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Thread: My Obamacare Ordeal!

  1. #1

    My Obamacare Ordeal!

    So this year I thought I would give Obamacare a try. I am tired of paying 800.00 a month to have a low deductible. So I went to a Obamacare help site. They found me a Humana hmo with a 1500.00 deductible for 591.00 a month. I have to pay full price because of income. No problem with that as long as I get good service and treatment. So the agent that sold me the policy said my pcp and urologist is on the list. They sent me a letter that said I can't use my pcp and assign me someone else. But I can go on their site and request someone else from their list and they will let me know if I can switch. So I checked out the pcp they selected. What a joke. This doctor has been practicing for 30yrs. Graduated from Universidad Central Del Este. You think I want my care from someone that studied at a third world school. Plus very small practice. Only sees Humana patients.

    So I went to their web site. Registered. The site said I will have to wait 5 to 7 business days for verification to surf the site. Now I am scared that their whole list will be of reject type doctors.

    I will update as this ordeal goes. Let me know if anybody else has good or bad experiences. Thanks!

  2. #2
    Senior Member lynnifer's Avatar
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    I wouldn't judge someone without meeting them first.

    Guy at the clinic next door can barely speak english. Born in Africa (honestly not sure which country there) but spent time in Belgium and schooled in England. Awful accent all over the place ... but he's knowledgeable as hell - even about spinal cord injury. My own doctor that I've had for more than twenty years .. not so much .. and he has an excellent practice in a well-to-do area with other well respected physicians. pfft!
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

  3. #3
    Suspended Andy's Avatar
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    You know what they call a doctor that graduated with the lowest GPA from whatever school they went to, right? Doctor. Given the option, if any, why are you doing an HMO? You know that the doctor who is assigned to be the gatekeeper to medical access is financially penalized for 'excessive' care as determined by some insurance bean counter creating a conflict of interest. Might be better to see if you can get a PPO option and just go wherever as the need arises.

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    Senior Member Oddity's Avatar
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    Wow, for my family premiums would be $2494 a month for that plan. After laying out ~$18,000 a year in premiums, another $6,000 in deductibles ($1,500 per, non-embedded!), I'd still be liable for another $6,000 in co-insurance/pays until I hit the $12,000 OOP max per year limit. Hmmmmm...lemme think...is that good insurance? Guaranteed $18,000 annual loss, possible $30,000 if I actually use it. Hmmmmm....tough decision. NOT.
    "I have great faith in fools; self-confidence my friends call it." - Edgar Allen Poe

    "If you only know your side of an issue, you know nothing." -John Stuart Mill, On Liberty

    "Even what those with the greatest reputation for knowing it all claim to understand and defend are but opinions..." -Heraclitus, Fragments

  5. #5
    Suspended Andy's Avatar
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    You sound like an evil tea party guy. Obamacare is awesome, just ask...uhh, someone! I forget, is this access to medical care or a scheme to give money to an insurance carrier under threat of sanction?

  6. #6
    Re: "Might be better to see if you can get a PPO option and just go wherever as the need arises".[/QUOTE]

    Florida and Texas have pretty much eliminated the ACA PPO option.

    They've come up with the EPO, which rhymes with PPO if that counts.

    "An Exclusive Provider Organization (EPO) only covers care within its network of providers and asks patients to pay through premiums and co-pays, much like an HMO. But unlike HMOs, EPOs allow you to see in-network specialists without a referral. What?s the catch? An EPO?s network is typically smaller than that offered by an HMO or PPO."

    So, a smaller network than an HMO but you don't have to go through a Primary Care Provider to see a in-network specialist.

    Folks in Illinois still have the ACA option for a Blue Cross Multi-State PPO.

    TheRainman: If you keep the HMO and are planning out of state travel, make sure you notify your HMO Primary Care Provider in writing in advance of the visit.

  7. #7
    Suspended Andy's Avatar
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    Haha, EPO. I guess that's one way of saying they cant get any providers to participate in that pay structure.

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    dumd question why are you not on medi care

  9. #9
    Quote Originally Posted by lynnifer View Post
    I wouldn't judge someone without meeting them first.

    Guy at the clinic next door can barely speak english. Born in Africa (honestly not sure which country there) but spent time in Belgium and schooled in England. Awful accent all over the place ... but he's knowledgeable as hell - even about spinal cord injury. My own doctor that I've had for more than twenty years .. not so much .. and he has an excellent practice in a well-to-do area with other well respected physicians. pfft!
    I would feel a lot better if this doctor was schooled in England!

  10. #10
    Senior Member lynnifer's Avatar
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    It's odd that a lot of those folk come to Canada and our folk migrate to the States, in medicine.
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

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