Affordable Care ACT
 

Before anyone gets upset or offended at the title "I'm not slamming the president or inciting a political debate" but wanted to share my recent experience with this new plan.

A little history: I've been on my employers insurance plan or COBRA for the last year. I am so extremely grateful for this plan and for the kindness of my employer! However, my COBRA benefits will run out in in August and it is very expensive so I thought possibly with the new healthcare plan that I could save some money and switch over. OMG was I shocked.. not only are the prices higher than what I am paying, the deductibles are 7K-12K and out of pocket more than quadruples what I currently pay per year AND not one plan will allow me to stay with my current doctors and that ****** me off more than anything. I consulted with every single PM doctor who has an understanding of CRPS II/Causalgia within a 4 hour radius of where I live who I felt would work well with the rest of my medical team. My team involves doctors from several different big hospitals including one at our states University and NOT ONE of the 8 physicians are covered under any of the plans. I am so angry.. then I decided to see what medicaid offered because I would qualify for that but wanted to stay with private insurance for better options in care.. again NOT ONE doctor is accepting medicaid patients and if I sign up I would have to go to whomever 'they' decide I should see. Utterly stupid!

Have you looked at the gold and platinum plans? I have found that they have no deductible and the plan is actually better then what I get from work, and cheaper too. The companies were all the same ones work places offer (Anthem, Blue Shield, Kaiser, etc).

My DH was complaining about it. The plans he was looking at were the catastropic plans. You don't need that.

Maybe it's the difference in our state or something. I'm in CA.

It is different in every state and county and then it also depends on age I am only 45 and we don't have children living at home. There weren't any plans with a zero deductible .. and I need a PPO to keep my current doctors. My plan from work is incredible so I doubt I would find that anywhere but something close.. without huge out of pocket charges. After doing the math and calling my doctors for amounts of cash payments it would be cheaper to pay cash and add catastrophic insurance just in case cancer raises its ugly head again.

So Sorry
 

So sorry this happened to you. I am just waiting for the shoe to drop on me too as I have had an individual policy for nearly 40 years. I am just hoping to hang on for the next two years. I have said many many times, it does not matter how great the coverage if your doc and hospital do not accept it or vice versa.

I know what you mean about waiting for the shoe to drop.. I actually heard through our company grapevine that BCBSIL may cancel our policies.. the thing is many of them also don't show (except in the fine print) the many things they don't cover. Like vision and dental for adults, off label prescriptions and even chiropractic care. I know many people don't believe in chiro.. but mine has been helping me and knows more about CRPS II than many of the PM's I consulted with.. I had it with my old plan I should have it with my new plan.

I actually made several calls today to find out how much it would cost on a cash basis.. and now I am thinking about going that route with a catastrophic plan for major issues if one arises. Here is an example of what one doctor would cost me with cash vs. billing an insurance company.

Currently I pay a $25 co-pay to my PM.
He bills BCBSIL $356.00 for a 20 min. basic visit
BCBSIL pays him $156.00 after the contract discount

If I pay cash I would only be charged $82.50.. SHOCKING.. really!! Think I'm going cash.. my reasoning.. being that there is no cure or real treatment other than medications and I won't be having surgery unless it is life/death situation due to the CRPS II and I can't have MRI's because of my SCS.. unless I cancer raises its ugly head again or something else catastrophic I am better off paying cash in the long run I would be about $400+ dollars ahead every month.

Ugh.. it is just another stress to our already stressful lives.

Cash may be good option
 

I so understand what you are saying. CASH may be the only thing that will be accepted soon and in many cases will be the cheaper way to go. No one seems to know or feel secure about all the chaos with health care and health insurance at the moment. A lot of people that are currently covered under their employers, are healthy, and think none of the current turmoil affects them may soon find themselves in a similar boat. We here with health issues are more aware as we are affected first.

I only hope that when all the dust settles, everyone comes out of all this without too much harm but I fear that will not be the case.

Wishing you the best and hope we can keep our docs. Nothing is more important to me than being able to choose who I trust with my life and health. I don't just want a doctor, .... I want MY doctors. It IS MY life that is in their hands.

Well said Hopeless! That is exactly how I feel. Unfortunately being that we suffer from a disease that not many are aware of and it is also a 'chronic pain' condition I fear that we will be under cared for or brushed off if we aren't able to choose or stay with qualified physicians.

Like you.. I hope when the dust settles the picture I see currently has a whole different look. Praying for those who are already being affected by this mess. They really should have waited and researched the medical/treatment maze through people who it affects on a daily basis!

Wishing you well,
Tessa

I removed my last comment. I don't want to get into a political debate either, and I feel this just opens the door for one. Thanks.

Understand
 

I have tried very hard not to state any "opinion" or political issue, just some fears and realities that are happening to people that have chronic health issues.

Yes, it is difficult not to talk about such a "hot" topic without expressing some things that may not be allowed or would possibly offend.

I hope I have not offended you or anyone else. I am just afraid of my future and my relationship with my physicians.

I must admit that I am now curious as to what your comment might have been. :)

Are you saying that using Medicaid for Healthcare would cost you MORE than you are paying with your COBRA plan ?

I understand how frustrating it can be to get adequate care for RSD even when living near a major medical hub. There have been many posters here though who don't have ANY pm docs who understand RSD within a 4 hour commute.

The "they" who decide which doctors Medicaid patients can see are usually not the administrators of the Medicaid plans......the "they" who decide which doctors Medicaid patients can see are usually the doctors themselves who refuse to accept those patients because they feel the reimbursement rates are far too low.

I am grateful that we live in a country where it is possible to get decent health care for many conditions (it's obvious from this forum that so many with RSD are NOT getting great treatment for THIS condition :o ) I just wish it all didn't cost so dang much !