Obamacare Rates Jump 51%
- Thread starter somarco
- Start date
- 4,716
Well that's largely a decision by the doctor not the ACA.....docs have been flip flopping ins carriers/networks long before the ACA.
This law needs to be reformed. The fact that lawmakers r or d(mostly d) are not hearing their constituents problems.i think they all should be fired!!! Friend from Germany came over to visit me and i was asking her about her medical copays deductibales. She told me what is a deductibale!!! Past Client from Netherlands came i my old office about his vacational home insurance. Got to know him. That got spent 1 year in hospital due to his cancer and when he was dismissed he payed only $ 500!!!! My manager almost cried . His wife 30 with bone cancer has been fighting and struggling for 5 years!!! USA Gov blows money on programms that dont make sense. Why canr they fix this.Can someone tell me why this pigs are still in their seats???
Sure, I'm smoking subsidy money
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See, now premiums are going down! Woohoo! What a deal.
I understand moving parts. My wife had those fixed.
I also understand satire (commonly referred to as political spin).
Dan
- 8,448
This is not surprising to those of us in the forum, but the "experts" are astounded by this... $1 out of every $4 dollars spent by our government on the Affordable Care Act (aka ObamaScrew) goes towards simple overhead.
Story: Obamacare's big overhead costs to top $270B
If insurance companies spent +25% of their premiums on "overhead", the government would slap some kind of mandate on them to be more efficient!
Story: Obamacare's big overhead costs to top $270B
If insurance companies spent +25% of their premiums on "overhead", the government would slap some kind of mandate on them to be more efficient!
- 1,227
Oh, surely you do not believe there would ever be a lie from our government? You know insurance is all about paper and promises; right?
- 4,716
This is not surprising to those of us in the forum, but the "experts" are astounded by this... $1 out of every $4 dollars spent by our government on the Affordable Care Act (aka ObamaScrew) goes towards simple overhead.
Story: Obamacare's big overhead costs to top $270B
If insurance companies spent +25% of their premiums on "overhead", the government would slap some kind of mandate on them to be more efficient!
Are you suggesting an MLR equivalent for the Government to adhere to???
Surely there is a Gulag just waiting for you......................
It was nice knowing ya AC..................
- Thread starter
- #28
But now there's a new question doctors offices are asking.
Doctors office - Is your plan on-exchange?
Patient - Yes
Doctors office - I'm sorry, we don't accept on-exchange plans
Last year I had a back and forth with a doctors office. The client, who also happened to be a good friend, called me from the doctors office (OB/GYN - his wife was pregnant).
Client - Hey Scott, the doctors office is saying they don't take "Obamacare" plans.
Me - If you recall, we checked the network and even confirmed with the doctors office they are in network.
Client - I know, but now they are saying they don't accept this plan.
Me - Hand the phone to the front desk person.
Front desk - Hello?
Me - I'm not understanding why you are telling this patient that you won't accept their plan when you are clearly showing in network and we even called your office and confirmed.
Front desk - Well all I can say is we've been told we are not to accept any "Obamacare" plans.
Me - Do you mean on-exchange plans?
Front desk - Huh?
Me - Are you aware there are on-exchange and off-exchange plans?
Front desk - Huh? Can I let you talk to my office manager?
Me - Please
Office manager - Hi sir, as you were told, we are not accepting any Obamacare plans because the carrier can come back and ask for any claims money they paid us for up to 60 days.
Me - I'm aware of that rule and it pertains to on-exchange plans. This patient has an off-exchange plan.
Office manager - Huh? Is it a new plan? If so, it's an Obamacare plan.
Me - Are you the business manager for the entire practice?
Office manager - No, I am the office manager for this location, but what does that matter?
Me - It matters because I think you may be a little confused and possibly misinformed. I don't mean that in an ugly way. It's perfectly understandable considering this is a new law with lots of information flying around. And if you aren't the business manager then you likely got your info from the business manager and I'd like to have a conversation with that person so I can hopefully clear up some confusion.
Office manager - Well, I trust she knows what she's talking about.
Me - I think that's great that you trust your manager. But if it's all the same to you, I'd love to get her number and speak with her if you don't mind.
So after getting her number, I called and got her voice mail. I left a detailed message about the situation. The next day I received a phone call from her apologizing for the confusion and that she would get a memo out to all of their offices to make sure the staff understood that if it's an off-exchange plan then they will accept it (assuming they are in-network).
About 4-6 weeks later I get a call from the same client while at the doctors office. "Hey Scott, they are telling us they do not take Obamacare plans again". I told him to give me a minute. I called the business manager and was able to get her on the phone. I asked her if she remembered our conversation and she said she did. I then explained what was going on. She was not happy and told me she would get it handled right away. I called my client back and told him it was being taken care of. While we were still on the phone the front desk person received a call and then apologized to my client.
I realize that's a long story, but it's just more of the crap people are having to deal with. And this wasn't the last time this happened to a client of mine. So now not only are doctors going in and out of networks as they've always done, they are adding a new wrinkle and rejecting some who have on-exchange plans.
Don't forget new carriers entering in when they have no idea how to price. If they are smart they need to come in competitive the other carriers or every year the cheapest carrier is going to be stuck holding the bag because they are attractive to the people who want to use it the most. Reverse hot-potato.
Our on-exchange Co-op was the cheapest by 20% this year. They have not even filed rates for next year, that can't be good.
The ones really getting screwed in all of this are the people at 401% of poverty.
Our on-exchange Co-op was the cheapest by 20% this year. They have not even filed rates for next year, that can't be good.
The ones really getting screwed in all of this are the people at 401% of poverty.
