Last year millions of Americans discovered the hollowness of President Barack Obama’s pledge that under ObamaCare they could keep their health insurance if they liked it. Now, having obtained insurance on ObamaCare exchanges, many are also discovering that, contra Obama, they can’t keep their doctors — or their own hard-earned money — either.
It has long been known that insurers were cobbling together narrow networks of providers whose services they would reimburse under exchange coverage; The New American and many other outlets reported this in late 2013. At that time, however, information on just how narrow the networks would be was still somewhat sketchy. In many states, hardly anyone — healthcare providers included — knew for sure just which doctors and hospitals would be covered by the various exchange plans.
Today, according to the Los Angeles Times, consumers are learning the hard way that the providers they desire simply aren’t in their health plans’ networks — and the insurance companies, not the law that created the problem, are taking the blame.
Simply put, people who bought coverage on California’s exchange, known as Covered California, were often unable to determine which providers would be covered by their insurance before they purchased it — the exchange had promised an online provider directory for open enrollment, but it never produced an accurate one — and even now are plagued by contradictory provider information from insurers.
For example, Jean Buchanan, 56, of Fullerton, “lost her previous coverage when her insurer dropped out of the individual market last year,” writes the Times. The paper continues:
She was diagnosed with breast cancer in July, so she opted last fall for a Platinum plan, the highest level of benefits on the state exchange, from Blue Shield.
Buchanan started treatment at UC Irvine Medical Center in the fall, and her oncologist there took her new Blue Shield insurance in January and February. Then the day before her lumpectomy, UC Irvine called to say her insurance wasn’t accepted after all. She initially canceled the surgery, but her family and friends told her she shouldn’t risk waiting.
Buchanan proceeded with the surgery and must now pay its $8,000 cost in monthly installments.
“I thought I had done everything right, and it’s been awful,” she told the Times. “How am I going to come up with that much money?”
Likewise, Tom DiCioccio, 64, of Oceanside, ended up stuck with a $20,000 tab for lymph cancer surgery after Blue Shield switched him from his old policy to an ObamaCare-compliant one with fewer providers, reports the Times. Contacted by the paper, the insurer agreed to cover DiCioccio’s treatment in full, saying he “shouldn’t be penalized for going out of network because he was already undergoing treatment before his policy changed.”
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