{"id":5060,"date":"2014-10-10T07:20:19","date_gmt":"2014-10-10T14:20:19","guid":{"rendered":"http:\/\/bone-in-the-throat.com\/Blog\/?p=5060"},"modified":"2021-08-26T18:38:57","modified_gmt":"2021-08-27T01:38:57","slug":"been-head-down-working","status":"publish","type":"post","link":"https:\/\/bone-in-the-throat.com\/Blog\/2014\/10\/10\/been-head-down-working\/","title":{"rendered":"Been Head Down working"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" style=\"float: right;\" title=\"Healthcare reform.png\" src=\"https:\/\/bone-in-the-throat.com\/Blog\/wp-content\/uploads\/2014\/10\/Healthcare-reform.png\" alt=\"Healthcare reform\" width=\"275\" height=\"183\" border=\"0\" \/><\/p>\n<p>Tuesday I got a call from my normal doctor. I was expecting it&#8230;<\/p>\n<p>The office staff called to tell me that the Doc wants to see me again. I look at the calendar and it&rsquo;s been over a year. In truth I was expecting this call, the Doc is good about making sure he&rsquo;s not just renewing prescriptions without seeing his patients.<\/p>\n<p>While I&rsquo;m on the phone with the staff, I remember that the insurance card I&rsquo;ve been carrying around has proven to be completely useless and before I set up an appointment I ask them if they can verify that the insurance card will be honored.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" style=\"float: right;\" title=\"Affordable Care.png\" src=\"https:\/\/bone-in-the-throat.com\/Blog\/wp-content\/uploads\/2014\/10\/Affordable-Care.png\" alt=\"Affordable Care\" width=\"259\" height=\"194\" border=\"0\" \/><\/p>\n<p>The staff says sure, and I give them my card number. About an hour later, they call back and tell me that they can&rsquo;t accept this flavor of insurance. Yes, it&rsquo;s a PPO but it acts more like an EPO and they&rsquo;re not part of that network. They also told me to contact one of the attorney&rsquo;s involved in the class action lawsuits against Anthem and to contact the Insurance Commissioner. Can you say this is a problem they&rsquo;ve gotten tired of dealing with??<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" style=\"float: right;\" title=\"MickeyObama.png\" src=\"https:\/\/bone-in-the-throat.com\/Blog\/wp-content\/uploads\/2014\/10\/MickeyObama.png\" alt=\"MickeyObama\" width=\"260\" height=\"194\" border=\"0\" \/><\/p>\n<p>I make the appointment anyway, By December I&rsquo;ll have either come up with a real insurance carrier or I&rsquo;ll not have insurance at all. Either way I&rsquo;m going to see my doctor.<\/p>\n<p>After a decade of him taking care of me I have no desire to have that relationship destroyed. There are damn few people I trust with my life outside my family. My Doctor is one of those people.<\/p>\n<p>After getting off the phone with the Doctors office, I call Anthem and ask them what the hell is going on? Once again I&rsquo;m assured that I have a PPO plan, once again I ask &ldquo;If this is a PPO plan then why can&rsquo;t I simply go to any physician that takes Anthem insurance?&rdquo;<\/p>\n<p>That&rsquo;s when I get a lot of dancing around about how PPO plans have changed and that there are no PPO plans available in California because of ACA. I&rsquo;m told that Cedars Sinai is now taking the PPO plan that I have and that Anthem negotiated with Cedar&rsquo;s to make sure patients weren&rsquo;t being excluded.<\/p>\n<p>In other words, let&rsquo;s put some more lipstick on this pig.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" style=\"float: right;\" title=\"CoveredCA.png\" src=\"https:\/\/bone-in-the-throat.com\/Blog\/wp-content\/uploads\/2014\/10\/CoveredCA.png\" alt=\"CoveredCA\" width=\"249\" height=\"300\" border=\"0\" \/><\/p>\n<p>After much discussion the Anthem representative tells me that I can&rsquo;t make changes to my plan until open enrollment. I comment that since I&rsquo;ve been unable to get any medical care under this plan I&rsquo;ve been wondering if I wouldn&rsquo;t be better off with a simple catastrophic injury plan.<\/p>\n<p>The representative begins to tell me that if I had a catastrophic plan I might not be covered for hospitalization or emergency room visits. I retort that the definition of a catastrophic plan is a plan to provide those services. The representative does finally concede that perhaps, given my difficulties with their PPO plan I might consider a catastrophic plan during open enrollment which begins November 15th.<\/p>\n<p>I spend the rest of the day researching my options&#8230;<\/p>\n<p>Sigh, why can&rsquo;t we just get the goods and services we pay for?<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tuesday I got a call from my normal doctor. I was expecting it&#8230; The office staff called to tell me that the Doc wants to see me again. I look at the calendar and it&rsquo;s been over a year. In truth I was expecting this call, the Doc is good about making sure he&rsquo;s not &hellip; <\/p>\n<p class=\"link-more\"><a href=\"https:\/\/bone-in-the-throat.com\/Blog\/2014\/10\/10\/been-head-down-working\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;Been Head Down working&#8221;<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[102,16,153],"tags":[175],"class_list":["post-5060","post","type-post","status-publish","format-standard","hentry","category-aca","category-mens-health","category-obamacare","tag-male"],"_links":{"self":[{"href":"https:\/\/bone-in-the-throat.com\/Blog\/wp-json\/wp\/v2\/posts\/5060","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bone-in-the-throat.com\/Blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/bone-in-the-throat.com\/Blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/bone-in-the-throat.com\/Blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/bone-in-the-throat.com\/Blog\/wp-json\/wp\/v2\/comments?post=5060"}],"version-history":[{"count":2,"href":"https:\/\/bone-in-the-throat.com\/Blog\/wp-json\/wp\/v2\/posts\/5060\/revisions"}],"predecessor-version":[{"id":5062,"href":"https:\/\/bone-in-the-throat.com\/Blog\/wp-json\/wp\/v2\/posts\/5060\/revisions\/5062"}],"wp:attachment":[{"href":"https:\/\/bone-in-the-throat.com\/Blog\/wp-json\/wp\/v2\/media?parent=5060"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/bone-in-the-throat.com\/Blog\/wp-json\/wp\/v2\/categories?post=5060"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bone-in-the-throat.com\/Blog\/wp-json\/wp\/v2\/tags?post=5060"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}