Are You Concerned That You Can’t Use Your Doctor With Obamacare?

PregnantI still keep in touch with my best friend from high school even though he lives in Chicago.  He knows what I do and occasionally he asks me a question about something he has heard on the news.

Most recently, he has heard stories about people who claim that they will no longer be able to see their preferred doctor after January 1, 2014 because of Obamacare.  Apparently, horror stories, like that, are popping up on news stations around the nation.

In fairness to Obamacare, those news stories are only telling part of the truth.  (I know that it will shock you to learn that the media and politicians, withhold the entire story when it comes to health insurance.)

The fact is that people who are losing access to their doctors because of Obamacare have two options.

  1.  If they want to pay their doctor out of their pocket, as opposed to using insurance, they can still do that.  Every doctor I know will take money, whether it is from an insurance company or a patient’s wallet.  Press and politicians who are saying that people cannot go to the doctor or hospital of their choice are lying.
  2. The people who are getting “locked out” from their desired doctor/hospital for insurance purposes have elected to get one of Obamacare’s “Affordable” HMO plans.  If they will spend the extra money to get a PPO style plan, they will be able to go to any doctor/hospital they want.

The only people who are losing access to their preferred doctor are using doctors who have either closed their practice or are one of the few doctors who will only take patients who have specific insurance plans.

Most doctors will be glad to take your money.  If you elect to pay their higher, non-insured, rate or the negotiated insurance rates, they do not care.  As long as your money spends, they will treat you.

It may be helpful to remember that the days of the altruistic doctor, who treats everybody, are gone.  Medicine is big business today.  Doctors and hospitals expect to get paid very well, for keeping the rest of us healthy.

However, I do understand why Americans might be concerned about the horror stories they are hearing.

If you have a doctor that you like and are concerned that you could lose access to him/her, there is something that you can do to protect yourself.

The politicians brag about how “Affordable” health insurance will be under Obamacare.   When they say that, they are talking about Bronze and Silver level plans.  In most cases, they are also talking about HMO type plans.

Those plans often limit access to only doctors and hospitals that are within their network.  If you elect to use a doctor or hospital that is not in their network, you will have no health insurance, in most cases.

To keep from falling into this trap, when you enroll in a health insurance plan for 2014, or later, avoid HMO type plans.  If you spend the extra money to get a PPO type plan, you will be much happier.

Yes, you will still have a network associated with your plan.  However, there is one huge difference.  If you elect to go to a doctor or hospital that is not in your plan’s network, you will still get some help from your insurance company with the bill.

Yes, the help the PPO will give you for using a provider that is “Out-of-network” will be less than if you had used a provider that is “In-network.”  However, it will be better than the $0 that your HMO will pay if you do not use one of their “Network” providers.

If you travel, or have children away at school, I encourage you to double-check your health insurance election.  It should be either a PPO (Preferred Provider Organization) or a POS (Point Of Service) plan.  A HMO would require your sick child to return home so that he/she could go to a network doctor.