Here in CA, in order to purchase insurance through the marketplace, we had to go through our state marketplace instead of using the national marketplace. I am finding that doctors are not taking the insurance we, in good faith purchased. When you call to make an appointment and they ask for your insurance and you say Blue Shield, they ask if it was purchased under Obama care and if so, they don't take it. They say it reimburses at too low a rate. My question is, is anyone in any other state who purchased insurance through the national marketplace having the same problems?
Hell on Wheels - thank you very much for the info. I had not tried Sutter Health because they are not real close to me, but they are close enough that I can and will call for an appointment. Again, thank you for the information! I don't know why I didn't think to reach out here before now! ETA: I called Dr. Berman - we were good until we got to the insurance question. Then they said call back on Monday to talk to their insurance person because she was not sure they accepted it. I also got a list of Sutter doctors and have called two - they also won't take the insurance. I think I'm going to quit paying the premiums - I'm getting no benefit from it and I could use that money to actually pay cash at the doctor's office. I am considering trying Kaiser during the open enrollment in October. Unfortunately, I have to purchase through the marketplace because I need the subsidy.
AKmom - that's what I thought when I purchased the coverage but sadly no. They ask if you purchased through the exchange and if you did, they tell you sorry, we don't take it.
I haven't expierenced this personally, but there is a sign at the doctors officei go to that they do not accept the obamacare plans.
C., we live in Sacramento and have had no trouble at all with doctors accepting our insurance. We switched from Kaiser to the Blue Shield Covered California PPO and I have my choice of great doctors. Have you tried Sutter Health? Our pedi, internal med doctor, and surgeon are all with Sutter and it has been very smooth sailing.
ETA: My other thought, if you are actually in San Pablo, is to call Dr. Ronald Berman's office. My husband goes to see him on occasion (we started seeing him when we lived in Berkeley, stayed with him when we moved to Walnut Creek... and love him so much we still go see him from Sacramento!). He is in San Pablo and is wonderful.
ETA 2: C., I logged on to Blue Shield and did a search of doctors who accept this insurance (we have the Preferred PPO, not sure if that is what you have, and that may change these results). Anyway, here is the list. Maybe some of these people are close to you and/or have the specialty that you would prefer: https://www.blueshieldca.com/fap/app/search.html
Blue shield is blue shield regardless of where you purchased it, this sounds fishy to me. Maybe they just don't blue shield?
I can write a book on this. Horrible. Make sure you have the exact name of the Blue Cross Policy. There are so many. Before you purchased it, did you look at the doctors that accepted it or did you assume everyone did. You do not have to purchase insurance thru the exchanges. You need to go thru it if you want subsidies. If you don't need subsidies, you can go to any insurance company.
I'm in PA, we don't have a state exchange, I used the national one. And I have a BC/BS policy, as well as a Delta Dental policy, and no one has given me any trouble accepting my insurance. These policies aren't suppose to reimburse at lower rates, and I am very troubled by the allegations that they are doing so.
And people thought I was being alarmist when I warned this would happen.
Yep, its a nationwide issue... We don't have it, but I know my husbands clinic doesn't accept it bc the reimbursements are ridiculous!
All I can say is I'm sorry.
I didn't vote for him nor did I want 0bamacare.
In Virginia, many doctors are NOT accepting 0bamacare plans because it takes the government too long to pay and what they pay is way less than what they charge. For example, a doctor charges $65 for your office visit (yes, it's expensive - but you need to keep in mind you are paying for more than just their time, but their own insurance, office rent/lease, nurses, etc.) and with 0bamacare, they may get $25 for that $65 charge. People already complain that 15 minutes is NOT enough for some doctor time. How many patients would they have to see on a daily basis to keep their practice open?) I would guess you are paying MORE for this policy than you were paying before, correct??? 0bamacare is NOT affordable!! Sorry!!
As it stands for non-0bamacare policies, if they charge $65, they get $45. Not all but at least more reasonable, right?
When you signed up for 0bamacare - did you look at the list of approved providers and call to ensure they accepted the plan before you bought it? We don't have 0bamacare. So thankfully, we haven't been put through this wringer. Please know I'm sorry!!
Are some article about this from earlier in the year, about California specifically. This one is among the most recent. If you Google 'doctors not taking ACA coverage' several others will pop up from other news sources. I've also seen articles about Florida and Oklahoma encountering this problem, and those were also Blue Cross/Blue Shield related, so there is some debate over if this is an ACA problem or a BC/BS problem.
How Obamacare Leaves Some People Without Doctors
Posted: 04/10/2014
http://www.huffingtonpost.com/2014/04/10/obamacare-patien...
I don't know what is going on now because it is beyond the scope of my employment but as of March we had no contracts with the exchange, not us, them. When we did contact them they wanted us to accept medicaid rates. No one can stay in business accepting medicaid rates but what is worse, they are charging people full private insurance rates. Would love to know where the money is going because it isn't to the doctors.
So there is Blue Cross and then Blue Cross Obamacare, two very different animals. Those that do contract with Obamacare are treating them like Medicaid so they are limit who they allow.
I wish I knew more but this is across the country.
I live in Texas and have seen several new doctors in the past month, at four different offices. Each time I have been asked what insurance I carry and I have answered Blue Cross Blue Shield. All four times the following question has been, group or exchange.
When I say group through our employer they all answer, "Good we take that." I have asked each time if I had been on the exchange would they have taken my insurance. All four answered, "No!"
So this summer we would have been denied seeing doctors had we been on the exchange.
Does any doctor's office take exchange insurance??
