MRG
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
- Joined
- Apr 9, 2013
- Messages
- 11,078
And if you try to log on late at night you get the "The System Is Down for Maintenance" message!
Sad but true.
MRG
And if you try to log on late at night you get the "The System Is Down for Maintenance" message!
I thought I'd try CoveredCa again, but once again I got the message that the certificate is invalid.
I haven't been following this thread closely so this may be old news. The local news provided a link to a "back door" into healthcare.gov allowing anyone on the Federal operated exchange to view what plans/insurers were available in their individual county:
https://www.healthcare.gov/health-plan-information/
From the article:
"Moreover, once consumers are able to see which medical providers are part of the insurance networks, they might be in for a bit of a surprise: In an effort to keep premiums low, some major insurance companies are limiting the numbers of doctors and hospitals they are offering consumers.
Blue Shield of California confirmed to this newspaper that it will offer only 50 percent of its network doctors and 75 percent of its network hospitals to those who sign up for its exchange plans. Anthem Blue Cross of California will offer 95 percent of its hospitals to exchange customers -- but only 60 percent of its network doctors to consumers, said company spokeswoman Leslie Porras.
. . .
Similarly, Blue Shield spokeswoman Lindy Wagner said the company is confident that its networks will be adequate for its Covered California customers. "We want to keep our exchange product affordable," Wagner said.
California's new health exchange still doesn't list doctors and hospitals - Inside Bay Area
The negotiation on price (for each service) between insurance company and hospital system is based on the relative size of each. General Motors pays less for each wiper blade than you do.Does anyone know why the size of the network effects the costs to the insurance company and therefore the cost of the policy?
Why does more choice for the policyholder cost more? I guess the implication is that some hospital networks and doctors are much more expensive than others.
The negotiation on price (for each service) between insurance company and hospital system is based on the relative size of each. General Motors pays less for each wiper blade than you do.
The same thing happened to me. I am still waiting for the callback....I am in identity verification purgatory so I created an account this morning with DH as the primary. I made it all the way through the application submission and received notification I was eligible for a subsidy.
I went back to the website to view plans and prices but can't get there. I called and it's the same thing everyone else is getting. "Must be a glitch" or "please try again later when the system is not under stress."
I made the application about 7 am. I'll try again late this evening.
I am in identity verification purgatory so I created an account this morning with DH as the primary. I made it all the way through the application submission and received notification I was eligible for a subsidy. I went back to the website to view plans and prices but can't get there. I called and it's the same thing everyone else is getting. "Must be a glitch" or "please try again later when the system is not under stress." I made the application about 7 am. I'll try again late this evening.
I'm as far as having my ID verified, eligibility confirmed, subsidy letter and ready to enroll. I can browse plans, filter choices (although that doesn't always work) and save plans for later perusal. I'm quite pleased that I'm at this step because the first 2 weeks of this odyssey were like being caught in a corn maze, with no one on duty to help you navigate.
Anyway, I'm trying to learn as much as I can about our plan options and running into pages not working when I go to see details or try to check the provider network, drug formulary of other official plan info.
I'm going to make a few calls to providers.
"resolution specialist" within 2 days to get this taken care of ..... But, of course, if I don't, to please call back.
What state do you live in? It's nice to see at least one person can actually look at plans. Maybe if you find all the bugs, they can fix them before the rest of us get that far.
The specialist did drop a VM while I'm on this call. I guess I can call back for the next 30 days about my duplicate data, need to call from the correct phone number. This gets sillier every day.
MRG
Never got the callback. However after logging in 3 times today, my application is done and I can look at plans. There are 3 companies and most are hmos. The lowest cost silver plan from Coventry is an HMO that does not have any doctors within 100 miles of where I live. I'm not sure how they can say they are offering coverage in my county. If I lived in Wyoming, I could understand how something like this could happen, but I live in Florida. In any event, I am definitely making progress. The plan filtering is slow and buggy, but the basic info is there. I hope it is still there next time I log in.The same thing happened to me. I am still waiting for the callback....
Wow we had the same thing it duplicated us. I called was told two business days. That was up on Monday, called today asking why no callback? Rep says 'that groups really busy right now', I'm trying to stay calm, but have to ask if 'their too busy to meet the commitments they made'? Rep takes my info entered an application for me. I ask how will I see this? Oh wait a few days, it should show up under your account. Of course I ask what one, she confirms its the account that is unusable, so she claims she switched it to the one I can log into, of course now I'm waiting...... The specialist did drop a VM while I'm on this call. I guess I can call back for the next 30 days about my duplicate data, need to call from the correct phone number. This gets sillier every day. MRG
I'm saying that each insurance company negotiates rates with each provider. That is why there is no one price on health care services, like there is for merchandise at Walmart. The relative leverage of each entity (insurance company or health care provider) determines where that negotiated price ends up. A big insurance company can steer away enough business to sink a small healthcare provider, while a big health care provider has enough clout to command premium prices from the insurance company. The insurance companies factor in the negotiated rates when they decide which hospitals are "in network" to ensure that they make a profit.So are you saying larger hospital systems can demand higher reimbursement rates from the insurance companies so they are left out of the cheaper plans?
Or that insurance companies can negotiate much better prices which still makes me wonder why the networks are limited in cheaper plans?