Who is Losing their PPO Health Plans?

[Jack Mayer]

Yes, that what she was told. So unless you have an employer plan, you are on your own next year. We are seeing the same thing at UTSW, with one maybe exception, and "things are still be worked on" per the latest we have been told.

I that even legal? You won't treat me unless I work for a company? Including cash payment?

[sailwing2003]

I that even legal? You won't treat me unless I work for a company? Including cash payment?

MD Anderson would be out of network, so she would have to pay cash. If you have the cash, you are golden till one runs out of course.

 

UTSW is showing almost the same thing, with one exception, Humana, which is owned by Aetna. We are waiting to see if the posted website info at UTSW is going to show they have reached a deal with any individual health plans. All that is showing now is that they will take employer sponsered plans.

[Daveh]

R, Walter. I consider today's news from United Healthcare to be extremely concerning for the future of the ACA. We are now set up for a wild 2016 with major health financing issues needing to be addressed in the middle of a presidential election. This is very discouraging for those of us hoping for stability in the individual insurer market. Our concerns may become much broader than the PPO market'

 

Although United Healthcare is a huge health insurer, they are only about 10% player on the individual market.However, United does have a heavy presence in some states so for those states 10% understates the case. I guess the question is whether the marketplace is unworkable or whether United Healthcare is just getting its lunch eaten by the other insurers. Other profit reports will be quite interesting.

 

This seems a much bigger threat to the ACA then the noise in Congress or any additional Supreme Court case.

[Zulu]

In today's news, United HealthCare, this country's largest insurer in health care, is contemplating dropping out of the ACA's health exchanges because of the impact on profitability. If United is having financial problems writing health care insurance under the ACA, one can reasonably suppose that other health care insurers are having similar, if not worse, financial problems.

An important note -- they're offering plans for 2016, but may not for 2017.

[sailwing2003]

United Health Care is not offering us any options in our zip code, for Arlington TX, any age we checked. We looked, off exchange, individual plans.

[Zulu]

United Health Care is not offering us any options in our zip code, for Arlington TX, any age we checked. We looked, off exchange, individual plans.

We're in Arizona. The wife needs it for just this year -- next year Medicare.

 

For those under 65 still considering a domicile, it looks like it's more about selecting the right Zip Code.

[GreyDawg]

Is there a single website to use to search for OFF-exchange options by zip code? I tried Kyle's site, but all I could find there was an "instant quote" button.

 

I just want to have a look at what my options might be.

[Zulu]

Is there a single website to use to search for OFF-exchange options by zip code? I tried Kyle's site, but all I could find there was an "instant quote" button.

 

I just want to have a look at what my options might be.

 

Also consider the Exchange . . . for example, in AZ, UnitedHealthCare has PPO Exchange plans, but no PPO plans off the Exchange.

[Mariner]

I'm amazed by people who overlook the fact of others having their premiums skyrocket, deductibles reach a point of absurdity, or are scrambling to find any kind of healthcare they can afford, but will continue to make excuses as to why we're so much better off. I guess ignorance is bliss, or they just like burying their heads in the sand. Personally, I care very much about those under 65 who are having such a difficult time, and are scared something catastrophic could happen without the coverage they need. The REALLY scary thing is United Healthcare could be the first domino to fall. Then where will we be if it all collapses like a house of cards? Interesting times, indeed!

[GreyDawg]

 

Also consider the Exchange . . . for example, in AZ, UnitedHealthCare has PPO Exchange plans, but no PPO plans off the Exchange.

 

 

Thank you, but I have already looked on Exchange via HealthCare.gov and HealthSherpa. My options in central Texas (Travis Country zip, but travel about 11 months of the year, mostly out of Texas and about half out of the USA) are not good on the Exchange.

 

I need, therefore, to compare the OFF-exchange options to the ghastly on-exchange options. At a minimum I want to find a policy that has an out-of-network max, since my travel patterns will almost assuredly put me in an out-of-network location if and when I have a catastrophic event.

 

So, is there a website comparable to HealthSherpa that I can use to get a list of policies available in my zip, off-exchange?

 

Thanks!

[Daveh]

This article shows the States that would be impacted the most if United Health pulls out of the individual market in 2017. http://www.vox.com/2015/11/19/9763946/united-obamacare-map?utm_medium=social&utm_source=facebook&utm_campaign=voxdotcom&utm_content=thursday

[Daveh]

This article provides some even handed analysis to the United Healthcare news for those wanting to know more. http://www.bloombergview.com/articles/2015-11-19/obamacare-insurers-are-suffering-that-won-t-end-well-

[Zulu]

My options in central Texas (Travis Country zip, but travel about 11 months of the year, mostly out of Texas and about half out of the USA) are not good on the Exchange.

 

I need, therefore, to compare the OFF-exchange options to the ghastly on-exchange options. At a minimum I want to find a policy that has an out-of-network max, since my travel patterns will almost assuredly put me in an out-of-network location if and when I have a catastrophic event.

Good luck finding an Out-Of-Network max that isn't "Unlimited".

 

So, is there a website comparable to HealthSherpa that I can use to get a list of policies available in my zip, off-exchange?

 

I think you'll have schlepp though each TX health provider sites.

 

Here's a start . . .

 

[Zulu]

I'm amazed by people who overlook the fact of others having their premiums skyrocket, deductibles reach a point of absurdity, or are scrambling to find any kind of healthcare they can afford, but will continue to make excuses as to why we're so much better off. I guess ignorance is bliss, or they just like burying their heads in the sand. Personally, I care very much about those under 65 who are having such a difficult time, and are scared something catastrophic could happen without the coverage they need. The REALLY scary thing is United Healthcare could be the first domino to fall. Then where will we be if it all collapses like a house of cards? Interesting times, indeed!

What do you want Mariner?????? Seriously. What is the goal of your posts? Do you want us to scream and throw our hands up in despair? Do you want us to promise to vote exactly the way you want us too? Do you want us all to just write you directly rather than ask others questions? What solution to any problem have you offered?

 

I have reported you to the moderators before. I will try one more time. But I feel like we are done with Escapees.

 

Mariner's The-Sky-Is-Falling and Daveh's It-Isn't-That-Bad posts are both so not relevant to those of us looking for good health care plans.

 

I believe the point is to Play the Hand You've Been Dealt. Damning your cards or wishing for better ones gets you nowhere.

 

For me that was discovering that residing in the "right" Zip code can make all the difference because that's how the new health care system is structured.

 

My wife and I accidentally picked the right AZ Zip code for our current domicile. We're lucky because we only have to ride out one more year before Medicare kicks in.

 

However, if I had to look forward to several more years of having to buy individual health care, I'd start looking at the plans available in "choice" Zip codes. Remember, we're RVers -- far more mobile than the rest of the population.

 

What's a "choice" Zip code?

 

Probably NOT some place where there are lots of RVers -- like Polk County, TX. The demographics for this area are not a health insurer's dream: the median age in Polk County is 5 years older than all of TX and the median income is lower.

 

However, when I checked the health plans in Austin, TX (younger, more affluent) -- Bingo! Lots of PPOs.

[Barbaraok]

Zulu,

 

What mail service is located in Austin that will give you the necessary address in order to be able to apply for the insurance?

[R. Walter]

R, Walter. I consider today's news from United Healthcare to be extremely concerning for the future of the ACA. We are now set up for a wild 2016 with major health financing issues needing to be addressed in the middle of a presidential election. This is very discouraging for those of us hoping for stability in the individual insurer market. Our concerns may become much broader than the PPO market'

 

 

This seems a much bigger threat to the ACA then the noise in Congress or any additional Supreme Court case.

 

Agree 100%. And the root of the problem goes back to bringing in approx. 40+ million previously uninsureds and providing free and subsidized insurance to this group.

[Zulu]

What mail service is located in Austin that will give you the necessary address in order to be able to apply for the insurance?

 

Beats me.

[Barbaraok]

And therein lies the problem. You have to have a legal address that you use for drivers licenses, insurances of all kinds, voting, etc.

 

Barb

[Zulu]

And therein lies the problem. You have to have a legal address that you use for drivers licenses, insurances of all kinds, voting, etc.

 

So how could someone go about getting a legal address in another TX county, Barb?

[Barbaraok]

That's why I asked about mail service in Austin. I don't know if a UPS Store would suffice?

[Zulu]

That's why I asked about mail service in Austin. I don't know if a UPS Store would suffice?

 

I've used two non-UPS Store mail forwarding services (WI & AZ), and they've both worked so far.

 

It looks like about 1/3 of TX counties have PPO plans.

[jbh]

> mail service is located in Austin

 

Look for a UPS Store. I don't know about Texas but I do know that in Florida a UPS Store is a legal address.

[GreyDawg]

And therein lies the problem. You have to have a legal address that you use for drivers licenses, insurances of all kinds, voting, etc.

 

Barb

 

I am based in Austin, where I used a Pak-Mail address for federal tax returns, BCBS mailing, etc. Don't know about DL and vehicle registration, as those are still at a deceased family member's address pending moving them to the Pak-Mail address in 2016. in 2015 I used the Pak-Mail address for my BCBS enrollment.

[Daveh]

BREAKING: CMS may impose minimum provider-network standards for ACA plans

 

This story just broke today. And for once, great news, This is the perfect opportunity for each of us and the Escapee organization to emphasize the problems so many of our members encounter due to the narrow provider networks. The best part of this is that we will not need additional legislation as the answer seems to lie within CMS agency rule making authority. Even if they require that each company provide at least one plan with an expanded provider network under 65 will be in a much better position.

 

http://www.modernhealthcare.com/article/20151120/NEWS/151129988?utm_campaign=socialflow&utm_source=twitter&utm_medium=social

[trostberg]

I don't know how they would address the travel issue if they use a mileage rule for access to providers. They would take the distance from your address of record. I know that CMS has used 25 miles for critical access hospitals for their designation from other hospitals in the past

 

But it is good to see something at least toward the positive side. But then I could make more insurance companies pull out. It is beginning to look like insurance companies refusing to participate may force a change.

 

Has it been taking on patients with pre existing conditions and those who never bothered to sign up that is causing insurance companies their financial issues?