So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

[JumpinJack]

I got an HMO this year because Blue Cross pulled its PPOs out of the state. HMOs, as you know, are "managed care" policies. You have to name in advance a "primary care physician," and you can only go to that dr., unless he refers you.

Blue Cross named one for me. When looking at the dr's "practice" and experience (almost none), I saw that he is not admitted to practice at any hospital, and his "practice" is one of those 24 hr urgent care clinics. ???? They advertise that they handle insect bites & flu shots. ??? They don't even make appts. I called anyway. He was an employee but is not there any more. I called a couple of more clinics his name was associated with, but he's left there. I can't find him.

When calling around other drs on the list for my network, about 1 1/2 hours, I have been unable to find another dr. who will take the policy.

If there's no PCP that will take an insurance, is it really usable insurance? I'll have to call the govt and see what to do about the situation.

Oh, yeah, I forgot to say....Obamacare is wonderful!

(Am thinking I might be better off going to Sam's Club, where they offer free cholesterol screening, then to one of those cheap clinics...they'll give you an annual for $100.)

 

[ttwtt78640]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

BCBSTX is accepted in many places - it should not be that difficult to find a PCP accepting that insurance.

https://www.zocdoc.com/primary-care-doctors/dallas-211240pm/blue-cross-blue-shield-304m

http://www.bcbstx.com/onlinedirectory/pdf/hmo/dallashb.pdf

 

[JumpinJack]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

BCBSTX is accepted in many places - it should not be that difficult to find a PCP accepting that insurance.

https://www.zocdoc.com/primary-care-doctors/dallas-211240pm/blue-cross-blue-shield-304m

http://www.bcbstx.com/onlinedirectory/pdf/hmo/dallashb.pdf

I have found ONE doctor so far, after spending about 2 hours looking. Well, not exactly a doctor. He won't take it, but he'll let me see his nurse assistant as my PCP, instead. Seems they've found a way around the low fees.

This is very discouraging. I am close to cancelling the insurance. It'll get me sick to have to worry this much about it. I don't know what to do.

twtt: You have to get on the phone and call each one, to see if they'll take your plan. The lists are just a guide and are outdated (if not entirely fake....as I said, the doctor BC picked out for me has disappeared and can't be found, which shows hte caliber of doctor we're talking about).

I am looking for a certain radius of my home, and other things. I'm not going to do what a guy in a neighboring town did, which was accept a PCP in a different city so he had to travel 50 miles for an exam. I'm just not going to do that. It also isn't practical to have a dr that far away, if you're sick, etc.

A couple I called....one office didn't answer the phone, another's was busy for about 45 minutes. The phone was busy? Strange. These are some odd providers, the ones who will accept these plans.

I can get a non-ACA short term policy. I don't get a free preventive (but I don't really get a free preventive under the ACA....the "doctor" who agreed to let his assistant see me requires a pre-visit visit, at full price, just to meet and greet and fill out paperwork. So...not free to me.)

The short term has a narrow drug list (very), and other restrictions, and they can cancel you, but it's not nearly as pricey, and you get to buy just what you need (no maternity coverage or inpatient drug rehab!), and more providers will accept it. The govt will come after me, if I do that. They require you get an ACA plan. I'll think about it.

 

[Deuce]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

Notice there wasn't a single bit of criticism leveled at Blue Cross

 

[sangha]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

I got an HMO this year because Blue Cross pulled its PPOs out of the state. HMOs, as you know, are "managed care" policies. You have to name in advance a "primary care physician," and you can only go to that dr., unless he refers you.

Blue Cross named one for me. When looking at the dr's "practice" and experience (almost none), I saw that he is not admitted to practice at any hospital, and his "practice" is one of those 24 hr urgent care clinics. ???? They advertise that they handle insect bites & flu shots. ??? They don't even make appts. I called anyway. He was an employee but is not there any more. I called a couple of more clinics his name was associated with, but he's left there. I can't find him.

When calling around other drs on the list for my network, about 1 1/2 hours, I have been unable to find another dr. who will take the policy.

If there's no PCP that will take an insurance, is it really usable insurance? I'll have to call the govt and see what to do about the situation.

Oh, yeah, I forgot to say....Obamacare is wonderful!

(Am thinking I might be better off going to Sam's Club, where they offer free cholesterol screening, then to one of those cheap clinics...they'll give you an annual for $100.)

Is this the same policy you claimed didn't include any oncologists in their network even though another poster found oncologists listed in their network?

 

[countryboy]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

Is this the same policy you claimed didn't include any oncologists in their network even though another poster found oncologists listed in their network?

I guess you missed the part about the lists not being accurate. :roll:

Amazing how quickly libs will turn on one of their own, for speaking negatively about your lord and savior's signature "healthcare" legislation. :roll:

 

[Greenbeard]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

Effective 1/1/2016, Texas state law requires provider directories be updated no less than monthly.;

The health benefit plan issuer shall conduct an ongoing review of the directory and correct or update the information as necessary. Except as provided by Subsection (e), corrections and updates, if any, must be made not less than once each month.

The health benefit plan issuer shall conspicuously display in the directory required by Section 1451.504 an e-mail address and a toll-free telephone number to which any individual may report any inaccuracy in the directory. If the issuer receives a report from any person that specifically identified directory information may be inaccurate, the issuer shall investigate the report and correct the information, as necessary, not later than the seventh day after the date the report is received.

If you're saying that not one of the 239 PCPs (or, less absurdly, any appreciable number) listed as participating in the Blue Advantage network within Dallas city limits are not actually participating in the plan network, then BCBSTX has a problem on its hands. Aside from violating the transparency law, they could well be in violation of your state's network adequacy requirements.

I do like that your first instinct in response to BCBS allegedly posting a fraudulent provider directory isn't to reach out to the Texas Department of Insurance, it's to lash out at Obamacare on a message board.

 

[Vern]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

I guess you missed the part about the lists not being accurate. :roll:

Amazing how quickly libs will turn on one of their own, for speaking negatively about your lord and savior's signature "healthcare" legislation. :roll:

the thing is CB, you've missed the posts where JJ has been dishonest (and repeatedly so) so you really shouldn’t believe what he says. Case in point, he claims to be a 60 year old woman who scrimped and saved forgoing the niceties in life like new clothes or family vacations,

But I worked my butt off for 40 years to save for my old age. I've sacrificed a lot. Vacations, nicer clothes, electronics, trips to see family. Things that poorer people sprung for that I did not, choosing instead to save for my old age. To give away my savings would be just as bad as leaving me in the dust without affordable insurance...it would give away to someone else all my hard work over decades. That's no answer.)

But he referred to a 59 year old man as “old dude”. Not something I’d expect a 60 year old spinster to say. He’s also said “not cool” and “don’t get your panties in a wad”. These are things spinsters don’t say. Is that conclusive proof of his dishonesty, no but its should make you skeptical of anything he says. This is where I prove it.

Here is his post from 1-19-15

I did notice that this year some oncologists were added to one or more of the low level HMOs in my city, so that's an improvement. I heard on the news that the fed was unhappy about the network provider lists and was contemplating adding a provision to the ACA about it. So maybe that helped.

Just so you know, other posters proved his “just added” statement false. But look what he said 8-4-15

This means we'll be able to get only an HMO, I guess. That may mean that insureds may lose coverage for cancer and other illnesses, since oncologists and some other specialized doctors (and many general doctors) don't take HMOs. So although the policy theoretically covers any illness, an insured will not be covered for a particular illness like cancer, if there are no specialized doctors in the city accepting that policy.

JJ cant keep his stories straight so CB, don’t bet the farm on what JJ says.

 

[countryboy]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

the thing is CB, you've missed the posts where JJ has been dishonest (and repeatedly so) so you really shouldn’t believe what he says. Case in point, he claims to be a 60 year old woman who scrimped and saved forgoing the niceties in life like new clothes or family vacations,



But he referred to a 59 year old man as “old dude”. Not something I’d expect a 60 year old spinster to say. He’s also said “not cool” and “don’t get your panties in a wad”. These are things spinsters don’t say. Is that conclusive proof of his dishonesty, no but its should make you skeptical of anything he says. This is where I prove it.

Here is his post from 1-19-15


Just so you know, other posters proved his “just added” statement false. But look what he said 8-4-15


JJ cant keep his stories straight so CB, don’t bet the farm on what JJ says.

Keeping that close of track to her that you have **** bookmarked for cut and paste at the ready? Creepy.

 

[sangha]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

Keeping that close of track to her that you have **** bookmarked for cut and paste at the ready? Creepy.

That's right. Pretend that you didn't see proof of how the OP has repeatedly lied about her experiences and try to make the thread about Vern.

 

[Vern]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

Keeping that close of track to her that you have **** bookmarked for cut and paste at the ready? Creepy.

creepy? geez CB, why are you at a debate forum? You've never added anything of substance to any thread, just chat room-esque nonsense. And as Sangha points out you are simply trying to make it about me instead of addressing my post. My post did give you just the excuse you were looking for to ignore that Greenbeard shredded JJ's thread topic. But how you do ignore my post when I've proven you shouldn't believe anything JJ says? oh yea, you think its a chat room.

 

[JumpinJack]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

Keeping that close of track to her that you have **** bookmarked for cut and paste at the ready? Creepy.

Yes, he is creepy. He and hte other creep are upset because I'm pointing out the problems with ACA, as I work my way through it, trying to get coverage at a reasonable price, and find a doctor. They are so upset as these issues are pointed out (not just by me, but by others as well) that they have resorted to stalking me and claiming "you lie!" a la Joe Wilson.

Just for the record, I'm very honest. I have no reason to lie. That would be silly. ESPECIALLY SINCE I WAS A STRONG ACA SUPPORTER AND A CONTRIBUTOR TO OBAMA'S CAMPAIGN. I was totally surprised we had been lied to and fooled.

I have learned that as long as others have theirs, they don't really care about anyone else. So they just shout "you lie!"

Note: The ins. I had last year was a PPO and is not the ins. I have this year. Because Blue Cross has withdrawn all PPOs from the state of Texas. No other large ins. co. offers PPOs. That leaves only HMOs as an option.

(There is a hospital that self-insures with PPOs...but it's not practical. It's very expensive, and you can only get treatment or drugs at that particular hospital complex. There is also another PPO by a new ins. co. named, of all things, Oscar, but that's risky. It's also very expensive.)

The Plano couple that had the same trouble I'm having (finding a PCP to take the ins.) has Molina. I didn't buy Molina because it's more costly and it's network providers list was VERY small. I knew it would be a problem finding a doctor for Molina. I am surprised there's a problem with Blue Cross, though.

 

[JumpinJack]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

I guess you missed the part about the lists not being accurate. :roll:

Amazing how quickly libs will turn on one of their own, for speaking negatively about your lord and savior's signature "healthcare" legislation. :roll:

He's talking about 2014, when I posted about oncologists. AND THERE WEREN'T ANY. Seriously. No oncologists in my large city that has tens of thousands of doctors. For the policy I was considering at that time. Someone LATER posted that there were....but that was later in time and/or for a different plan. They were mistaken as to the point in time, when I accessed the network provider lists. (And you do have to call them. The list, as I'm learning, is minimally useful.)

I've worked in insurance litigation and know a bit about insurance. Believe me, I'm pretty sure I know what I'm doing when I read the summary of benefits and review the provider and drug lists.

 

[JumpinJack]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

Effective 1/1/2016, Texas state law requires provider directories be updated no less than monthly.;




If you're saying that not one of the 239 PCPs (or, less absurdly, any appreciable number) listed as participating in the Blue Advantage network within Dallas city limits are not actually participating in the plan network, then BCBSTX has a problem on its hands. Aside from violating the transparency law, they could well be in violation of your state's network adequacy requirements.

I do like that your first instinct in response to BCBS allegedly posting a fraudulent provider directory isn't to reach out to the Texas Department of Insurance, it's to lash out at Obamacare on a message board.

The tone of your post is such that you are offended that the ACA is turning out to be bad for some people. But that is the case.

The PCP list for those w/in 5 miles of my zip code total about 39. Some of those are in the same office, so the # is smaller than 39. I've called about half the list. That has taken hours, and it's hard to take, being rejected time after time.

The list is, in fact, fake. One of the drs I called is a knee specialist and not a PCP at all. Others aren't taking new patients. The rest won't take my particular plan. One told me today point blank that even though they take all kinds of insurance, they don't take Blue Cross ACA HMOs.

There is a point at which it's useless to keep trying to find a doctor who will take a particular insurance. I live within a few miles of several large hospitals and medical complexes, with literally thousands of doctors. It speaks volumes that none of them will take this insurance.

There are two reasons they won't:

1. The HMO ins. doesn't pay much. Good drs won't take those paltry sums because they don't have to.

2. There is a thing with payment. I get a partial subsidy, which means I get it through the exchange. If you get it through the exchange, the ACA prohibits the ins. co. from cancelling the policy for about 90 day for nonpayment. That means that patients can cont. getting medical care that the ins. co. won't pay for, but the provider doesn't know that.

I am not lashing out at Obamacare. I'm merely reporting one person's personal experiences with this insurance. You don't have it, so you can't relate. The fact that you don't understand what a PCP list is, or find it unthinkable that the list is false, says a lot of about lack of knowledge.

If you don't personally have individual ACA coverage, it's best not to try to pretend knowledge you don't have. Best for you to read and learn. I'm not the only one. I posted about the couple in Plano (a Dallas suburb) who had the same problem I'm having. They weren't "lashing out at Obamacare," either.

Let's not try to blame the victim, okay? Let's put the blame where it belongs: On an ins. co. getting hundreds of dollars a month for something a person has been unable to use thus far. And providing a list that is almost useless. There was no attempt on the part of BCBS to ensure the list was anywhere near accurate.

This was in the news last year, as well. Although I didn't have trouble last year, because I had a PPO (no need for a PCP, and PPOs pay more than HMOs).

I can't even go get a flu shot. I have to get referred by a PCP. Which I don't have.

I did find one dr who won't take the ins., but he will let me see his assistant (he'll turn in the bills under his name, I guess). But there's a catch. Before you can go for an annual exam, they require you go for a meet-and-greet and pay for a full exam. That isn't covered by insurance, of course. In my case, because I have a high deductible, that means I'd have to pay 100% out of pocket in order to get the "free" preventive exam. You can't make this stuff up. Truth is stranger than fiction.

For the record, I was a STRONG supporter of the ACA, voted for Obama, and contributed to his campaign. I have absolutely no reason to attack the ACA. I merely report my experience, and it's been horrible. I've learned that unless people personally have to go through this, they can't relate. I also learned that once people have what they need, they really don't care about others. All the years I spent voting for the benefit of others....misguided on my part.

 

[sangha]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

There are two reasons they won't:

1. The HMO ins. doesn't pay much. Good drs won't take those paltry sums because they don't have to.

2. There is a thing with payment. I get a partial subsidy, which means I get it through the exchange. If you get it through the exchange, the ACA prohibits the ins. co. from cancelling the policy for about 90 day for nonpayment. That means that patients can cont. getting medical care that the ins. co. won't pay for, but the provider doesn't know that.

ACA requires the insurer to notify the doctor 30 days after non-payment so the provider *does* know.

I am not lashing out at Obamacare. I'm merely reporting one person's personal experiences with this insurance. You don't have it, so you can't relate. The fact that you don't understand what a PCP list is, or find it unthinkable that the list is false, says a lot of about lack of knowledge.

If you don't personally have individual ACA coverage, it's best not to try to pretend knowledge you don't have. Best for you to read and learn. I'm not the only one. I posted about the couple in Plano (a Dallas suburb) who had the same problem I'm having. They weren't "lashing out at Obamacare," either.

Let's not try to blame the victim, okay? Let's put the blame where it belongs: On an ins. co. getting hundreds of dollars a month for something a person has been unable to use thus far. And providing a list that is almost useless. There was no attempt on the part of BCBS to ensure the list was anywhere near accurate.

This was in the news last year, as well. Although I didn't have trouble last year, because I had a PPO (no need for a PCP, and PPOs pay more than HMOs).

I can't even go get a flu shot. I have to get referred by a PCP. Which I don't have.

I did find one dr who won't take the ins., but he will let me see his assistant (he'll turn in the bills under his name, I guess). But there's a catch. Before you can go for an annual exam, they require you go for a meet-and-greet and pay for a full exam. That isn't covered by insurance, of course. In my case, because I have a high deductible, that means I'd have to pay 100% out of pocket in order to get the "free" preventive exam. You can't make this stuff up. Truth is stranger than fiction.

For the record, I was a STRONG supporter of the ACA, voted for Obama, and contributed to his campaign. I have absolutely no reason to attack the ACA. I merely report my experience, and it's been horrible. I've learned that unless people personally have to go through this, they can't relate. I also learned that once people have what they need, they really don't care about others. All the years I spent voting for the benefit of others....misguided on my part.

No, you're making stuff up. In previous posts, you said you hadn't gone to a doctor. In this post you're claiming you did go to doctors and had no problem finding them.

 

[Greenbeard]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

The tone of your post is such that you are offended that the ACA is turning out to be bad for some people. But that is the case.

I don't know what the ACA has to do with BCBS apparently maintaining a fraudulent provider directory in very clear violation of your state's laws.

If we repeal the ACA tomorrow, is your provider list suddenly going to be accurate? Will Texas suddenly be more inclined to enforce the network adequacy and directory accuracy laws that already exist in your state?

I am not lashing out at Obamacare. I'm merely reporting one person's personal experiences with this insurance.

And my point was that your reporting would be more productive if directed at Texas DOI, particularly given the fact that your legislature has passed legislation pertaining to exactly this circumstance.

 

[JumpinJack]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

ACA requires the insurer to notify the doctor 30 days after non-payment so the provider *does* know.




No, you're making stuff up. In previous posts, you said you hadn't gone to a doctor. In this post you're claiming you did go to doctors and had no problem finding them.

Stop stalking me.

Read news articles before you post nonsense.

 

[sangha]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

Read news articles before you post nonsense.

You should read more
Key Facts: Premium Payments and Grace Periods | Beyond the Basics

nsurers must pay for medical care received during the first month of the grace period for enrollees who are receiving an APTC. However, for the second and third months of the grace period, insurers may withhold (or “pend”) payment for medical claims until the enrollee pays all outstanding premiums. If an enrollee’s coverage is terminated for failure to make all payments in full, the individual will be responsible for paying any medical expenses incurred during the second and third months of the grace period.

For enrollees not receiving an APTC, the insurance company may withhold payments during the grace period subject to any relevant state law or regulation. The enrollee may be responsible for these charges if payment is not made in full by the end of the grace period.

Insurers are supposed to let providers know if a policyholder’s claims are being held because he or she is in a grace period. Providers may choose not to provide care until premiums are paid, even though the person is still technically enrolled in the plan until the grace period end

Health Policy Briefs

The ACA outlines the responsibilities of insurers to enrollees who are receiving advanced payments of premium tax credits. The grace period is only briefly discussed. The statute states that if a subsidized enrollee does not pay his or her premium, the insurance issuer must notify HHS of such nonpayment and allow a three-month grace period for nonpayment of premiums before the insurer discontinues coverage. Again, an individual only qualifies for the grace period if he or she has paid at least one month's premium.

CMS regulations have expanded upon the law's language. In final regulations, CMS said issuers must pay all appropriate claims for medical services rendered to the enrollee during the first month of the grace period, and the insurer may put on hold claims for services rendered to the enrollee in the second and third months. Issuers must also...notify providers of the possibility for denied claims when an enrollee is in the second and third months of the grace period.

When will you stop lying about ACA?

 

[countryboy]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

You should read more
Key Facts: Premium Payments and Grace Periods | Beyond the Basics



Health Policy Briefs



When will you stop lying about ACA?

Why do you doubt the veracity of JJ's posts? What possible reason could she have to "make stuff up"?

 

[Renae]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

I got an HMO this year because Blue Cross pulled its PPOs out of the state. HMOs, as you know, are "managed care" policies. You have to name in advance a "primary care physician," and you can only go to that dr., unless he refers you.

Blue Cross named one for me. When looking at the dr's "practice" and experience (almost none), I saw that he is not admitted to practice at any hospital, and his "practice" is one of those 24 hr urgent care clinics. ???? They advertise that they handle insect bites & flu shots. ??? They don't even make appts. I called anyway. He was an employee but is not there any more. I called a couple of more clinics his name was associated with, but he's left there. I can't find him.

When calling around other drs on the list for my network, about 1 1/2 hours, I have been unable to find another dr. who will take the policy.

If there's no PCP that will take an insurance, is it really usable insurance? I'll have to call the govt and see what to do about the situation.

Oh, yeah, I forgot to say....Obamacare is wonderful!

(Am thinking I might be better off going to Sam's Club, where they offer free cholesterol screening, then to one of those cheap clinics...they'll give you an annual for $100.)

I'm am sorry to hear you've been having these issues Jumping Jack. Here in SA I have decent insurance and finding a Primary Care doc is a pain...

 

[Renae]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

Why do you doubt the veracity of JJ's posts? What possible reason could she have to "make stuff up"?

Sangha likes to be contrary.

 

[Vern]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

Why do you doubt the veracity of JJ's posts? What possible reason could she have to "make stuff up"?

CB, you cant be serious. You just don't get to pretend I didn't post JJ contradicting his own posts. You replied to it and whined I was creepy for holding JJ accountable. Oh that's right, you're a conservative, of course you can pretend I didn't post JJ contradicting his own posts. Hey CB, here's another glaring example of JJ's "integrity". Here he tells us he's a 60 year old and doesn't qualify for a subsidy.

I'm unemployed, almost 60 years old, with my life savings that has to last me for 30 years. Income is too low to qualify for a subsidy, and I don't qualify for Medicaid.

Here he tells us that you have to make more than 12 k to get a subsidy

You don't know much about the ACA, do you? You have to have an income higher than $12k to get a subsidy. But you can have assets.

Here he tells us that he wont have to pay a penalty in response to me telling him he posted he makes less than 12K

Yes, it is. That's why I won't have to pay a penalty. I COULD withdraw from my retirement account, which would count as taxable income. But that's money I need for my old age.
.

Here he tells he never said he makes lower than 12K (his bolding not mine) in response to me again telling him he said he made less than 12K

I never said I made lower than $12k, so you are misremembering and altering past statements to fit your perception.

I found that odd because I had thrown the “I don’t qualify for a subsidy” in his face several times. That’s when I figured he’s posting stories of woe at numerous sites and was unable to keep track of his lies.

and CB, you asking a question "why would he make it up" doesn't make the facts disappear. And what's truly sad is cons have shown they'll always chose narrative over integrity. Why? I don't know but they do. Hey just look at your own post asking "why do you doubt JJ" after I posted JJ lying. you kinda prove my point. thanks.

 

[SocialD]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

I got an HMO this year because Blue Cross pulled its PPOs out of the state. HMOs, as you know, are "managed care" policies. You have to name in advance a "primary care physician," and you can only go to that dr., unless he refers you.

Blue Cross named one for me. When looking at the dr's "practice" and experience (almost none), I saw that he is not admitted to practice at any hospital, and his "practice" is one of those 24 hr urgent care clinics. ???? They advertise that they handle insect bites & flu shots. ??? They don't even make appts. I called anyway. He was an employee but is not there any more. I called a couple of more clinics his name was associated with, but he's left there. I can't find him.

When calling around other drs on the list for my network, about 1 1/2 hours, I have been unable to find another dr. who will take the policy.

If there's no PCP that will take an insurance, is it really usable insurance? I'll have to call the govt and see what to do about the situation.

Oh, yeah, I forgot to say....Obamacare is wonderful!

(Am thinking I might be better off going to Sam's Club, where they offer free cholesterol screening, then to one of those cheap clinics...they'll give you an annual for $100.)

YOu can still get a PPO in your state, you just have to get it through Scott & White instead of Blue Cross. You can still get Blue Cross but only as an HMO.
With your stated age, and assuming you make around 12k as has been the .. discussion.. between you and others.. and in the Dallas area and assuming you don't smoke and its a plan for just you... you could qualify for a subsidy of ~$540 per month so you could then get a PPO plan for as low $179$ your cost. Although I know that's not low considering what you supposedly make.
And HMO plan would cost you basically nothing given the same circumstances.

 

[JumpinJack]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

Here he tells us that you have to make more than 12 k to get a subsidy



Here he tells us that he wont have to pay a penalty in response to me telling him he posted he makes less than 12K



Here he tells he never said he makes lower than 12K (his bolding not mine) in response to me again telling him he said he made less than 12K


I found that odd because I had thrown the “I don’t qualify for a subsidy” in his face several times. That’s when I figured he’s posting stories of woe at numerous sites and was unable to keep track of his lies.

and CB, you asking a question "why would he make it up" doesn't make the facts disappear. And what's truly sad is cons have shown they'll always chose narrative over integrity. Why? I don't know but they do. Hey just look at your own post asking "why do you doubt JJ" after I posted JJ lying. you kinda prove my point. thanks.

Vern:

You just don't understand. Or you are intentionally not reading entire posts of mine.

I am retired. I don't work. I have not much income. I have retirement savings and regular savings and a few taxable investments.

I can withdraw money from my IRA (making it taxable income)....or not. Now do you get it? I withdraw money from my IRA in order to get a partial subsidy. If I didn't do that, my income would be below $12k.

Read up on the background of the ACA, and you'll find that one of its lesser known purposes is so that retiree don't have to use their life savings for medical bills or premiums. I would be one of the ones they put that provision in for.

Get a grip on yourself. What possible purpose would anyone have to spend time on posts with specifics, when the facts aren't true? It boggles my mind to think how your mind works, to come to that conclusion. Of course, I think the answer is...you don't like the fact that someone is pointing out deficiencies in the ACA, as I report my progress with it (or lack of it).

There aren't many in the forum who have individual ACA policies. Certainly not you, since you don't seem to understand how it works.

As for my having trouble finding a PCP, that was indeed true. I will post a separate post indicating that my issue is not a rare one. BCBS is being sued over it, and someone else in a suburb of my city was on the NEWS because they had such a difficult time finding a PCP with BCBStx HMOs, and the husband is sick. That is a big deal. So big, that the local news ran a story on it. My experience was the same as theirs.

However, I have now found a PCP. When I located this dr office, the woman who answered the phone told me she's not surprised when I told her that I had almost given up finding a PCP. She said their office, which is in Dallas, has been getting calls from people in Houston and San Antonio, because this Dallas dr's name was incorrectly on the lists providers for those people in Houston and San Antonio (HMOs don't have providers outside the area).

Stop stalking me.

 

[JumpinJack]

re: So far, can't find a fully practicing primary dr to take my "insurance" [W:28]

YOu can still get a PPO in your state, you just have to get it through Scott & White instead of Blue Cross. You can still get Blue Cross but only as an HMO.
With your stated age, and assuming you make around 12k as has been the .. discussion.. between you and others.. and in the Dallas area and assuming you don't smoke and its a plan for just you... you could qualify for a subsidy of ~$540 per month so you could then get a PPO plan for as low $179$ your cost. Although I know that's not low considering what you supposedly make.
And HMO plan would cost you basically nothing given the same circumstances.

The enrollment period is closed. So I can't change unless I have a "qualifying event." (I will soon be able to change, since I'm moving to a new city. I don't think there are any PPOs there, though.)

However....and stay with me here....I am a "low" user of medical services. My Scott & White premium (which restricts you to going to the hospital and pharmacy...not useful if you're really sick, since it's about 10 miles from me, through the heart of downtown) would add to the cost such that I would end up paying over $3,200 for medical services, counting the premium. But I would end up paying a little over $1,000 for a low level HMO. (My premium would run around $190-195; this is because I claim over $12k income, because I cannot pinpoint it exactly ahead of time, so I give myself wiggle room, in case I make over the amount I claim.) In other words, the healthier you are, the less advantage it is to have a high premium policy.

There is an alternate to an HMO I can choose, however, That is United Health Care's EPO plan. It's like an HMO, but you don't have to have a PCP referral for everything. I didn't know about that difference, or I probably would've gotten that, instead.