Obamacare Plans Block Access to Health Care

Thousands of patients are scrambling to get medical procedures done before the new year. Why? New Obamacare plans block access to health careaccess to health care providers.

Those who were receiving medical care before being forced to sign up to a new plan on HealthCare.gov will, in many cases, be locked out of hospitals and prevented from seeing doctors who they had typically used. The WSJ contends that about 70% of new plans are more restrictive in the range of doctors and hospitals available to patients than their predecessors.


Most ACA Obamacare health insurance plans sold on the exchange in Georgia are HMO policies with limited access to health care from doctors and hospitals. Some plans only have one hospital in network. If you live in rural Georgia you may drive past several hospitals to get to one that is in your network.

If you buy a Blue Cross of Georgia plan your only choice, on or off the exchange, is an HMO. When you have an HMO you have limited access to health care.

If you want unfettered access to health care you need to consider broad network PPO plans available OUTSIDE the exchange. Bob Vineyard at Georgia Insurance Shop can help you choose from up to 80 different ACA health insurance plans that are only available off the exchange.

Supporters of the Affordable Care Act may argue that procedures will continue to be available, the plans severely curb access to health care from certain doctors and hospitals, preventing patients from getting the level of care they are used to at their usual price. In particular, insurers now using the Obamacare system have begun to exclude major academic institutions from their coverage, as these compete with cheaper community hospitals ostensibly providing the same service.

Under Obamacare it is no longer your doctor, your choice, if you buy from the exchange.

If you already bought an exchange plan, or a BCBSGA plan (on or off the exchange) it is not too late to correct your mistake. Let us help you find a plan that fits your needs and budget and gives you full access to health care.


Obamacare Exchanges | Not the Only Way to Buy

Much has been made about the coming Obamacare exchanges, but they may not be for everyone. In fact, unless you get a significantobamacare exchanges train wreck taxpayer funded subsidy, you probably want to look off exchange. If you earn less than 250% of the FPL (Federal Poverty Level) the best place for you probably is the exchange.

But if your income is above that level and below 400%, you should still look off exchange.

Some insurers may opt to offer richer policies or continue grandfathered plans off the exchange to hold onto long-time customers. These policies may have more comprehensive doctors’ networks or lower drug co-pays … with a higher premium to boot,

Money CNN

One of our favorite carriers, Cigna, will not be participating in the Obamacare exchanges in Georgia. We are encouraging people to lock in current LOW rates which will probably be close to HALF 2014 rates.

Click now to shop and compare today’s LOW RATES  >>>>> click for quote

The off-exchange policies may also attract enrollees who won’t want the additional work of going through the exchange, which involves gathering pay stubs or W2 forms, settling up an account and waiting for income and citizenship status to be verified by federal agencies.

When you buy outside of the Obamacare excchanges you don’t have to give up your personal information to navigators and risk passing that information through the unsecure data hub.

Some consumers have also told Blue Cross that they intend to go off the exchange because they don’t want anything to do with Obamacare, either because they oppose it politically or they equate it with government assistance programs such as Medicaid.

Nice move.

Obamacare has been described as a train wreck, and quite adequately I might suggest. Unless you are getting a significant taxpayer funded subsidy you would be wise to avoid anything to do with Obamacare exchanges.

Testing the Obamacare Exchange

With three months to go before kickoff for the Obamacare exchange the folks who are responsible for Frankenstein’s monster are kicking the tires and taking it for a spin. After all, what good does it do if you have a new car and it falls apart the first time you take it off the lot?            obamacare exchange

Might as well be one of those Cash 4 Clunkers trade in deals.

Will the Obamacare exchange be ready to roll on October 1, 2013 or will it sputter and die?

That process is complex enough by itself. How much coverage do you want? What deductible? Are family members on the plan? Do you need an asthma program? Do you want to keep your current doctor? What about dental?

Health-act proponents liken the signup software to Expedia or Travelocity, where travelers can book flights and hotels. It may be more like TurboTax, escorting you through requirements and choices much more complex than whether you want a flight in the afternoon or the morning.

Kaiser Health News

TurboTax is a good analogy. With all the financial information required to move you to the next page, I believe most consumers will just walk away.

Like other filtering software, Connecture’s program is a multi-step search engine, screening out inappropriate options (based on your input) to deliver a manageable menu. After getting past the basics (Stripped-down “bronze” plan or high-benefit “platinum”? High deductible or low?), the program asks if it’s important to keep your current doctor.

“Based on our research, the choice of doctor was probably the No. 1 and No. 2 [features] of what people are looking for in a plan,”


The ONLY reason to shop on the Obamacare exchange is to (possibly) get a taxpayer subsidy. Otherwise you will find more options OFF the exchange.

Doctor and hospital networks will be skinny, more like an HMO. Drugs on the formulary will be mostly generics and few brand names.

So if you are expecting to find “your” doctor and “your” medication on an Obamacare exchange plan you will be very disappointed.

To try to reduce sticker shock, Connecture shows your net premium price — after the tax credits are applied — early in the shopping process. But perhaps the most important feature is the one estimating the total cost of coverage, including deductibles and co-pays, based on your reported health status. Without that information somebody with a chronic condition requiring lots of care could choose a plan based only on a low premium, not realizing the total expense could be substantially reduced by paying a larger premium up front.

The average health insurance consumer has the attention span of a 3 year old. How many are willing to spend 45 minutes trying to find out if they qualify for a subsidy, and then search through networks for their doctor.

And if you want to see the drug formulary, good luck. That information is normally only available once you buy . . .

Then there is this.

If you have a S L O W internet connection you may need to roll a fatty to get through the process.

Obamacare Georgia Insurance Exchange

On Oct. 1, a little more than 100 days from now, the government will open the Georgia  insurance exchange, a marketplace on the Internet where individuals may shop for health insurance. The Georgia insurance exchange is designed chiefly for people who don’t have insurance through their employers.                       obamacare georgia insurance exchange

For many of those who can’t afford the premiums, the government will offer taxpayer funded subsidies to help pay for insurance.

How will it work?

The Georgia insurance exchange will be a website that enables you to apply for insurance for yourself and your family and lets you compare prices and options.

Key ingredients

The most important factors in this calculation are your age, where you live, how much you earn and whether you smoke.

  • Age: Health risks are lower for younger people; so are insurance rates.
  • Home area: Rates are lowest in metro Atlanta and highest in South Georgia.
  • Income: The government will pay part of the insurance cost on the exchange if your income falls between 100 percent and 400 percent of the federal poverty rate.
  • Smokers are at higher risk of illness, so their insurance costs more.


The color key

Each plan is classified as platinum, gold, silver or bronze. Platinum and gold cost the most but provide the best coverage. Each plan’s “metal” designation is based on the percentage of health care expenses it would cover, on average, for a large group of people. Bronze plans cover 60 percent of expenses, leaving the consumer to pay the remaining 40 percent; silver plans generally cover 70 percent, and gold plans 80 percent. (Platinum covers 90 percent, but most insurers won’t offer many platinum plans on the Georgia insurance exchange because they will be so costly.)

 To study the likely costs of plans on the Georgia insurance exchange, the AJC selected one proposed plan from the gold, silver and bronze tiers offered by Blue Cross and Blue Shield of Georgia. (Seven companies applied to sell insurance on the Georgia insurance exchange, but these examples are limited to selected plans on Blue Cross’ filing.) Note that insurers may offer more than one plan within each “metal tier” with co-payments and deductibles that will vary. Here is the cost-sharing information related to the selected plans:

  • Gold plan: $750 deductible, 0 percent coinsurance
  • Silver plan: $2,000 deductible, 20 percent coinsurance
  • Bronze plan: $6,300 deductible, 0 percent coinsurance

The prices, which are premiums per month, assume that the consumer lives in metro Atlanta and is a nonsmoker.


COMMENT: Prices for Obamacare plans will be significantly above current premiums. Shop and compare now.


CONSUMER PROFILE: 26-year-old single person (2013 rates for comparable plan)

  • Gold: $355    (N/A)
  • Silver $267    ($120)
  • Bronze: $201    ($97)

Subsidy examples

Income: $12,000 a year (just above federal poverty line). This person would be expected to contribute about $240 a year toward a silver plan. A subsidy projected at about $2,800 would pick up the remainder of the cost.

Income: $35,000. This person is unlikely to get a subsidy since the cost of a silver plan (about $3,000) would be less than 9.5 percent of her income – what this consumer would be expected to contribute given his or her income level.


Prices for Obamacare plans will be significantly above current premiums. Shop and compare now.


CONSUMER PROFILE: Husband is 32, wife is 30, 1-year-old daughter (2013 rates)

  • Gold: $1,024    (N/A)
  • Silver: $771    ($423)
  • Bronze:$580    ($345 )

Subsidy examples

Income: $20,000 (just above the poverty line). The family would be expected to pay $400 toward for a silver plan.A subsidy projected at about $8,500 would cover the rest.

Income: $60,000 (about 300 percent of poverty line). Family would be expected to pay $5,700 a year toward a silver plan and could get a subsidy of about $3,200 to cover the rest of the cost.


Prices for Obamacare plans will be significantly above current premiums. Shop and compare now.


CONSUMER PROFILE: Husband is 47, wife is 42, kids are 25, 20 and 16  (2013 rates)

  • Gold: $1,790    (N/A)
  • Silver: $1,348    ($824)
  • Bronze: $1,014    ($668)

Income: $28,000 (at poverty line). The family would be expected to pay $560 toward a premium and could get a subsidy of about $15,000 a year to cover the rest of the cost.

Income: $84,000 (300 percent of poverty). Family would be expected to pay about $8,000 a year for a silver plan and could get a subsidy of about $7,600 to cover the rest.


Prices for Obamacare plans will be significantly above current premiums. Shop and compare now.


CONSUMER PROFILE: Husband and wife are both 62 (2013 rates)

  • Gold: $1,994     (N/A)
  • Silver: $1,500    ($1038)
  • Low Bronze: $1,130    ($843)

Subsidy examples

 If this couple’s income is $16,000 a year (at the poverty line) it would be expected to pay $320 a year toward a premium and could get a subsidy of about $17,000 to cover the rest of the cost of a silver plan.

If this couple’s income is $47,000 a year (300 percent of poverty line) it would be expected to pay about $4,500 toward a plan and could get a subsidy of about $13,000 to cover the rest of the cost of a silver plan.

Subsidy calculators

The Kaiser Family Foundation’s subsidy calculator helps you determine the amount, if any, the government might pay toward your insurance bill. Another option is the state of Colorado’s exchange site. See “Calculate your savings” at bottom left of the home page.