Health exchange insurance plans/obamacare: Any difficulties getting treatment?

[Dr. Orly Avitzur]

I am a neurologist and medical writer interested in hearing about the patient perspective.

If you have enrolled in an Obamacare plan/health exchange insurance plan, what has been your experience?

Are you having any difficulty finding a neurologist or getting your medications covered?

I am considering writing a story on this subject for Neurology Now.
If you have a situation that fits this description, please contact me at dravitzur@earthlink.net

Thank you!

[Mike Weins]

Dr. Avitzur has permission to post here at BT as an "authorized researcher" Check out her website if you'd like to know more about her. Only registered and activated users can see links., Click Here To Register...

[Lazarus]

Just a note about your wording....

The wording of your questions, in the subject line as well as within the body of the question, seems to invite responses from those who have had difficulties. I think that might skew the responses you get.

[Cherie]

I have not had any problems but have opted to continue to pay for private insurance at a real premium in cost. However, as an MS Certified nurse, I am hearing from people all over the country that their MS Neurologists have been taken off "preferred provider" lists and they cannot see an MS neurologist with their new healthcare plan. I am also hearing this from people on Medicaid in various States.

[Parsi]

When I checked the list, several were there. But when the question of who accepted new patients the results turned up none found

[newone]

I had my own private insurance. Unfortunately, it was cancelled due to the ACA and I purchased another private individual policy with the same carrier. It is more expensive,is more restrictive and the maximum out-of-pocket is higher. Several of my medications are no longer covered. I am quite concerned if copaxone goes generic that the insurer will no longer cover the 20mg brand copaxone as well.

[Earth Mother 2 Angels]

My son is a Medicaid patient, and long before the ACA became law, neurologists in our area refused to treat him in their office. They treated him during his hospitalizations, because that was required of them by the hospital as part of their privileges. But outside of the hospital, we were on our own. My son's PCP prescribes all anti-seizure meds and orders and interprets all blood levels on them.

We have at least a dozen neuros in our area, but to find one, who would treat Jon, we would have to travel at least 20 miles to a run down, unsafe neighborhood. Last year, my friend's son was at the mercy of one of these neuros, who would not admit her son, when he was clearly in status. When he was finally admitted to our hospital, evidently none of the on call neuros were interested in helping him. He died 8 months later. Still in status, still improperly medicated, dehydrated, and unable to accept nutrition.

The overreaction to the ACA is already affecting Jon's care. We have had major dust ups with medical suppliers for his respiratory supplies. Jon's home health nurse has shared with us that the hospital isn't admitting patients unless they are "at death's door," and home health nurses are now turning into ICU nurses.

We pay privately for a house call from a podiatrist every 6 weeks. And soon, we'll pay privately for a GI doc to make a house call to change Jon's G Tube. We have paid privately for Jon's major equipment needs: his alternating pressure mattress, hospital bed, electric lift, pulse ox, as well as a generator to keep that equipment operating during a power outage. We buy our own gloves by the case, all of Jon's underpads, syringes, a long list of items, which Medicaid will not cover, or will not cover adequately.

For anyone, who might mistakenly think that Medicaid is a free ride, I just wanted to clarify that it certainly is not. And if Jon didn't have us to provide for those needs, which Medicaid doesn't or does poorly, then I guarantee you, Jon wouldn't still be here physically on this planet.

I haven't had health insurance since I lost my outside job in 1985. I was denied private insurance, when I was finally able to afford the least coverage available, because of a pre-existing condition. So imagine how excited I am to finally be eligible for Medicare!

Thank God that I didn't have a catastrophic illness during these last 30 years without health care coverage. If I had, we would have lost our home and all of our assets. That is what happens to many people, who have health insurance, and to everyone who doesn't.

I'm sure that the ACA has many glitches, because ... well, let's face it ... what doesn't? At least it is a start. And if, at any time, in the past 30 years, the ACA passed and made it possible for me to have health insurance, I would have jumped for joy and not been as terrified of aging.

If you have the money, and can afford Cadillac insurance, then you're blessed. But, if you are barely scraping by, but aren't quite poor enough to qualify for Medicaid, some insurance is better than no insurance. That is likely the case in all countries, which provide some form of universal health care to its citizens.

It's the "Affordable Care Act," which means that insurance companies, medical suppliers, hospitals, medical corporations, pharma, will all be scrambling to find ways to make it profitable to them. Blame your insurer if your rates are raised or the quality of your coverage is reduced. That is the company's reaction to the ACA and their greed to recoup perceived losses. They are in it for the money, not because they care about you, which they do not.

Anyone, who feels that they are being abused by the ACA should speak up and protest. Write to your Congressional Representatives and Senators and President Obama with your complaints and concerns. Remember that they work for us, not the other way around. Laws require fine tuning. Democracy isn't static; it's dynamic. Let your voice be heard.

Love & Light,

Rose

[newone]

Cadillac plans are even offerded for individual coverage in my state. Of course, I wouldn't most likely be able to afford it. The plan I have now costs $1000 per month, has a high deductible and a higher out-of-pocket max and as I said before, it covers less than I previously had....

[newone]

PS I suspect the carrier I am with (and have been for over 30 years) would be pleased if I went to another carrier - of course, it's my understanding that I can't do that until next January...