Tags: California | Obamacare

California Obamacare: Fewer Choices, No Directory

By    |   Monday, 29 Sep 2014 07:37 AM

Californians looking for a doctor who accepts Obamacare have no directory to match their plans with available physicians. Provider networks are limited and Covered California customers say that they are having difficulty finding participating physicians, The Los Angeles Times reported.

As 1.2 million Californians get set to renew their policies and hundreds of thousands register for the first time, between Nov. 15 and Feb. 15, the number of doctors participating is in some instances being cut. The Affordable Care Act will see more clients under Covered California— which includes 10 insurers— but fewer choices of available doctors, according to the Times.

Some 80,000 physicians and other providers are participating. That represents about 90 percent of practicing doctors. However, not all doctors accept all health plans. Many are affiliated with only one or two.

Covered California directs clients to insurance company websites. Some consumers have belatedly discovered that their health providers are out of network and have been billed accordingly. Some doctors listed as participating turn out not to be. The California Department of Managed Health Care is investigating whether insurers misled consumers, the Times reported.

"It's been a low priority for insurance companies to maintain…provider directories, and states really aren't pushing back on narrow networks," said Sabrina Corlette, a research professor at Georgetown University's Center on Health Insurance Reforms, the Times reported.

The biggest California plans are Anthem Blue Cross, Blue Shield of California, Health Net, and Kaiser Permanente. Anthem and Blue Shield have racked up dozens of complaints. A revamp at Health Net will leave it with 54 percent less doctors and no reimbursement for out-of-network coverage. Anthem and Blue Shield have limited networks though Anthem has added doctors, according to the Times.

Narrow physician and hospital networks help keep costs down though on average premiums will increase in 2015 by 4.2 percent. While doctors make less money per visit in narrow networks they get to handle a larger volume of patients, the Times reported.

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Californians looking for a doctor who accepts Obamacare have no directory to match their plans with available physicians. Provider networks are limited and Covered California customers say that they are having difficulty finding participating physicians.
California, Obamacare
327
2014-37-29
Monday, 29 Sep 2014 07:37 AM
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