The uninsured rate

[ritaxis]

I don't want to take away from the success, such as it is, of the Affordable Care Act. But when they say that the uninsured rate has dropped this much or that much, it doesn't actually mean that the number of people who are getting medical care has risen this much or that much. Down here in the trenches it's still largely chaos. Many of us are nominally covered but aren't actually getting any actual health care covered due to network confusion and the difficulty of finding doctors and other practitioners who can be paid by our new insurance.

As for me, personally, that confusion has cost me at least five hundred dollars, if not seven hundred, as I followed through on medical care prescribed by a doctor who was in-network the day I signed up and who did not discover he was no longer in network until after I had had two visits, a raft of blood tests, and two months of prescriptions. Currently I no longer have a primary care doctor in network and I have another round of prescriptions due. I can renew them and pay for them without coverage (which is probably my best option), skip a month (which is not a viable option for at least two drugs), or I don't know what, because finding a new doctor will take a while.

Also: as an uninsured person who paid cash up front I had certain discounts I do not have as a nominally insured person.

A single payer system would not have done this to me. Just sayin'.

Comments

[randwolf.livejournal.com]

Is perhaps the pharmacy your prescriptions are at still part of the network? If so, you can just go to the pharmacy and ask for a renewal, and they will contact your doctor's office.

If not, can you can go to an in-network pharmacy, have the prescriptions transferred, and then if necessary have them renewed? Or your old doctor's office might be willing to write new ones as a courtesy and submit them to an in-network pharmacy, if you explain the situation.

And, yeah, it's a bad system. But perhaps you can work it in your favor.

[ritaxis.livejournal.com]

The pharmacy is in network, and the lab is in netwrok, but they're refusing to pay the lab because the doctor who ordered the tests is not in network and I expect them to refuse the medicine for the same reasoning. But I'm still on hold here so I haven't given up hope for some recourse.

[randwolf.livejournal.com]

Sounds like a reason to change your plan, come next open enrollment. Good luck. There is probably somewhere to appeal to at the state level as well, though likely that will take time. I have generally found that persistence pays off in dealing with the social insurance bureaucracy in California and Washington.

[randwolf.livejournal.com]

May I quote you over on Balloon Juice? I'd like to afflict the comfortable over there. Oh, and also, are you in a Medi-Cal plan or an Exchange plan?

[ritaxis.livejournal.com]

Hang on. Wait for a couple days because my story is changing quickly. Soon I will understand it better. But when I report back, please feel free to quote.

[randwolf.livejournal.com]

OK, I'll hold off.