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Only one insurer in city

JumpinJack

JumpinJack

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So I'm going to be moving. So I check into whether there are any good doctors there who will accept this or that plan (ACA individual market).

To my surprise, only one insurance company sells plans in that mid-sized city. And only HMOs.

What was the spiel when trying to pass the ACA? MORE choices they said?

Things could not be more different.

(Disclaimer: I was checking now, but it's not until November 1st that final plans and prices are posted, so it's possible it could change.)
 
I was under the (mistaken?) impression that PPACA insurance was offered on a statewide basis. Obviously, provider facilities accepting a given insurance policy may vary, but that is a problem with any HMO.
 
JumpinJack said:
So I'm going to be moving. So I check into whether there are any good doctors there who will accept this or that plan (ACA individual market). To my surprise, only one insurance company sells plans in that mid-sized city. And only HMOs. What was the spiel when trying to pass the ACA? MORE choices they said? Things could not be more different. (Disclaimer: I was checking now, but it's not until November 1st that final plans and prices are posted, so it's possible it could change.)
Click to expand...

Do you mean only one hospital accepts your insurance? I live in OK and our insurance ( ACA through Blue Cross/Blue Shield) is sold state wide and both of Lawton's Hospitals accept it, many doctors do as well. I know Wichita Falls Tx, Regional accepts it. I didn't go to a local agent to purchase insurance but did it over the phone. because of my income I bought none subsidized insurance.
 
notquiteright said:
Do you mean only one hospital accepts your insurance? I live in OK and our insurance ( ACA through Blue Cross/Blue Shield) is sold state wide and both of Lawton's Hospitals accept it, many doctors do as well. I know Wichita Falls Tx, Regional accepts it. I didn't go to a local agent to purchase insurance but did it over the phone. because of my income I bought none subsidized insurance.
Click to expand...

No. I mean only one insurance company sells health insurance there. And it only sells HMOs. There are only 6 HMO plans to choose from.

It's like, if you wanted to get insurance from another company (in your case, switch from BCBS), you couldn't. Only that ins. company sells insurance there. And only HMO plans (not PPO plans).

But since you mentioned hospitals, I need to check and make sure the local hospital or hospitals accept those plans.


(Edited to add: I checked, and the local hospitals accept the HMO plans I checked on.)
 
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ttwtt78640 said:
I was under the (mistaken?) impression that PPACA insurance was offered on a statewide basis. Obviously, provider facilities accepting a given insurance policy may vary, but that is a problem with any HMO.
Click to expand...

I've never heard of PPACA. Do you mean PPO plans under the ACA? If they have to be offered statewide, maybe there will be one added by November, the enrollment period. I'm checking now, so things are not final. The one insurer that provides ins. there is BCBS, which is removing all its PPO plans from the state end of year.

I checked for doctors, and there are a decent # of doctors that accept those HMOs. I just checked the hospitals, and they accept those plans, as well. So that's good. A big improvement over 2014, when these plans first came out. Few providers in my city accepted any HMOs. Maybe that's a big city thing, though. The providers in my current city, which is a large city, are very wealthy and have patients coming out of their ears, so they don't need to accept HMO patients.
 
JumpinJack said:
So I'm going to be moving. So I check into whether there are any good doctors there who will accept this or that plan (ACA individual market).

To my surprise, only one insurance company sells plans in that mid-sized city. And only HMOs.

What was the spiel when trying to pass the ACA? MORE choices they said?

Things could not be more different.

(Disclaimer: I was checking now, but it's not until November 1st that final plans and prices are posted, so it's possible it could change.)
Click to expand...

There's a Blue Cross Blue Shield Texas and Humana off a fast Google search. Why do you say in your city. Health insurance is sold statewide.
 
MaggieD said:
There's a Blue Cross Blue Shield Texas and Humana off a fast Google search. Why do you say in your city. Health insurance is sold statewide.
Click to expand...

The policies are sold by zip code/geographical areas. The plans are for certain areas called "marketplace areas." Each marketplace area has a number. So I could buy a policy from Houston, for example, which isn't my city, but none of the providers in the city I live in would be in the network, since they're out of that marketplace area and don't participate in that plan. It would be useless outside of the Houston area for normal medical care.

For example, when I look at a plan for my new marketplace area, there is a provider list for that plan and that area. When I look at the provider list, only the hospitals in that marketplace area are approved for that plan. I could get health care out of that area only if it's an emergency.

Only BCBS is in the list on the healthcare.gov site for that mid-sized city. But as I say, we can't actually see final 2016 plans until November 1st.

The ins. cos. sell statewide, but they sell different individual plans for each geographical area, with a different cost and different provider list for each area.
 
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JumpinJack said:
I've never heard of PPACA. Do you mean PPO plans under the ACA? If they have to be offered statewide, maybe there will be one added by November, the enrollment period. I'm checking now, so things are not final. The one insurer that provides ins. there is BCBS, which is removing all its PPO plans from the state end of year.

I checked for doctors, and there are a decent # of doctors that accept those HMOs. I just checked the hospitals, and they accept those plans, as well. So that's good. A big improvement over 2014, when these plans first came out. Few providers in my city accepted any HMOs. Maybe that's a big city thing, though. The providers in my current city, which is a large city, are very wealthy and have patients coming out of their ears, so they don't need to accept HMO patients.
Click to expand...

PPACA is the ACA just the full acronym
 
JumpinJack said:
So I'm going to be moving. So I check into whether there are any good doctors there who will accept this or that plan (ACA individual market).

To my surprise, only one insurance company sells plans in that mid-sized city. And only HMOs.

What was the spiel when trying to pass the ACA? MORE choices they said?

Things could not be more different.

(Disclaimer: I was checking now, but it's not until November 1st that final plans and prices are posted, so it's possible it could change.)
Click to expand...

Before ACA, there was at least one entire state (NH) that had only one insurer so a city with only one is an improvement.
 
New Hampshire had at least 13 insurance companies offering health insurance in the state before 2014, including one non-profit members-only company. It now has 4 or 5.
 
JumpinJack said:
New Hampshire had at least 13 insurance companies offering health insurance in the state before 2014, including one non-profit members-only company. It now has 4 or 5.
Click to expand...

In 2013, one insurer had more than 90% of the market cornered

Individual Insurance Market Competition | The Henry J. Kaiser Family Foundation

NH was one of the states with the least competitive markets for health insurance
https://www.advisory.com/daily-briefing/blog/2014/06/insurers-jumping-in-year-2

By some measures, New Hampshire was already the sixth-least-competitive insurance market in the nation, with Anthem controlling more than 90% of market share…and that was before Obamacare even launched.
Click to expand...
 
JumpinJack said:
So I'm going to be moving. So I check into whether there are any good doctors there who will accept this or that plan (ACA individual market).

To my surprise, only one insurance company sells plans in that mid-sized city. And only HMOs.

What was the spiel when trying to pass the ACA? MORE choices they said?

Things could not be more different.

(Disclaimer: I was checking now, but it's not until November 1st that final plans and prices are posted, so it's possible it could change.)
Click to expand...


A second insurer popped up on the healthcare.gov website today for that mid-sized city. Yay! Even better, it's United Health. Still only HMOs, but at least there's a choice of insurers. I've had UHC insurance before (a PPO, pre-ACA), and was happy with it and the company. So things are looking up. Not that BCBS is bad, but it's always better to have a choice. Esp. since UHC is a tad less expensive.
 
JumpinJack said:
So I'm going to be moving. So I check into whether there are any good doctors there who will accept this or that plan (ACA individual market).

To my surprise, only one insurance company sells plans in that mid-sized city. And only HMOs.

What was the spiel when trying to pass the ACA? MORE choices they said?

Things could not be more different.

(Disclaimer: I was checking now, but it's not until November 1st that final plans and prices are posted, so it's possible it could change.)
Click to expand...

Many things about ObamaCare are much different than what was promised. Tell me you're surprised.
 
sangha said:
In 2013, one insurer had more than 90% of the market cornered

Individual Insurance Market Competition | The Henry J. Kaiser Family Foundation

NH was one of the states with the least competitive markets for health insurance
https://www.advisory.com/daily-briefing/blog/2014/06/insurers-jumping-in-year-2
Click to expand...

Well, that's one way to spin your misinformation that NH had only one insurer. NH STILL had 13 insurers pre-ACA, and 4 or 5 now. People chose whichever ones they liked the most or could afford. "Choice" is the operative word.
 
JumpinJack said:
Well, that's one way to spin your misinformation that NH had only one insurer. NH STILL had 13 insurers pre-ACA, and 4 or 5 now. People chose whichever ones they liked the most or could afford. "Choice" is the operative word.
Click to expand...

There's a word for a business that controls more than 90% of a market.

The word is "monopoly"
 
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