I Won't Write that App !!

[Yagents]

HMO's = Medicaid Plus

Obamacare Exchanges Are Looking Like Dysfunctional Medicaid - US News

Consider the numbers: In the first two quarters of 2014, 6.1 million people were added to the Medicaid program. Another net 2.5 million people enrolled in private health insurance during that time, but the new plans available in the Obamacare exchanges – while technically private – look and function more like Medicaid plans with limited networks, low physician reimbursement, and high public costs.

A McKinsey and Co. study shows that 70 percent of Obamacare plans offer "narrow" or "ultra-narrow" networks. (Compared to 23 percent of large-group non-Obamacare plans.) This means that, because there are few providers available in these new plans, patients face significant barriers to actually receiving the care they need. They are technically insured, but face restricted access to care.

 

[FLM2]

HMO's = Medicaid Plus

Obamacare Exchanges Are Looking Like Dysfunctional Medicaid - US News

Consider the numbers: In the first two quarters of 2014, 6.1 million people were added to the Medicaid program. Another net 2.5 million people enrolled in private health insurance during that time, but the new plans available in the Obamacare exchanges – while technically private – look and function more like Medicaid plans with limited networks, low physician reimbursement, and high public costs.

A McKinsey and Co. study shows that 70 percent of Obamacare plans offer "narrow" or "ultra-narrow" networks. (Compared to 23 percent of large-group non-Obamacare plans.) This means that, because there are few providers available in these new plans, patients face significant barriers to actually receiving the care they need. They are technically insured, but face restricted access to care.

You can't just universally condemn all HMOs for not having doctor availability.

I have had a Medicare HMO for the past two years and have had no real issues in seeing doctors or obtaining quality medical care.

The worst network in Florida, by far, is the Florida Blue Select EPO-it is basically a Medicaid network although pawned off by Blue as an 'EPO', whatever that means.

Much of this depends on location, of course, and the company offering the network. An Aetna or United HMO is less likely to have issues than a small, regional carrier (I don't represent any for either ACA or Medicare).

As long as my client understand the differences among the various networks and their doctor accepts the selected plan I have no major objections to having a client save money by enrolling in an HMO. If they have an HMO for a year and are unhappy, they will be probably want to spend more for a PPO next year.

 

[Yagents]

I just post the articles, I don't write them.

 

[FLM2]

I just post the articles, I don't write them.

And I only comment on the articles.

I was going to write a longer post about the article but, at the end of the day, I'm not going to change anyone's opinion so why bother-the system is what it is and until something changes we are all stuck with it.

I've always taken the position that I don't have to like the system to represent my clients' best interests (the same as a CPA or attorney) and I have no reason for this to change now or in the future.

 

[kgmom219]

HMO's = Medicaid Plus

Obamacare Exchanges Are Looking Like Dysfunctional Medicaid - US News

Consider the numbers: In the first two quarters of 2014, 6.1 million people were added to the Medicaid program. Another net 2.5 million people enrolled in private health insurance during that time, but the new plans available in the Obamacare exchanges – while technically private – look and function more like Medicaid plans with limited networks, low physician reimbursement, and high public costs.

A McKinsey and Co. study shows that 70 percent of Obamacare plans offer "narrow" or "ultra-narrow" networks. (Compared to 23 percent of large-group non-Obamacare plans.) This means that, because there are few providers available in these new plans, patients face significant barriers to actually receiving the care they need. They are technically insured, but face restricted access to care.

Just another reason consumers need an agent who can explain the differences between the plans and networks....

 

[beachgal]

Yagents I think navigators are replacing us. Selling, advising etc. All unlicensed. Where's NAHU?

 

[Yagents]

Yagents I think navigators are replacing us. Selling, advising etc. All unlicensed. Where's NAHU?

I haven't run across or lost 1 piece of business to a navigator. They go after a different segment of the population.

Plus, I'll make a hunch with the new republican congress controlling the purse strings, that funding for navigators will be diminished in future years. Nav's don't make financial sense, nor have the experience of an agent.

Using a navigator cost = premium + tax payer dollars
Using an agent cost = premium only

You would think the gov't (liberals) would love for us to take it out of the insurance company margins. But instead they (liberals) just enjoy spending the tax dollars of the rich.

 

[somarco]

Where's NAHU?

NAHU has no regulatory authority over navigators. Neither does the state DOI (although some states have tried to require what amounts to pre-licensing CE).

As carriers gain more market share the need for agents diminishes and future commission cuts will happen.

 

[pcbinsurance]

Impossible to say how much business was lost due to navigators. Most health agents I know were busy all day, every day, so it was business they certainly didn't "miss".

 

[timsip]

When discussing topics such as this, the biggest factor gets ignored. In AZ, maybe the networks for HMOs are so skinny it is impossible to see all the doctors an unhealthy person needs to see. Compare that to Central Iowa, you can get onto an HMO with hundreds of PCPs within 10 miles of you and the majority of specialists. It all depends on your geography. Go to a major city like LA where it takes three hours without traffic to get across it on the freeway and you are going to see that city cut into many rating areas and in turn many HMOs (I am assuming, I don't have a reason to look at Cali). In Des Moines, my major market, there are two major hospital networks- Mercy and Unity Point. Last year the CoOp grabbed up Mercy and Unity Point went to Coventry. This year, you can choose either one if you sign up for Coventry (100% of my new clients went to Coventry). Both networks have over 1000 doctors in the network counting specialists. If you can't find a doctor in your network, nothing is going to satisfy you.

YAgents is not wrong with his reasoning. It likely fits the network limitations in his geographical marketing areas. I sell the hell out of HMOs here because I can easily find you a dozen doctors that fill your needs within a few miles of your house. Most likely I can probably find one that you can walk to. But it only takes 15 minutes to get across Des Moines without traffic....25 during rush minute.