Posted on 02/14/2015 10:13:04 PM PST by grundle
WHEN Karen Pineman of Manhattan received notice that her longtime health insurance policy didn’t comply with the Affordable Care Act’s requirements, she gamely set about shopping for a new policy through the public marketplace. After all, she’d supported President Obama and the act as a matter of principle.
Ms. Pineman, who is self-employed, accepted that she’d have to pay higher premiums for a plan with a narrower provider network and no out-of-network coverage. She accepted that she’d have to pay out of pocket to see her primary care physician, who didn’t participate. She even accepted having co-pays of nearly $1,800 to have a cast put on her ankle in an emergency room after she broke it while playing tennis.
But her frustration bubbled over when she tried to arrange a follow-up visit with an orthopedist in her Empire Blue Cross/Blue Shield network: The nearest doctor available who treated ankle problems was in Stamford, Conn. When she called to protest, her insurer said that Stamford was 14 miles from her home and 15 was considered a reasonable travel distance. “It was ridiculous — didn’t they notice it was in another state?” said Ms. Pineman, 46, who was on crutches.
She instead paid $350 to see a nearby orthopedist and bought a boot on Amazon as he suggested. She has since forked over hundreds of dollars more for a physical therapist that insurance didn’t cover, even though that provider was in-network.
(Excerpt) Read more at nytimes.com ...
It’s like legislating every family can have lobster for dinner on Fridays... Without telling lobsters that they need to kick up reproduction.
Hey, I've got as great idea. Let's all go to 'single payer' so we cut out all the hassle and frustration and everybody gets treated for free!
Oh, wait. You way that already is the idea? Never mind, then. Everything is running smoothly and right on schedule.
55 mins with the express from GCT. If you’re on crutches they have elevators to the lower level and escalators from the upper level.
Yeah, the examples they used were bogus. They also mentioned that an in-network physical therapist wasn’t covered but maybe the doctor didn’t think she needed PT...they didn’t explain why it wasn’t covered.
Provider directories have been FUBARed for many years. I’ve always had to call the MD to see if they participate with my plan because the directories are always wrong.
I looked into Medishare as an alternative but there aren’t any providers within 100 miles of me.
I bet if she wanted a sex change operation, she could find one in NYC.
Even if you have a regular insurance plan (if there is such a thing these days but you know what I mean) there is no guarantee you care going to be able to get into a doctor you like or one that is close.
It is getting increasingly difficult to find a doctor that is accepting new patients.
Bump
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