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Tenpoundbass
2013 Nov 18, 3:43am
Get 'em homeboy, here's another one of them there racist anti Obamacare agitators.
turtledove
2013 Nov 18, 4:00am
Out of network providers could always balance bill. Only those in-network providers who sign a contract with the insurance company in question are not allowed to balance bill. No out-of-network facility or doctor can be compelled to the terms of a contract they don't participate in. I'm not sure I understand why you think this is different than the way it's always been. Perhaps I'm not understanding your concern.
curious2
2013 Nov 18, 4:55am
Perhaps I'm not understanding your concern.
As I wrote at the start of the thread, "I have been trying to "choose" the least bad Obamacare plan," and in order to do that, I want to know what the plans cover. According to the California Supreme Court, California HMO customers were protected from "emergency room" balance billing prior to Obamacare, and I am trying to understand if that applies to Obamacare HMOs or EPOs or other plan types, and to other emergency charges (e.g., ambulance, ICU, and the corporate practice groups that employ the physicians working in the hospital).
I'm not sure I understand why you think this is different than the way it's always been.
I didn't say this was different from the way insurance was before, but there is a difference: Obamacare is mandatory. In the past, you could save your pennies for a rainy day, but now you are required to fork them over to an insurance company in exchange for a handful of magic beans "secret plan" to end something. I hope you don't think I'm asking too much when I ask, as a prospective customer, what will these secret plans actually cover? The website people don't answer, i.e. you have to buy the policy and get hit by a truck to find out what's in it.
In a prior thread, @Bellingham Bill claimed to have a BS policy that covered these charges, but when I asked him to provide a link or copy, he never replied.
Tenpoundbass
2013 Nov 18, 5:27am
I hope you don't think I'm asking too much when I ask, as a prospective customer, what will these secret plans actually cover? The website people don't answer, i.e. you have to buy the policy and get hit by a truck to find out what's in it.
I've been asking for facts that goes beyond premium subsidies for nearly three years. All I get is a circular reference back to my original question. I am yet to see a comprehensive list of what is covered under Obamacare and to what extent, beyond being assured and told, that all of the warm and fuzzy family planning stuff, and the crap that liberates pre teens from the oppressive Victorian rules of their parents house is covered extensivly and can get some quite comprehensive details on the liberal need for those provisisions. But they wont or can't tell you what you'll pay if you get hit by a truck and end up in the hospital or if you actually get stricken by some disease what you'll have to pay up front or just be left to die. What I get in exchange is this sense that all of America's health problems are because of Fat people.
If we can just get rid of fat people, then we wont get leukemia, cancer, diabetes, heart problems, mersa,legioneers decease, broken bones, arthritis, Liver complications...
Fuck you know what? If we can just get rid of the fat people, then we can just toss out the Medical dictionary, then that way if you need any health services, then that's a lifestyle choice and you're on the hook for a cure no different than someone seeking ripped abs from a fitness trainer.
Which btw, probably IS covered under Obamacare.
Private healthcare bllling : Screw balance! We charge whatever we please.
curious2
2013 Nov 18, 9:19am
Get 'em homeboy....
@Homeboy, you rush to defend Obamacare all the time, surely you have an answer to this question?
@Bellingham Bill, your BS policy?
I have been trying to "choose" the least bad Obamacare plan, and that process has required me to read more about "balance billing." Although the Obamacare navigators I asked had never heard of it, the pattern of "balance billing" is widely known and reported.
Obamacare supporters ignore "balance billing," because Obamacare "does not prohibit balance billing by out-of-network providers." You can read more about it in the regulations but keep in mind those are subject to change; the actual statute requires insurers to pay only the amount Medicare would pay, which by law is the lowest of all payors (commonly 30% of the total bill). Obamacare regulators "concluded that even though PPACA does not prohibit balance billing, they believe it defeats the purposes of the PPACA protections to permit such an arrangement to exist." HHS and IRS thus required a sometimes higher payment than the statute does, and it remains to be seen whether the regulatory requirement (contrary to the statute) will stand. Regulators effectively acknowledged that reading the statute as written would defeat what they assumed to be the purpose of the statute, but the authors of the statute wrote it to say what it said, for their own purposes.
The California Supreme Court ended emergency room "balance billing" by out of network hospitals for HMO customers. Obamacare lumps HMOs together with EPO and other plan types, and when I click on the links for further information, they send me back to a previous webpage in an endless loop. Also, there is no information about charges outside the emergency room (e.g. ambulance, ICU). If you sign up for an Obamacare EPO, how do you know whether you might be liable for "balance billing" if you are hit by a car and wake up in the ICU of an out of network hospital?
Any documented answers, i.e. with links to sites that can be cited by injured patients should the need arise, would be very helpful.
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