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isn't the thread title a bit overdramatic? I'm still waiting for a post that explains how a Doctor, Hospital or any other general medical practitioner is actually going to determine in real life just how to distinguish between an individual BCBS PPO plan purchased on the exchange with one from a group policy when they both use the same network and have the same essential health benefits. Does the article you link explain that? It's behind a paywall, so no way to tell.
Ours did and some small claims were paid, but most went toward the deductible. Medicare does pay them.
Deductibles have been rising steadily for years and have nothing to do the the ACA, but now they are on the front page, and I think people are now realizing that health care and health care insurance in the US are very expensive.
Homeopaths can be covered by ACA policies somewhere? What about faith healers?
Oooh, Oooh! I sense a business opportunity!
A provider can see the group and plan numbers, but if an issuer has numerous plans, what distinguishes or identifies a plan offered on an exchange, and why would a provider even care? The provider is interested in reimbursement, not policy issuance. If an issuer uses the same network for different plans, and some of those plans are offered on the exchange, it is basically irrelevant to the provider. This is certainly the case with many BCBS and Humana PPO plans, as they reference the same national networks used for other group plans they issue.
"Acceptable" to whom? If the ACA reigns in costs by making insurers compete in a more transparent way, that will be great. Is this what you are referring to, or is there some other mechanism that establishes the "acceptability" of health insurance prices? The "percent spent on care" hoop obviously doesn't address the situation to which you refer, since the providers would be the source of the rising costs.
To the people paying the insurance premiums. Perhaps "affordable" would have been a more precise word. Prior post edited to avoid confusion.
I really wonder about this premise of deductibles being forced higher by ACA and "high deductibles" somehow meaning people won't be able to afford to pay for care, and that paying some money out of pocket for medical care is a horrible thing.
Agreed. That "ordinary folks" are talking and thinking more about health care/health insurance costs is a good byproduct of this ACA and the way it has been fielded. These discussions and the national focus on costs will probably accelerate a lot next year when small employers (above 50 FTE) are required to join the fray and a lot more people become participants rather than bystanders. It's too bad it didn't happen this year (as required by the legislation), but it's better late than not at all.
