article. There is plenty of information about specific plans and the limitations that these plans are making on providers and hospitals. And it really sounds like the tip of the iceburg. It is silly to imagine that these insurance companies are just going to provide coverage out of the goodness of their hearts at a loss. They are going to find some way to make money one way or another.
    The bold is where the speculation comes in Gloria. Thats just a scare tactic, Scary words to throw in there to make it sound like the sky is falling without true knowledge of that happening.

    Of course more affordable plans aren't going to be the best coverage (there are other ways to get better coverage mind you if you can afford it)...but what do you really want if your options are limited. To have coverage with limitations or no coverage at all.

    If you are actually sick, a mini-med program is akin to no coverage at all. You have put your money into a plan that basically expects you to always be healthy in order for it to work. That is NOT health insurance.

    Anti Obamacare people act like what low wage earners have available to them now works. It doesn't.

  3. #43
    Posting Addict GloriaInTX's Avatar
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    Quote Originally Posted by KimPossible View Post
    The bold is where the speculation comes in Gloria. Thats just a scare tactic, Scary words to throw in there to make it sound like the sky is falling without true knowledge of that happening.
    A scare tactic? Actually we do have knowledge of what is happening. The insurance companies are pulling out and refusing to provide these policies.

    California and 9 other States Where Obamacare Wipes Out Existing Health Care Plans | The Cal Report - Califonia News & Politics
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  4. #44
    Posting Addict KimPossible's Avatar
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    Quote Originally Posted by GloriaInTX View Post
    A scare tactic? Actually we do have knowledge of what is happening. The insurance companies are pulling out and refusing to provide these policies.

    California and 9 other States Where Obamacare Wipes Out Existing Health Care Plans | The Cal Report - Califonia News & Politics
    Yes a scare tactic because you don't actually know what the consequences to these actions will end up being yet you sell them as so destructive that things like mini-med plans are a better alternative? That assumption is not based on any facts

    The absence of many larger insurers on the exchange isn't necessarily a bad thing for consumers, said Alan Weil, executive director of the National Academy for State Health Policy. The exchanges, which will include many smaller regional players and companies that have catered mainly to the Medicaid market, are expected to be very competitive in terms of premiums.
    Smaller insurers, however, may not have as extensive a list of doctors and hospitals in their networks, he said. But that's one of the tradeoffs for affordability.
    "What brand of insurance is available on the exchange does not concern me a lot," Weil said. To top of page
    You also don't know what, long term, these companies will decide to do. Its not like you have one chance to opt in and can never offer anything again.

    Yes....change is scary. But you cannot sell this idea that low income part time wagers being in mini-med plans is a good thing. Its just not!
    Last edited by KimPossible; 10-01-2013 at 05:59 PM.

  5. #45
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    In response to why the old plans are no longer going to be available, there are new guidelines that insurance plans have to meet. I know several people who will no longer be able to have their currant plan because their plans do not meet those guidelines. For example, BIL is a small business owner. He had private insurance for his family. His insurance company sent him a letter saying that his plan did not meet the guidelines and will no longer exists. He can buy a different more expensive plan or buy an exchange, but he can not keep what he has. Same with DH's work. The currant plans that they offered did not meet the guidelines so they are no longer offering them.

    This is happening a lot in this area. It seems like the insurance plans where many of you live already met the new Federal guidelines, but many of the plans here did not so they will no long be offered.

    ~Bonita~

  6. #46
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    It's really hard to debate this for me. A lot of points made are just general business decisions in the insurance agency and I don't feel like living my job right now. Basically, most insurance plans are looking to reduce their provider size in a number of ways. This has started well back before any mandates. Costs are astronomical for health care. My company takes in hundreds of millions with 91-92% of that spent on claims. That's a LOT of money. The rest is for admin purposes of the plans (claims processing, service departments etc.) A huge way to reduce claims is to limit provider networks. It doesn't necessarily mean lack of providers. It can mean having smaller referral circles (like your pcp refers only to those in their "group") to help contain costs and stop duplicate services like labs (such as pcp takes labs, then specialist repeats labs b/c they didn't get report etc.). They can also just make regional networks...like you live in this area of the state...you can see these providers. There are lots of options. It definitely does not mean lack of providers or care. Those are scare tactics.

    So, a lot of this is just industry stuff. Unless you live it day to day you are probably going to be missing 1/2 of the picture. I don't mean that in a bad way at all. I don't take the time to learn the ins and outs of business that I don't need to know (auto insurance...no idea on the backgrounds of that for example.)

    By the way, we don't have a limited network for most plans in Massachusetts and we have the closest example to NHCR with our state requirements. Scare tactics.

    If your plans didn't meet the minimum guidelines...I have to say that I think you had cruddy coverage that should something bad really happen you are up a creek without a paddle.
    Mom to Elizabeth (6) and Corinne (4)

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    OT - But has anyone been able to get the website to work? I am curious about what the plans cover, but have not been able to get through.

    ~Bonita~

  8. #48
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    From what I've heard on the news, it's been hard to get through due to volume of users.
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    Yeah the Maryland Health Connection website has been high in volume and I wasn't able to look yesterday, yesterday night, or now.

    ETA: As soon as I said that I just tried again and I was able to get through lol!

  10. #50
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    Quote Originally Posted by mommytoMR.FACE View Post
    Yeah the Maryland Health Connection website has been high in volume and I wasn't able to look yesterday, yesterday night, or now.

    ETA: As soon as I said that I just tried again and I was able to get through lol!
    I have tried about a dozen times between today and yesterday and have not gotten through. (Just tried and nothing)

    ~Bonita~

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