Insurance with $20,000 Deductible?!

[Anonymous]

Cool thanks!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Some specialists---like child psychiatrists-- don't take insurance at all, as pp noted.

But Inova is a big system, I'm curious about the specialists who aren't in network. Because they sell this to their employees as more like an hmo and one of the selling points is how varied the network is.

Well....do a search on a specialty, and there will be (admittedly rare) instances where it comes up saying, "no in-network specialist."

Please provide us with an example of this, because so far I haven't found any specialties without providers in the Innovation network.

OP here. I will work on it. As I said, it's uncommon, but it does occur. I'll get back with an example.

I'm back. Here's one: urogynecologist. I have no idea what they would treat that a urologist or gynecologist would not, but if a customer needed that specialty, they would have to go out of network and pay the first $20,000 on their own. (Naturally, they wouldn't select this plan if they knew they needed that specialist, but things change....)

I have to go bsck to work and can't keep looking, but it has also been reported that psychiatrists is a common specialty missing from exchange plans, too. I don't know about this particular one. (Other than that single specialty I found, they DO seem to have robust coverage, and Innova is definitely a big system.)

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Some specialists---like child psychiatrists-- don't take insurance at all, as pp noted.

But Inova is a big system, I'm curious about the specialists who aren't in network. Because they sell this to their employees as more like an hmo and one of the selling points is how varied the network is.

Well....do a search on a specialty, and there will be (admittedly rare) instances where it comes up saying, "no in-network specialist."

Please provide us with an example of this, because so far I haven't found any specialties without providers in the Innovation network.

OP here. I will work on it. As I said, it's uncommon, but it does occur. I'll get back with an example.

I'm back. Here's one: urogynecologist. I have no idea what they would treat that a urologist or gynecologist would not, but if a customer needed that specialty, they would have to go out of network and pay the first $20,000 on their own. (Naturally, they wouldn't select this plan if they knew they needed that specialist, but things change....)

I have to go bsck to work and can't keep looking, but it has also been reported that psychiatrists is a common specialty missing from exchange plans, too. I don't know about this particular one. (Other than that single specialty I found, they DO seem to have robust coverage, and Innova is definitely a big system.)

None are listed under urogynecology, but they actually do have some in-network. For instance, there is Dr. Maria Canter in Reston, she's listed in the provider list under gynecology but she's actually a urogynecologist.

[Anonymous]

We have an Innovation Health Gold plan, 3 kids in good health. DH has some medical issues BUT everything so far has been in network for us. Typical well checks are $30 a visit specialists are $60 a visit.

Been on this plan for 2 years, never have we had to pay more than $1,500/year plus premium.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Some specialists---like child psychiatrists-- don't take insurance at all, as pp noted.

But Inova is a big system, I'm curious about the specialists who aren't in network. Because they sell this to their employees as more like an hmo and one of the selling points is how varied the network is.

Well....do a search on a specialty, and there will be (admittedly rare) instances where it comes up saying, "no in-network specialist."

Please provide us with an example of this, because so far I haven't found any specialties without providers in the Innovation network.

OP here. I will work on it. As I said, it's uncommon, but it does occur. I'll get back with an example.

I'm back. Here's one: urogynecologist. I have no idea what they would treat that a urologist or gynecologist would not, but if a customer needed that specialty, they would have to go out of network and pay the first $20,000 on their own. (Naturally, they wouldn't select this plan if they knew they needed that specialist, but things change....)

I have to go bsck to work and can't keep looking, but it has also been reported that psychiatrists is a common specialty missing from exchange plans, too. I don't know about this particular one. (Other than that single specialty I found, they DO seem to have robust coverage, and Innova is definitely a big system.)

Inova has an entire department listed under urogynecology department. But many of the specialists list themselves as colorectal surgeons because the procedures are generally pelvic surgeries.

[Anonymous]

Here is the department: https://www.inova.org/ifh/dept-ob-gyn/urogyn

BTW the specialty has only been around for a few years. The first certifications in the new subspecialty were given out in 2013. So most of the doctors who have been doing this work for 20-odd years are unlikely to have the credential next to their name.

[Anonymous]

Anonymous wrote:I still say we need to blow up the whole system - get rid of insurance companies would be top on my list of what should happen next.

My insurance company's CEO makes 3X more than any other insurance company CEO - and they have screwed us out of tons of money this year and continue to deny claims for my child's therapy services that are necessary.

There has to be a more sane way to deal with medical costs.

Yeah, it's called a single payer system so you can negotiate lower costs but SOCIALISM!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Some specialists---like child psychiatrists-- don't take insurance at all, as pp noted.

But Inova is a big system, I'm curious about the specialists who aren't in network. Because they sell this to their employees as more like an hmo and one of the selling points is how varied the network is.

Well....do a search on a specialty, and there will be (admittedly rare) instances where it comes up saying, "no in-network specialist."

Please provide us with an example of this, because so far I haven't found any specialties without providers in the Innovation network.

OP here. I will work on it. As I said, it's uncommon, but it does occur. I'll get back with an example.

I'm back. Here's one: urogynecologist. I have no idea what they would treat that a urologist or gynecologist would not, but if a customer needed that specialty, they would have to go out of network and pay the first $20,000 on their own. (Naturally, they wouldn't select this plan if they knew they needed that specialist, but things change....)

I have to go bsck to work and can't keep looking, but it has also been reported that psychiatrists is a common specialty missing from exchange plans, too. I don't know about this particular one. (Other than that single specialty I found, they DO seem to have robust coverage, and Innova is definitely a big system.)

The vast majority of psychiatrists do not take any insurance at all. Most people either go out of network or get psychiatric medication from their general practitioner.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Some specialists---like child psychiatrists-- don't take insurance at all, as pp noted.

But Inova is a big system, I'm curious about the specialists who aren't in network. Because they sell this to their employees as more like an hmo and one of the selling points is how varied the network is.

Well....do a search on a specialty, and there will be (admittedly rare) instances where it comes up saying, "no in-network specialist."

Please provide us with an example of this, because so far I haven't found any specialties without providers in the Innovation network.

OP here. I will work on it. As I said, it's uncommon, but it does occur. I'll get back with an example.

I'm back. Here's one: urogynecologist. I have no idea what they would treat that a urologist or gynecologist would not, but if a customer needed that specialty, they would have to go out of network and pay the first $20,000 on their own. (Naturally, they wouldn't select this plan if they knew they needed that specialist, but things change....)

I have to go bsck to work and can't keep looking, but it has also been reported that psychiatrists is a common specialty missing from exchange plans, too. I don't know about this particular one. (Other than that single specialty I found, they DO seem to have robust coverage, and Innova is definitely a big system.)

None are listed under urogynecology, but they actually do have some in-network. For instance, there is Dr. Maria Canter in Reston, she's listed in the provider list under gynecology but she's actually a urogynecologist.

Ah! You are as good a detective as I. I actually called her office to verify, and she said she does NOT accept that plan - she dropped it and they didn't update the directory. There was a other one, too - same situation - used to accept the plan. She dropped it. So that brings up another question. What if you're someone who needs a urogynecolgist, check the plan at the start of the year and you have a couple of options, but then they drop out. You are then left with no in-network option. The main point is that you can't count on all your health needs being paid for, even if you have insurance. That wouldn't be a problem for smallish expenses, but what if you needed surgery? Basically, you could buy insurance and still go bankrupt. That was something ObamacRe was supposed to fix.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Some specialists---like child psychiatrists-- don't take insurance at all, as pp noted.

But Inova is a big system, I'm curious about the specialists who aren't in network. Because they sell this to their employees as more like an hmo and one of the selling points is how varied the network is.

Well....do a search on a specialty, and there will be (admittedly rare) instances where it comes up saying, "no in-network specialist."

Please provide us with an example of this, because so far I haven't found any specialties without providers in the Innovation network.

OP here. I will work on it. As I said, it's uncommon, but it does occur. I'll get back with an example.

I'm back. Here's one: urogynecologist. I have no idea what they would treat that a urologist or gynecologist would not, but if a customer needed that specialty, they would have to go out of network and pay the first $20,000 on their own. (Naturally, they wouldn't select this plan if they knew they needed that specialist, but things change....)

I have to go bsck to work and can't keep looking, but it has also been reported that psychiatrists is a common specialty missing from exchange plans, too. I don't know about this particular one. (Other than that single specialty I found, they DO seem to have robust coverage, and Innova is definitely a big system.)

None are listed under urogynecology, but they actually do have some in-network. For instance, there is Dr. Maria Canter in Reston, she's listed in the provider list under gynecology but she's actually a urogynecologist.

Ah! You are as good a detective as I. I actually called her office to verify, and she said she does NOT accept that plan - she dropped it and they didn't update the directory. There was a other one, too - same situation - used to accept the plan. She dropped it. So that brings up another question. What if you're someone who needs a urogynecolgist, check the plan at the start of the year and you have a couple of options, but then they drop out. You are then left with no in-network option. The main point is that you can't count on all your health needs being paid for, even if you have insurance. That wouldn't be a problem for smallish expenses, but what if you needed surgery? Basically, you could buy insurance and still go bankrupt. That was something ObamacRe was supposed to fix.

As I mentioned above, typically PPO plans have an appeals process to get in-network reimbursement rates for out-of-network providers if there truly are no providers in-network. A different pp mentioned Inova having an entire uro-gyn department, which I haven't looked into, but that might also be a good starting point if you needed to find one.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Some specialists---like child psychiatrists-- don't take insurance at all, as pp noted.

But Inova is a big system, I'm curious about the specialists who aren't in network. Because they sell this to their employees as more like an hmo and one of the selling points is how varied the network is.

Well....do a search on a specialty, and there will be (admittedly rare) instances where it comes up saying, "no in-network specialist."

Please provide us with an example of this, because so far I haven't found any specialties without providers in the Innovation network.

OP here. I will work on it. As I said, it's uncommon, but it does occur. I'll get back with an example.

I'm back. Here's one: urogynecologist. I have no idea what they would treat that a urologist or gynecologist would not, but if a customer needed that specialty, they would have to go out of network and pay the first $20,000 on their own. (Naturally, they wouldn't select this plan if they knew they needed that specialist, but things change....)

I have to go bsck to work and can't keep looking, but it has also been reported that psychiatrists is a common specialty missing from exchange plans, too. I don't know about this particular one. (Other than that single specialty I found, they DO seem to have robust coverage, and Innova is definitely a big system.)

None are listed under urogynecology, but they actually do have some in-network. For instance, there is Dr. Maria Canter in Reston, she's listed in the provider list under gynecology but she's actually a urogynecologist.

Ah! You are as good a detective as I. I actually called her office to verify, and she said she does NOT accept that plan - she dropped it and they didn't update the directory. There was a other one, too - same situation - used to accept the plan. She dropped it. So that brings up another question. What if you're someone who needs a urogynecolgist, check the plan at the start of the year and you have a couple of options, but then they drop out. You are then left with no in-network option. The main point is that you can't count on all your health needs being paid for, even if you have insurance. That wouldn't be a problem for smallish expenses, but what if you needed surgery? Basically, you could buy insurance and still go bankrupt. That was something ObamacRe was supposed to fix.

As I mentioned above, typically PPO plans have an appeals process to get in-network reimbursement rates for out-of-network providers if there truly are no providers in-network. A different pp mentioned Inova having an entire uro-gyn department, which I haven't looked into, but that might also be a good starting point if you needed to find one.

To go to the broader point, though, none of these things we're talking about are a result of Obamacare. They were all issues before Obamacare, there just wasn't a critical mass of people paying attention to these issues before Obamacare. Obamacare focused the public's attention on the flaws in our for-profit health insurance system, and people are mistakenly attributing them to Obamacare (and assuming they'd go away if Obamacare was repealed) rather than appreciating that they were pre-existing problems that Obamacare simply didn't solve.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OMG, it's going from bad to worse. One of the so-called "affordable" exchange plans is promoting itself as a PPO - with out of network benefits. Drill down, and you'll see they'll pay for 50% of out of network benefits only after you have met a separate deductible of $20,000! And that's for an individual - a family has a deductible of $40,000. Plus, they admit that they do not necessarily have every specialty in network, and you could be forced out-of-network. At the same time, a low-income person gets their insurance free, no premiums.....no deductible.....no co-pays. This entire legislation is a travesty - and seems to have been designed to demolish the middle class.

Seriously , Ive only talked about this Travesty the last 2 years. I'm not in DC. It's been this way the whole time for other parts of the Country.
Yes, Obumma designed it to demolish the middle class. What took you so long to come to the realization is the scary part. It's part of the reparations that Blacks have been talking about for so long. Ass wipe HRC is pushing ACA hard to maintain freebies for the Blacks and Latinos. It will get much worse under her administration before it gets better. All us Middle Class will end up in Bankruptcy at some point, making the elite all the more powerful. You can't fault Romney for telling the truth. We've reached the tipping point where more people receive Freebies in the electorate. They will continue to vote for Candidates that maintain Freebies.

The best we can hope for is that Trump wins, dies from a stroke and Ivanka takes over, LOL

#NeverHillary

This has to be one of the dumbest ass - dumb ass things I have ever read.

- Plenty of Black people in the Middle class

- Plenty of Black people who are Upper Middle class and Wealthy

- If you think the President is only interested in helping black people it would be rather dumb for the President to design a program that is designed to destroy the middle class when there are middle class black folk who would get crushed in the process.

- What are these mysterious, magical freebies black people getting ? I'm black, only freebie I have received lately was a dunking donuts gift card my boss passed along because she does not eat donuts.

-If you are worried about Obama destroying you. Were you pissed Wall Street when they destroyed the housing market and Pres. Bush designed TARP to save their asses?

- were you upset with the insurance companies BEFORE ACA when their premiums and coverage denials were devastating families(MIDDLE CLASS FAMILIES) leaving many without insurance and facing catastrophic medical debt?

- Are you mad at Trump because he's NOT BEEN PAYING TAXES all these years when your middle class ass was?

- Do you know what the fuck reparations even means? Not much of a system if I have to be sick IN ORDER TO GET THEM!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The whole point of that plan is to leverage Inova's local presence for maximum benefit. You don't buy that kind of plan to go out of network. It's like being mad that your car can't cross a lake.

lol, this. The person who started this thread is stupid. You don't look at an out of network deductible for a plan like this. Duh.

You are the stupid one. (I can't believe the way people who don't understand the shortcomings of Obamacare throw insults around.) The problem is there are real failings with Obamacare. They have limited in-network providers, and customers are not really fully insured because THEY DO NOT HAVE ALL SPECIALISTS IN NETWORK. It makes it appear that as long as you stay in-network, you'll be fine, but you don't always have that option.

That's the way it always works with insurance or are you new to acquiring insurance?

[Anonymous]

Anonymous wrote:Some specialists---like child psychiatrists-- don't take insurance at all, as pp noted.

But Inova is a big system, I'm curious about the specialists who aren't in network. Because they sell this to their employees as more like an hmo and one of the selling points is how varied the network is.

AND HAVE ALWAYS BEEN LIKE THIS

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Some specialists---like child psychiatrists-- don't take insurance at all, as pp noted.

But Inova is a big system, I'm curious about the specialists who aren't in network. Because they sell this to their employees as more like an hmo and one of the selling points is how varied the network is.

Well....do a search on a specialty, and there will be (admittedly rare) instances where it comes up saying, "no in-network specialist."

Please provide us with an example of this, because so far I haven't found any specialties without providers in the Innovation network.

OP here. I will work on it. As I said, it's uncommon, but it does occur. I'll get back with an example.

I'm back. Here's one: urogynecologist. I have no idea what they would treat that a urologist or gynecologist would not, but if a customer needed that specialty, they would have to go out of network and pay the first $20,000 on their own. (Naturally, they wouldn't select this plan if they knew they needed that specialist, but things change....)

I have to go bsck to work and can't keep looking, but it has also been reported that psychiatrists is a common specialty missing from exchange plans, too. I don't know about this particular one. (Other than that single specialty I found, they DO seem to have robust coverage, and Innova is definitely a big system.)

My urogynocologist is in-network