Medical homlessness

[B2G]

ConsumerWatch: Some Covered California Patients Say They Can’t See A Doctor

April 18, 2014 7:46 PM

MOUNTAIN VIEW (KPIX 5) – While open enrollment for coverage under the Affordable Care Act is closed, many of the newly insured are finding they can’t find doctors, landing them into a state described as “medical homelessness.”

Rotacare, a free clinic for the uninsured in Mountain View, is dealing with the problem firsthand.
Mirella Nguyen works at the clinic said staffers dutifully helped uninsured clients sign up for Obamacare so they would no longer need the free clinic.

But months later, the clinic’s former patients are coming back to the clinic begging for help. “They’re coming back to us now and saying I can’t find a doctor, “said Nguyen.
Thinn Ong was thrilled to qualify for a subsidy on the health care exchange. She is paying $200 a month in premiums. But the single mother of two is asking, what for?

“Yeah, I sign it. I got it. But where’s my doctor? Who’s my doctor? I don’t know,” said a frustrated Ong.

More at link:

http://sanfrancisco.cbslocal.com/2014/04/18/consumerwatch-some-covered-california-patients-say-they-cant-see-a-doctor/

[GeorgeGist]

1. The comments section makes me wanna puke ...

which is probably why this tripe was published.

[B2G]

2. This part is concerning

"More than 3 million Californians are newly insured. At the same time, a third of our primary care doctors are set to retire."

[oneofthe99]

11. Finding a primary care doctor who accepts new patients is a joke

I've had the same primary doctor for 12 years so I'm fine but my sister is searching for one that accepts new patients and her insurance.

The closest one she found was a 60 minute drive. I realize that's not the end of the world but in real terms that's
close to 70 highway miles away from where she lives. Mine is a 10 minute drive.

but I guess at least she found one

[Hoyt]

3. Sounds like primary care docs in red states have an opportunity to move.

[MineralMan]

4. In-network doctors are listed in the materials

sent to those who enroll. It can be tough, but a few phone calls should result in an appointment.

[B2G]

6. That's what I don't understand

The woman in the article who works at the clinic states:

"Nguyen said the newly insured patients checked the physicians’ lists they were provided and were told they weren’t accepting new patients or they did not participate in the plan."

[MineralMan]

8. Interesting. I believe I'd be talking to whatever insurance

company I was paying premiums to and getting them to find me a doctor. If they did not, I'd start contacting others.

[oneofthe99]

13. The insurance company has no obligation to find a doctor who accepts new patients

Their list is who accepts their insurance .

That is where their obligation ends

[MineralMan]

17. They have no obligation, but they're likely to help.

Depends on the company, of course, but I've found my insurance company helpful when I've called them. In fact, BC/BS of Minnesota has a very helpful customer support system. Their website also has up-to-date lists of network providers. Here in Minnesota, the larger multi-specialty clinics are pretty much all network providers, and they all accept new patients. Once you're one of their patients, same-day appointments are almost always available, as well, and most also operate urgent care facilities, usually at one of their clinics, for after-hours visits.

The Minneapolis St. Paul area is probably similar to most urban metro areas, in that multi-specialty clinics are common, and are by far the best place for primary care service. Since you can be referred within their clinic, and since most clinics have labs and imaging facilities, you pretty much end up with a one-stop medical service center. In most such clinics, you have a primary care physician who sees you each time for normal visits. I chose my own, after trying a couple at the clinic.

Now, I don't know where the person mentioned lives in California, so I don't know what the clinic situation is there, but if it's in an urban metro area, I'm sure there are many such clinics. The old days of the private practice primary care physician are fading fast, so it's unrealistic to expect that service with most insurance.

That will probably be the solution for that patient. There is almost certainly a clinic that will see him or her. It may not be as nearby as he or she might prefer, but there will be something. A call to the insurance company will help that person find one. Customer service often acts as a referral source.

Not every story has all of the information in it. I suspect that is the case here.

[B2G]

18. The linked story is in Mountainview, CA

which is in the Silicon Valley, near San Jose. I'm very familiar with the area, as I lived there for years and my oldest was born in Mountainview Hospital.

It's a very urban, progressive area. That doesn't bode well for smaller communities.

[MineralMan]

20. Well, if I knew what insurance company that person's insurance

was with, I'm sure I could find multi-specialty clinics who are in network and accepting new patients. I know Mountain View and the surrounding communities. Such clinics are common in that area.

However, even in smaller communities, the clinic environment is becoming the standard way health care is delivered. I suspect that we do not know everything about this particular situation, and the story isn't all that forthcoming with information.

[oneofthe99]

12. Yes that is the case , they can be on the list that they accept the insurance but they don't accept

new patients, very common

[B2G]

15. It sounds like some of them

shouldn't have been on the list in the first place.

[oneofthe99]

16. I believe it is just automatically put on the list by the insurance company

if the practice accepts their insurance.
My sister spent all day calling until she finally found one .

That would be tough for someone where their isn't reliable public transportation and they didn't have a car.

[Sunlei]

7. my 'in network' Doctors name is printed right on my insurance card as the ACA required in Texas.

It's also in several places in the one inch thick 'contract' I made the insurance company mail me. (they spent 8.00 to fedex that to me)

I'm not going paperless until I am sure I want to stick with this 'in network' Doctor and his huge clinic. The clinic is one of the large 'Urgent Care' 'for profit' clinics we have in Texas near Houston.

[B2G]

9. Do you have to get a new card

and contract if you change doctors? Never heard of a specific doctor being printed on an insurance card before. And can you go to others, or do you have to go to just him?

[Sunlei]

14. The Doctor is considered the gateway place I go for check-ups, exams. I have not needed a Doctor yet

I can change Doctors, there is a list but the contract says to call and ask. This was the least expensive silver plan, I pay about 75 a month and have paid 4 months payments. from Jan 1st. It is just good to have insurance now in case of disaster

If I don't like that Doctor or clinic, I will change to a plan that I saw allows many Doctors and even pays half for out of state, out of 'network' Doctors. But that one was about 170 a month

How to change ACA insurance? Enrollment opens again in November? then its allowed to change OR its easy to change plans on the ACA website if you meet some easy 'requirements'.

I'll 'move' out of the network area (wink wink) or use one of the other 'easy' ways to change Doctors.

I'd get in touch with the help directly on the ACA website, healthcare dot gov if any of these insurance companies try to make anything difficult. good luck, again it is nice to have 'insurance' just in case.

p/s edited to place in. I assume if the Doctor finds anything needing a specialist, they will refer. I live in Houston and we have many fine specialists here.

[Sunlei]

10. The clinic Doctors should call ACA and ask to become 'in network' care Doctors & get the Federal

money that is going to Blue Cross or Humana Corps.

[Ron Green]

19. Here's what's bullshit: Networks, open enrollment,

"bronze" and "gold," copays, deductibles.

Here's what's not: Health Care for all; everybody in and nobody out.

[B2G]

21. Many have noted that

health insurance is not healthcare. And availability of prescriptions is a whole other topic, one that's been addressed a lot here.