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10-10-2013, 11:42 AM | #31 | ||
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ginnie;
Florida is one of states that rejected the Federal Medicaid money. scrubbs |
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"Thanks for this!" says: | ginnie (10-10-2013) |
10-10-2013, 11:56 AM | #32 | ||
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Senior Member
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Yes, it should be on other forums as well.
Another thing to consider........ No matter what insurance you have, no matter how great the benefits, it is of no help if the providers (docs) will not accept it. Even if you want to keep your current policy under the "grandfather" clause, there is no guarantee that your insurance company will continue to offer it. Insurance companies are not required to continue to offer all their plans. The grandfather clause allows you to not have the mandated benefits listed under PPACA. Example: If the policy that you have was in force before passage of the PPACA, and it had a lifetime maxiumum, that will remain. The grandfather clause does not force insurance companies to continue to offer plans in effect prior to PPACA. Just means if they do and you were under it before passage, you have those provisions, not the provisions of ObamaCare. And you can NOT make any changes to your poicy or you lose your grandfather status. |
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"Thanks for this!" says: | ginnie (10-11-2013) |
10-11-2013, 10:53 AM | #33 | ||
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Member
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Hopeless you are exactly right. Doctors are either not accepting the insurance coverage or they are leaving the medical community because of the government involvement.
I have found that being covered by Medicare there are so many doctors that won't accept me. My supplemental coverage will cover anything that Medicare accepts. I have had two different doctors who are practicing within a group but there are only one or two doctors who will accept me in that practice. And it is mainly because Medicare dictates how much they will be paid for procedures. I actually have been to a Dermatologic Surgeon who accepts Medicare but you have to sign an agreement that you will be responsible to reinburse him for anything that Medicare reduces his charges. Southern Bell |
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10-11-2013, 11:58 AM | #34 | |||
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Wisest Elder Ever
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Is this legal? I thought doctors have to agree to accept whatever Medicare pays when they agree to be a doctor who accepts Medicare. I'd check with the State you're in to verify that this is legal (for the doctor to do).
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"Thanks for this!" says: | ginnie (10-11-2013) |
10-12-2013, 09:44 AM | #35 | ||
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Member
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I'm pretty sure that the state does not get involved in the coverage a doctor decides to accept or the choice he makes to get the patient to pay the outstanding balance.
If I didn't want to pay the difference, I have the choice to shop doctors. But this physician is highly recommended by my dermatologist and since the surgery was on my face I wanted someone who would do a good job so that there wouldn't be any bad scars. It was my choice to pay the difference. The state doesn't have the right to force doctors to accept insurance or Medicare coverage but with Obamacare the federal government will do that in the end, I have no doubt. The main purpose is to control the medical coverage Americans will or will not receive and hopefully end up with the "single payer system". Southern Bell |
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"Thanks for this!" says: | Kitty (10-12-2013) |
10-12-2013, 07:11 PM | #36 | ||
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Elder
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Is the lack of medicaid funding in this state the reason why no doctor will accept medicaid? I know they do not get paid that much with Medicare as well.
I never really understood all the ins and outs in this. ginnie |
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10-15-2013, 12:36 PM | #37 | ||
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Member
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Ginnie;
26 states have refused Federal dollars and in those states anyone on Medicaid will suffer greatly. They are concerned about Federal spending and the aid to the states will be Federal tax payers’ dollars We all pay for that. The 24 states that have accepted aid know it will reduce the costs for Medicaid in their states. The aid is only for the first 5 years of Obama Care and when that time expires the cost of insurance will be less for everybody and the costs to the Federal and local governments will be re deduced. They believe. Tax payers’ dollars are being used right now to pay for the uninsured and under insured in emergency rooms. While a hospital visit for the flu that might cost only a few hundred dollars, a visit by someone in a Myasthenia crisis could cost the tax payers tens of thousands of dollars. All 50 states feel their actions will save tax dollars. ginnie, until we find out what will happen you may be forced to use the emergency room for your medical needs. I wish you well. scrubbs |
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10-15-2013, 02:45 PM | #38 | ||
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Elder
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Thank you for the info. If my PCP stopped taking me, It would indeed be the emergency room. ginnie
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10-31-2013, 08:32 AM | #39 | ||
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Member
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Well, my husband brought home health insurance information from work last night. Indeed, we are able to keep our current policy next year. However, the cost of each month will go up a couple of hundred, to $1500 a month and there's now an out of pocket max of $22,500 before the policy covers us 100%. I don't have an extra $22.5K lying around for IVIG, so we get to choose from 3 "tempting" marketplace policies.
I don't have all the details on those yet, as the office will not open that information until Nov 4. However, when doing some checks on prescriptions, I was shocked to see that a medication my daughter has used since age 10 will suddenly be "banned" until she completes "step therapy" (trying less expensive alternative short acting meds vs the extended release one she uses now) before she can be approved to get the med. I am FURIOUS, as she is 16, a junior in high school, and is on a "streak of success" right now like she has never known in her life. Messing with her meds (for ADHD) at this point could really mess up her life and her future, in the worst case. I am going to be ALL OVER the folks in the marketplace, as well as writing my representatives, etc. Hell knows no fury like a ticked off Mama bear protecting her cub! In summary, I am not happy! Has anyone else found out information on their plans for next year? |
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"Thanks for this!" says: | Hopeless (10-31-2013) |
10-31-2013, 10:02 AM | #40 | ||
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Junior Member
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I don't know yet if this will work with the new plans but....
My husband's Cobra ended last September and I purchased an individual plan. When I went to renew a prescription he has used for years, it was denied and he was told to go through the Step process. I called Blue Shield about it. I told them that he had been using the prescription for years. They said that if he had been using the prescription and was stable on it on his previous plan, he did not have to go through the Step process. They needed my physician to indicate on the script that the precription has been used before. I don't see any reason that this won't work on the new plans, but we shall see.... |
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"Thanks for this!" says: | 4-eyes (10-31-2013) |
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