Insurance with $20,000 Deductible?!

[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.)

My urogynocologist is in-network

On the Inova exchange plan? Or off-exchange? The identical plan sold off the exchange often has a wider network.

[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.)

Here's the problem, OP. You said:

I'm the OP and I am back. No....it doesn't say on that form that they are missing specialists. But I know from experience that many plans - including this one - do. Congress knows as well, as there have been numerous complaints from exchange customers that the specialist they need is not in network. It actually pretty commonplace, and a REAL problem, but Obama is burying it. Still trying to hide how much damage he's done.
http://khn.org/morning-breakout/in-network-access-to-specialists-not-always-available-on-some-obamacare-plans-study-finds/

Then you say you needed to do "research" and came up with an obscure specialty area that you state you aren't familiar with, and then PPs found multiple instances of that being covered.

So, do you actually have experience with not being able to get in-network care on your specific ACA plan, or not?

Because it really sounds like not.

So, you're either lying or distorting something for your own purposes.

[Anonymous]

but, are you saving $2,500/yr and did you get to keep your doctor?

I'm actually glad they finally passed it, so I could finally get to read it. I couldn't before it passed.

[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.)

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.

That just shows how Obamacare screwed up the individual insurance marketplace. The urogynocologists listed under that Inova Urology Department don't accept the Aetna+Inova health insurance plan. Crazy, I know!

Basically, Obama destroyed the individual insurance market for the middle class. There is no choice, and what remains are wildly overpriced plans with high deductibles, leaving customers to pay for everything themselves anyway.

[Anonymous]

I thought there were subsidies up to families making around 97,000$... Am I wrong?

[Anonymous]

I got my ACA Open Enrollment email today

They had the gall to tell me that "most people find a plan for $50 to $100 per month".

Really? Some one is going to save me 600 bucks a month? Where?

[Anonymous]

Anonymous wrote:I thought there were subsidies up to families making around 97,000$... Am I wrong?

Don't know about families, but subsidies are available up to around $48k individual and $63k a couple. Thr insurance is very high to offset the free plans to the lower-income, and can run $800 for a silver. That's per person. So a couole earning $70k - pretty tight in the Dc region - would have to pay around $18,000 in premiums, plus deductibles of around $5000 each. So conceivably, a couple could have medical expenses of $28,000 (in a bad year) - or more than half their income after taxes. And THIS is what Oboma calls "affordable" care?

[Anonymous]

After reading many of these postings, all I can say is VOTE TRUMP.
Clinton will do nothing - NOTHING - to bring down the cost of insurance.

[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.

I just went onto the exchange and put the first seven names from the Urogynecology department into the system. Innovation health plan contains four of them.

[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.

I just went onto the exchange and put the first seven names from the Urogynecology department into the system. Innovation health plan contains four of them.

They dropped out of the insurance, and the directory was never updated. I called the insurance company and asked for the names of uro-gyns, and she checked her updated list.....and told me they have none.

[Anonymous]

Anonymous wrote:

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.

I just went onto the exchange and put the first seven names from the Urogynecology department into the system. Innovation health plan contains four of them.

They dropped out of the insurance, and the directory was never updated. I called the insurance company and asked for the names of uro-gyns, and she checked her updated list.....and told me they have none.

I think you do not understand something. Urogynecology is a certification that has been around only three years. So the really experienced people in the field are mostly going to be listed as colorectal surgeons.

But hey, if you really want the biggest list of providers, get the Carefirst Blue Cross Blue Shield plan. All of the names I put in are listed under the Exchange plan for BCBS.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

I just went onto the exchange and put the first seven names from the Urogynecology department into the system. Innovation health plan contains four of them.

They dropped out of the insurance, and the directory was never updated. I called the insurance company and asked for the names of uro-gyns, and she checked her updated list.....and told me they have none.

I think you do not understand something. Urogynecology is a certification that has been around only three years. So the really experienced people in the field are mostly going to be listed as colorectal surgeons.

But hey, if you really want the biggest list of providers, get the Carefirst Blue Cross Blue Shield plan. All of the names I put in are listed under the Exchange plan for BCBS.

I appreciate your input on this....but, Carefirst is not available where I live - only Anthem. There is way too little choice when it comes to buying is insurance - restricted by location - but that's another issue (and I realize not new to Obamacare).

But what you say about colorectal surgeons is encouraging, and I'll do more research as it applies to the urogyne certification. It is confusing, though, since some doctors are listing themselves as urogynocologists, and it sounded like a separate specialty.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I thought there were subsidies up to families making around 97,000$... Am I wrong?

Don't know about families, but subsidies are available up to around $48k individual and $63k a couple. Thr insurance is very high to offset the free plans to the lower-income, and can run $800 for a silver. That's per person. So a couole earning $70k - pretty tight in the Dc region - would have to pay around $18,000 in premiums, plus deductibles of around $5000 each. So conceivably, a couple could have medical expenses of $28,000 (in a bad year) - or more than half their income after taxes. And THIS is what Oboma calls "affordable" care?

I just ran the calculator for Maryland, and a couple can get a silver plan for $418 per month, an annual deductable of $4400 and an out of pocket maximum of $7150. That's for both people, not per person.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I thought there were subsidies up to families making around 97,000$... Am I wrong?

Don't know about families, but subsidies are available up to around $48k individual and $63k a couple. Thr insurance is very high to offset the free plans to the lower-income, and can run $800 for a silver. That's per person. So a couole earning $70k - pretty tight in the Dc region - would have to pay around $18,000 in premiums, plus deductibles of around $5000 each. So conceivably, a couple could have medical expenses of $28,000 (in a bad year) - or more than half their income after taxes. And THIS is what Oboma calls "affordable" care?

I just ran the calculator for Maryland, and a couple can get a silver plan for $418 per month, an annual deductable of $4400 and an out of pocket maximum of $7150. That's for both people, not per person.

Without subsidies? (And for a middle-aged couple?) The silver plans in Virginia for a 60-year old couple are about $750 to $850 a month EACH.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I thought there were subsidies up to families making around 97,000$... Am I wrong?

Don't know about families, but subsidies are available up to around $48k individual and $63k a couple. Thr insurance is very high to offset the free plans to the lower-income, and can run $800 for a silver. That's per person. So a couole earning $70k - pretty tight in the Dc region - would have to pay around $18,000 in premiums, plus deductibles of around $5000 each. So conceivably, a couple could have medical expenses of $28,000 (in a bad year) - or more than half their income after taxes. And THIS is what Oboma calls "affordable" care?

I just ran the calculator for Maryland, and a couple can get a silver plan for $418 per month, an annual deductable of $4400 and an out of pocket maximum of $7150. That's for both people, not per person.

Not possible - unless you're talking about a lower-income couple (or very young couple) heavily subsidized the middle class. I just ran it for a middle-aged couple in Virginia, earning $75k. The cost for a silver plan is $1360 a month, with a $5600 deductible before insurance kicks in, and an max OOP of $13,000.

Please face the facts, people. If you are are moderate earner (as opposed to low), Obamacare has made health care unaffordable! There is no way a moderate-earning couple can pay $15,000 a year in premiums PLUS as much as $13,000 in medical expenses. This whole thing was a way to provide free or cheap insurance to the lower income, paid for by the middle