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Old 01-12-2016, 09:55 AM   #61
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Same network does not equal same reimbursement. And just because a medical practitioner or group is "in network" does not mean they will accept you as a new patient.
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Old 01-12-2016, 09:58 AM   #62
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Originally Posted by Dogman View Post
He has a neighbor who brought his mother over from China and within months she is now on SS earning as much as he will when he can draw.
That is not the way SS works. You pay into the system for at least 40 quarters (10 years) and you can collect. 39 quarters and you can't collect.... If she was here before, and paid into the system via payroll taxes, and did so for 40 quarters/10 years- then her collecting is legit. If her husband paid into the system for 10 years she could collect spousal. But if she recently arrived and doesn't have a US work history she can't. Something is fishy about this story. Your friend maybe misunderstood.
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Old 01-12-2016, 10:18 AM   #63
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Originally Posted by Dogman View Post
My friend told me he has had it with everything. He and his wife have decided to sell his business (small repair business) pull all his money from his bank and put it in a safe at home. He is 61 and going to apply for medicaid, food stamps, and anyother state/federal program. Wait until he can draw SS, and live frugally.

This is the state lower income middle American has gotten to, it is a shame. He has a neighbor who brought his mother over from China and within months she is now on SS earning as much as he will when he can draw.

The Mom from China might be drawing SSI, but it's unlikely she's drawing SS or SSDI, as she would not have the required work history.

From direct observation, living "on the dole" isn't all it's cracked up to be...
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Old 01-12-2016, 10:29 AM   #64
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Originally Posted by John Galt III View Post
Maybe this is urban myth, but I read somewhere that the first 3 letters of your insurance ID can (sometimes?) allow the provider to tell whether you are on an Obamacare policy or not.
I really don't know about the 3 letter and I'm not sure how your are defining "Obamacare", but I'd bet it is real easy to know the network that your insurance covers. I'm not sure if they could tell if you bought the plan on or off exchange. I've checked 2 major insurers now in my state and both offer the same plans on and off exchange for individual with the same network. One of them also offers other plans for individuals (direct) that have different networks from the exchange.

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Maybe some clarity will help. After reviewing all plans, talking to my doctors, and what hospitals they service I chose Cigna Access Plus HSA Bronze 6000 plan that was closest to my plan in 2015. The cost was increased by 1,500.00 in Phoenix AZ. I contacted my doctors and asked them directly what insurance plan works best at their office. I was told if you chose an ACA/ObamaCare plan will not accept you as a patient any longer. I could have gotten an ACA plan, but the price was not much different but it included only HMO plans to doctors that no one I know had heard of and most name were extremely foreign. I chose to pay more for confirmed coverage with the doctors and hospitals I know. If I have a heart attack I did not want to have the lower care afforded by the ACA.
I think I understand what you are telling me, with the exception of how you define a ACA/Obamacare plan. If you mean "on exchange", then I think that you are missing the real point. I checked two major insurers in my state. Both offer the same plans that are on the exchange for direct purchase by individuals. One of them offers additional individual plans for direct purchase that have larger networks. If you were to buy a plan direct that is also on the exchange, you would still have your network problem. So, if ACA means on exchange, this invalidates what you claim since the same thing happens on or off exchange. If you buy a direct plan that has a larger network, your doctors may ... or may not be on that network depending upon your doctor's choice of accepting it.
Now if ACA means complying with the ACA law... I throw out that the plan you purchase likely complies with the law.
I don't think what you are seeing is that much more than what happened in the 1990's when my employer changed insurance carriers and we had to shift doctors or be out of network. It's been well publicized that you should check if you doctors participate in your insurance plan every year and when you change plans.
I think your doctors just know they don't take what is on the exchange. I would expect there are many other insurance plans they don't accept either.
But I'm pretty confident they would not take the exchange plans purchased directly from the insurer.
While $ may provide better care, it is not always true. I had a "high end" medical provider perform substandard work. I've switched to a more moderate end provider that is working out great. I use my reference for better and worse being feedback from a professor who not only practices the field, but teaches at the university. But I agree it is important to stay with providers your trust.
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Old 01-12-2016, 10:58 AM   #65
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This doesn't make sense. It's an insurance company that pays, not ACA.
Like I said, typical political rant against Obama regardless of the 'care'. OP doesn't understand who pays.
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Old 01-12-2016, 11:06 AM   #66
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Maybe some clarity will help. After reviewing all plans, talking to my doctors, and what hospitals they service I chose Cigna Access Plus HSA Bronze 6000 plan that was closest to my plan in 2015. The cost was increased by 1,500.00 in Phoenix AZ. I contacted my doctors and asked them directly what insurance plan works best at their office. I was told if you chose an ACA/ObamaCare plan will not accept you as a patient any longer. I could have gotten an ACA plan, but the price was not much different but it included only HMO plans to doctors that no one I know had heard of and most name were extremely foreign. I chose to pay more for confirmed coverage with the doctors and hospitals I know. If I have a heart attack I did not want to have the lower care afforded by the ACA.
ALL new private plans are ACA plans now, so I guess you'll be paying a lot more until you understand what networks you have and how insurance covers them. Do some research on the exchange with the providers available to you, there's ways to search for providers and drugs that are covered. Yes, HMOs do tend to suck but they are *usually* not the only option available.

This website is a good place to start:
http://www.healthsherpa.com

What your doctor's office said is 100% wrong btw unless they don't take private insurance. Your plan is an ACA plan and is probably the exact same one you could've gotten on the exchange.
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