Day: November 16, 2014

Welcome to Open Enrollment! Your ACA plan is serving you… UP!

As I’ve chronicled over the past year I’ve been involved with a nightmare called Anthem Blue Cross of California.

A month or two ago I was told that I’d have to wait for open enrollment to change my health care, I’m still not even sure how that works, or how they think that is going to work. I can change my health care any time I want to, ALL I have to do is not pay the bill!

And speaking of bills… I understood having open enrollment periods when I was working for a corporation. That makes sense, it tends to allow the company to budget their expenses and keeps the employees from jumping healthcare providers each time they don’t like something.

However, since I’m paying the bill, I’m the one buying the goods or in this case services, why do I have to screw around with open enrollment at all?

Technically, as a consumer of the insurance service, I am the Insurance company’s employer. As such, I ultimately have the capacity (Or I would in a non-socialist country…)  to hire and fire a poor provider at will. Oh yeah, but NOT under Obamacare.

---

Anyway, I’m shopping.

I can’t see myself putting up with more of the same from Anthem and not being able to see my primary care physician, (Even though they said I could. Then when I found that I couldn’t, they told me he must have dropped out of their network. But I have a PPO plan, networks are irrelevant… Well apparently it’s not really a PPO and My Doctor was NEVER in the plan they sold me). Or not being able to find a dermatologist. (And neither could they within 90 miles of my location.) 

You see, I’ve been paying through the nose for a policy that was at best only a catastrophic plan with prescription coverage because none of the doctors I wanted to see were in fact accepting the Anthem Pseudo- PPO. I could have saved about 1/2 of my medical costs per month by just having a catastrophic care plan, and paying for everything else out of pocket which is essentially what I’m doing anyway.  By the way, a catastrophic plan is one of the options I’m looking into.

Under the “Won’t get fooled again” premise I’m trying to compare companies based on how they’re rated by consumers. As I’ve been sorting through the data I’ve discovered a couple of interesting things. 

1) Of five companies I’ve checked on thus far, only two will allow me to purchase their policies based on my zip code.

All of these companies appear to service California but apparently they don’t all service the county in which I live.  

Sorry folks I’m an all or nothing kind of guy. If you’re selectively insuring counties that means that technically I can’t move from one county to another until the next open enrollment period. Doesn’t that also mean that when I drive across county lines, I’m out of network? Either you sell in all of California or don’t sell at all. 

I recall speaking to some insurance agent last year. That person said that even though I could purchase their insurance policy, AND that my Doctor was in their network, AND that the policy and my doctor were compatible, I still would be unable to see my doctor. Their explanation for this was that since my doctor and I were in different counties, he would be considered “Out of Network”. I seem to recall not purchasing that particular policy.

2) I can’t narrow down if my county theory is correct without requesting a quote from each possible provider — this is significantly slowing down the shopping process.

The upshot of all of this is that insurance shopping, which was always painful, has now become 100 fold more painful because there is no simple way to sort through the data to compare stuff. I have noticed that every policy seems to have an ACA metallic moniker;

Bronze, Silver, Tin, Rusted Iron, Busted Galvanized Pipe, Copper, Pyrite…

All of which mean the same damn thing…

I’m beginning to think we have no choice in policies, just a choice in the company administering them. 

In dealing with all of this bullcrap, I think that I’d rather pound my own testicles with a sledgehammer, (1000 FemNazis just came in their jeans) than shop for health insurance!

I just don’t think I have medical coverage for that…