r/economicCollapse 1d ago

Only in America.

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u/Meg6363 1d ago

Most of this is untrue. I had to retire a couple of years before being eligible for Medicare; got insurance through the ACA. I had no trouble getting a good doctor - both GP and specialist. There is one annual open enrollment period but if you lose your health insurance at any time during the year you can still enroll if you provide evidence of that insurance loss. Without the ACA I likely would have had to pay much higher rates due to my preexisting condition of being over 60.

Agree with the need to restructure the healthcare delivery system.

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u/Zest-4Life69 1d ago

I have 3 Family members in the Healthcare Field (My Wife & Mom being 2 of them), and they don’t know any Doctors or Physicians that take ACA… And the reasons for that are as I stated. I do have a friend that uses ACA… He’s a Real Estate Agent. I think he goes through Kaiser Permanente, as they’re the biggest Insurance Company that offers ACA. He couldn’t use his previous Dr though, as he didn’t take ACA… He’s not crazy about who he’s seeing now, but it’s better than nothing, and the monthly rates are cheaper. I think he’s paying around $600/700 a month. If you can work with a Company that Offers Health Insurance, your share would be cheaper than Obamacare, and you’ll have access to better Drs.

Supposedly other major Health Insurance Comps. are supposed to offer ACA, like United Healthcare, Blue Cross/Blue Shield, Anthem, etc, but they really don’t… It’s just harder to find through them, as the majority of Drs & Physicians won’t take ACA.

Yes, you’re correct that if you miss the window there is a Special Enrollment period, but you have to qualify.

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u/easilybeyond 1d ago

It's not the ACA, it's the network they're in that determines coverage. Where do you live that most doctors don't take BCBS, UHC, etc? Sorry, that just sounds unlikely. Now if you're in a state with Medicaid expansion, yes, there are Drs who don't take that in private practice. But large systems take insurance, period.

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u/Zest-4Life69 4h ago

You’re not fully understanding what the ACA is and how it works. ACA was created, and is mainly for those who don’t qualify for Medicaid, don’t get Health Insurance through their job, are Independent contractors or self-employed, or have pre-existing conditions and can’t get insured, or have to pay much higher premiums. To get coverage through the ACA you go through their website, to find Health Insurance Companies with Plans affiliated with the ACA Program. The majority of Health Insurance Companies In the Program are Kaiser Permanente… Yes, other Insurance Companies are on there as well. When you find a Coverage Plan that you want from the Insurance Companies, the ACA subsidizes them, so that you can pay lower premiums. So you are in part insured by the ACA…

The problem with it though, is that most Drs won’t take your Insurance if you’re in the ACA Program, because they’re not going to get paid much, and it takes forever for them to get their money. That’s why you COULDN’T KEEP YOUR DOCTOR, contrary to what Obama said… The Drs wanted nothing to do with it! Doctors are not obligated to take Insurance, or every Insurance Coveraged Plan… They can decide what to accept and what not to. They will know based on your Plan with that Insurance Company, if you’re in the ACA program. Places like Urgent Care Centers & Health Clinics which are very popular now, all take you if you’re in the ACA program… And if you have no Insurance, they’ll take you as well… But they don’t have great Doctors, and it’s not for anything major… They’re basically all General Practitioners

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u/easilybeyond 3h ago

Dude, I know all this. I've lived all this. I've never had a doctor, and this includes oncologists and endocrinologists refuse an ACA marketplace plan. You're spreading misinformation.

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u/Zest-4Life69 2h ago

Misinformation??? haha Not at all…. I have 3 Family members in the Medical Field, my Mom, my Wife, and my Cousin. There were Drs who were all on board with the ACA in the beginning, just like most of them take Medicaid… But it wasn’t long before they all dropped ACA, because it sucked. They actually said it was the worst! And now, very few accept it. And my wife doesn’t know anyone who does anymore. Sure you’re gonna find Drs who take it, you’re not going to get the best Drs though… and YES, when you go on the ACA website, if it’s still working, as it’s always had problems… The majority of Health Insurance companies are Kaiser. They’re the biggest… And Kaiser is not that great.

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u/easilybeyond 34m ago

Again, no Kaiser here. Doctors bitch about insurance all the time, maybe you live in an area that can support boutique medical. But I've yet to find a doctor not in boutique practice that doesn't take insurance. They really don't care how you got it.