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Ultra-narrow health care networks could be next big Obamacare controversy
Biz Journals ^ | 20 November 2013 | Chris Rauber

Posted on 12/05/2013 9:23:14 PM PST by Lorianne

The next big Obamacare-related controversy in California could well involve ultra-narrow doctor and hospital networks — many limited by county, some even restricted by zip code — that will be available under some policies sold through the Covered California exchange.

The problem seems most acute with Blue Shield.

"If the policyholder (in Marin or Alameda County) crosses the Golden Gate Bridge or Bay Bridge to consult with a San Francisco PPO doctor, (he or she) will have no insurance,"

"If a San Francisco resident moves to Alameda, (she) will not be able to keep her San Francisco doctors," she said.

Richard Brounstein, a financial consultant who lives in Fremont and wants to be able to see doctors at the Palo Alto Medical Foundation's satellite office there, says he can't sign up for Blue Shield of California's Alameda County offerings because of the zip code he lives in.

"I can't get Blue Shield even if I want it," Brounstein said. "I can only sign up for Anthem Blue Cross," which doesn't contract with his Fremont doctors.

"Blue Shield stated that all enrollees must reside near a participating Blue Shield-Covered California hospital,"

(Excerpt) Read more at bizjournals.com ...


TOPICS: Business/Economy; US: California
KEYWORDS:
Good grief, what a mess.

What if you want to see doctors who are closer to your work than where you live?

1 posted on 12/05/2013 9:23:14 PM PST by Lorianne
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To: Lorianne

“What if you want to see doctors who are closer to your work than where you live?”

Sorry about that...

What about when you travel for business or pleasure? Better not get sick or have an accident.

CC


2 posted on 12/05/2013 9:28:42 PM PST by Captain Compassion
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To: Lorianne

Too bad if you have one of these Obama Junk policies.


3 posted on 12/05/2013 9:36:25 PM PST by proudpapa (A school is supposed to be a safe place!' Yeah well so is a womb!)
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To: Lorianne

Obamacare had one goal: break the system to usher in single payer. But the donks jumped the shark on this one.


4 posted on 12/05/2013 9:36:44 PM PST by piytar (The predator-class is furious that their prey are shooting back.)
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To: Captain Compassion

True emergency care is always covered everywhere in the U.S.


5 posted on 12/05/2013 9:37:17 PM PST by steve86 (Some things aren't really true but you wouldn't be half surprised if they were.)
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To: steve86

“True emergency care is always covered everywhere in the U.S.”

Yes, but a life-threatening illness isn’t. You can go to the ER if you think you are having a heart attack, but you can’t get ongoing Prostate or Breast Cancer treatment that same way.


6 posted on 12/05/2013 9:43:19 PM PST by vette6387
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To: Lorianne
What if you want to see doctors who are closer to your work than where you live?

Some woman who lives in San Diego has been getting treated for a nasty form of cancer for about 7 years. Usually has a 2 year life expectancy.

For regular medical treatment, she goes to the UCSD Medical Center, which is local to her. For her cancer, she uses Stanford University Hospital. Her insurance covers BOTH institutions. That is - UNTIL NOW ...

After Obamacare kicks in - she has to CHOOSE between the two facilities since they ARE NOT on the same network.

EITHER go local for the convenience of NOT having to drive all day to get treated [and foregoing her cancer specialists]. OR, drive all day for treatment of EACH AND EVERY ailment ...

7 posted on 12/05/2013 9:44:03 PM PST by Lmo56 (If ya wanna run with the big dawgs - ya gotta learn to piss in the tall grass ...)
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To: Lorianne

And suppose, just suppose...you’re on a trip. To another state. Not even; maybe just another county in your own state.

You got no coverage.

Ambulance ride to your doc?

Ambulance rides, as far as I know, are not now covered by medicare. Don’t know if they are or are not under 0care.

And they’re gonna drive you to your home hospital? Sure they will.


8 posted on 12/05/2013 10:19:16 PM PST by Attention Surplus Disorder (At no time was the Obama administration aware of what the Obama administration was doing)
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To: piytar

Single payer might be his goal or.....a complete planned out 100% detonation of the existing health care system as 100 million people are now or soon to be without their previous policies. So bad that within the next 12 months there will be folks in the streets with guns. Once that happens it is Martial Law and game over. I don’t put anything passed the muslim boy as he follows the orders of his NWO puppet masters. They want a full societal ‘re-set’....this could be it.


9 posted on 12/05/2013 10:33:17 PM PST by bobby.223 (Retired up in the snowy mountains of the American Redoubt and it's a GREAT life!)
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To: steve86

Define “emergency”. We have this now. Most hospitals have emergency rooms.

CC


10 posted on 12/05/2013 10:34:54 PM PST by Captain Compassion
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To: Lorianne

this is what people who ane no experience in insurance or even running a business of any kind, do when they attempt to implement an extremely complex and massive project.

they don’t have the depth to make it work and fix the inevitable problems that arise.

they believe it’s like a movie montage, where the whiz kids have a big project to puill off, and then the music starts, and you see the quick cuts of them doing “work”, looking frustrated, then solving something, then finally getting the thing to work, and they think this is all they need to do.


11 posted on 12/06/2013 12:17:28 AM PST by Secret Agent Man (Gone Galt; Not averse to Going Bronson.)
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To: Secret Agent Man

More than a few believe this fiasco is not due to ineptness or of necessarily experience deprived facilitators, but quite the opposite. An intentional fail, of course, could be the aim, to break the insurance industry entirely and then call foul against any mix of government and profit bearing interests. Thus, the government incinerates the insurance industry, having cleared the path for government sponsored single payer healthcare.

The insurance industry evaporates and one sixth of the American economy falls into the hands of government.


12 posted on 12/06/2013 3:59:52 AM PST by RitaOK ( VIVA CHRISTO REY / Public education is the farm team for more Marxists coming.)
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To: Lmo56
OR see if it is illegal for the insurance company to cancel your insurance policy (if applicable to her situation, trumps Obamacare):

http://csteventucker.wordpress.com/2013/11/13/the-truth-about-preexisting-conditions/

HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 (Public Law 104-191 104th Congress)

SEC. 2742. GUARANTEED <> RENEWABILITY OF INDIVIDUAL HEALTH INSURANCE COVERAGE.

13 posted on 12/06/2013 5:14:29 AM PST by MissMagnolia (You see, truth always resides wherever brave men still have ammunition. I pick truth. (John Ransom))
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