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Thread: Health Care provider drops my insurance carrier

  1. #1
    Senior Member BonMallari's Avatar
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    Default Health Care provider drops my insurance carrier

    Never thought it would happen to me...I thought I had a "cadillac" insurance policy...but I was at my cardiologist this morning for a routine bi annual follow up after taking an EKG and routine blood tests last month...after signing in the receptionist informs me that they no longer accept my Culinary Union insurance, but I could opt to pay the 250 office visit fee...WTH

    Don't know if I should be mad at my union for not listing my doctor as an approved provider, my doctor for not agreeing to whatever my insurance pays....or the real culprit...the looming shadow of the Affordable Care Act...

    had my cardiologist for almost 4 years...good thing that one of my brother's friend/classmates is the chief of cardio thoracic at one of the new hospitals and was able to get me a referral right away.....it raised my BP up a bit but luckily I just got those prescriptions renewed last month

    has anyone else experienced this yet ( your physician dropping your insurance carrier)...our insurance carrier is the second largest in the state (next to VA) and my cardiologist is a member of one of the largest Health Care providers in the state...Guess this is what we all have to look forward to if they cant repeal Obamacare when Romney gets elected
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    Senior Member gmhr1's Avatar
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    Surprise surprise hello Obamacare . My premiums just went up! I thought Obama said if you liked your Dr you could keep him nothing would change do you think he lied to us again?
    Just found out today that two of our Drs have decided to quit.
    Last edited by gmhr1; 09-19-2012 at 09:28 PM.
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    I don't want to hi-jack this thread but.............docs here are just closing their office and going to work in a clinic somewhere else. Lost my health records that way. They got shipped to state office and stored ! Lady there refused to give any of them to me. I finally talked to a "legal being" and told her I had. She sent part of those records. Just a "heads up" grab your files before they travel.
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    Senior Member gmhr1's Avatar
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    But Obamacare is supposed to be a good thing, nothing will change if you like your Dr keep him, if you like your insurance keep it, we are all in big trouble.
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    Senior Member Franco's Avatar
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    Quote Originally Posted by BonMallari View Post
    Never thought it would happen to me...I thought I had a "cadillac" insurance policy...but I was at my cardiologist this morning for a routine bi annual follow up after taking an EKG and routine blood tests last month...after signing in the receptionist informs me that they no longer accept my Culinary Union insurance, but I could opt to pay the 250 office visit fee...WTH

    Don't know if I should be mad at my union for not listing my doctor as an approved provider, my doctor for not agreeing to whatever my insurance pays....or the real culprit...the looming shadow of the Affordable Care Act...

    had my cardiologist for almost 4 years...good thing that one of my brother's friend/classmates is the chief of cardio thoracic at one of the new hospitals and was able to get me a referral right away.....it raised my BP up a bit but luckily I just got those prescriptions renewed last month

    has anyone else experienced this yet ( your physician dropping your insurance carrier)...our insurance carrier is the second largest in the state (next to VA) and my cardiologist is a member of one of the largest Health Care providers in the state...Guess this is what we all have to look forward to if they cant repeal Obamacare when Romney gets elected
    Two years ago Blue Cross/Blue Shield was at odds with the my Cardiologist's group. It took them a while to settle as to what the doctors would accept and what Blue Cross would pay. All the while the Cardio group kept the co-pay at $60.

    I was there two weeks ago for my bi-annual checkup and blood analysis. Everything luckily for me was in order; bad cholestrol was low, triglisirides(sp)good and blood pressure normal. That's what eating Boudin and Craklins for breakfast will do your you, clear the arteries.

    I asked him about how Obama carewill affect me and my relationship with the Cardio Clinic. He said it wouldn't. Then he reminded me how much a stint procedure cost me in 05 compared to 2012, something we had talked about earlier. He said that another stint procedure, if I needed one in the future should cost less! I was in shock.
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  6. #6
    Senior Member BonMallari's Avatar
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    Quote Originally Posted by Franco View Post
    Two years ago Blue Cross/Blue Shield was at odds with the my Cardiologist's group. It took them a while to settle as to what the doctors would accept and what Blue Cross would pay. All the while the Cardio group kept the co-pay at $60.

    I was there two weeks ago for my bi-annual checkup and blood analysis. Everything luckily for me was in order; bad cholestrol was low, triglisirides(sp)good and blood pressure normal. That's what eating Boudin and Craklins for breakfast will do your you, clear the arteries.

    I asked him about how Obama carewill affect me and my relationship with the Cardio Clinic. He said it wouldn't. Then he reminded me how much a stint procedure cost me in 05 compared to 2012, something we had talked about earlier. He said that another stint procedure, if I needed one in the future should cost less! I was in shock.

    I am hoping that is the case with my Cardiologist, should have known my $27 co pay wouldnt last forever

    I know for a fact that most if not all the procedures that are covered at my brother's practice are going nowhere but up..the bureaucratic red tape is unbelievable...He has been using state of the art cold laser and other frequency modulation machines that have still not been cleared for payment by insurance carriers, so many of his patients just pay the fees out of pocket....good thing the accupuncture needles are a low cost item...if they ever allow him to practice on the road at FT's he could probably pay for his weekends with his patient list alone
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    Quote Originally Posted by lanse brown View Post
    A few things that I learned still ring true. "Lanse when you get a gift, say thank you and walk away. When you get a screwing walk away. You are going to get a lot more screwings than gifts"

  7. #7
    Senior Member Wayne Beck's Avatar
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    Thats ok. I was just denied coverage by a new health insurance coverage. This was all based on info i gave them plus the info they already had since I went from a group policy to an individual policy. I think in the last 5 years ive been to the dr maybe 10 times. had the flu twice, a couple of sinus infections and a few physicals. im 37 in decent health.. My only major problems are this time last year i was 330 pounds and now i am 240(im 6'2).. i had a heel spur act up in april and last month i got hit in the face with a piece of wood that kicked out of the wood chipper.. Im perfectly fine.. In fact im in better shape physically now than i was when i was 18.. I called to find out why and they danced around the answer with the standard HIPPA crap.. They told me I had to request in writing, then they would write back, then i have to reply in writing to their nonsense.. Needless to say i said alot of 4 letter words today and cant wait to read their BS response,
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    Member JimmyD's Avatar
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    My wife's employer informed her effective Jan. 01, 2013 due to rising insurance premiums; The 100% employee health care plan will no longer be offered to employees. Those who wish to have insurance will have to pay $155/pay period($310/mo) for less coverge than presently offered and our co-pay is increasing from $10 to $25 per office visit and $1000/procedure.

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    Senior Member Jason Glavich's Avatar
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    My wife went to the ER and we thought nothing about it and paid the copay. Several months later we get the standard bills for 10 or 20 bucks for random things the insurance did not cover. Then we get a bill from the Doctor that saw her at the ER for 800, I was like this must be a mistake. Called insurance, they informed me that the hospital accepts our insurance but the doctor has chose not to. How the hell was i supposed to know that this 1 doctor or maybe 2 did not take my insurance? I did not choose who we saw we went to the ER and were seen, no idea that a doctor employed at the hospital did not take our inurance that the hospital accepted.

    No worries though the ER saw about 20 people with the sniffles before taking the guy who had a blood soaked bandage on his hand that had to be changed 5 times by the ER triage nurse lady. We were seen 4 hours later and got out 3 hours after we went in the back to be told call your General care Dr and see what he thinks in the morning here is some tylenol, that is what i paid 800 bucks!
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  10. #10
    Senior Member Buzz's Avatar
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    Quote Originally Posted by Jason Glavich View Post
    My wife went to the ER and we thought nothing about it and paid the copay. Several months later we get the standard bills for 10 or 20 bucks for random things the insurance did not cover. Then we get a bill from the Doctor that saw her at the ER for 800, I was like this must be a mistake. Called insurance, they informed me that the hospital accepts our insurance but the doctor has chose not to. How the hell was i supposed to know that this 1 doctor or maybe 2 did not take my insurance? I did not choose who we saw we went to the ER and were seen, no idea that a doctor employed at the hospital did not take our inurance that the hospital accepted.

    No worries though the ER saw about 20 people with the sniffles before taking the guy who had a blood soaked bandage on his hand that had to be changed 5 times by the ER triage nurse lady. We were seen 4 hours later and got out 3 hours after we went in the back to be told call your General care Dr and see what he thinks in the morning here is some tylenol, that is what i paid 800 bucks!

    This happened to me about 10 years ago. I was informed that the ER docs don't work for the hospital, they are like independent contractors. They can take or leave your insurance even if the hospital is on your provider list. It sucks, but that is the reality that a lot of folks run into. I think it's total BS.

    Bon, please explain how this is in any way related to Obama Care. When I first moved to South Dakota 10 years ago, I was getting injections for a trapped nerve in an incision scar from a surgery I'd had. I had to pay through the nose because the anesthesiologists in the state would not contract with BC/BS, there was a dispute about payments and it was statewide. So there was not a single doc in the state that I could visit for my injections that would take my insurance, and the injections were like $1200 per. Talk about rape. I would get prepped by a nurse, a doc walks in, gives the injection and walks out. Total of maybe 2 minutes. That'll be $1200. It was just a steroid injection for crying out loud. We are getting raped by the medical profession because we HAVE to go to them. Witch doctors are not an option...
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