We like our insurance plan/doctor, but we are being "pushed out" of our plan

[SoCalDem]

Why?

The union contract changed and now we have been forced into Aetna. The change takes effect Sept 1, and we have still not gotten a single piece of paper in the mail that even tells us about our choices of doctors, or if my husband's current cardiologist, diabetes doctor are "in the plan".

He has to set appointments long in advance, and is now faced with the possibility that he will have to start all over with another set of doctors.

We called the union and were told that we would be receiving the "packet" in early August, and now the month is half over. The medical group we use does accept "some" Aetna plan, but they won;t know if ours qualifies, until we have the paperwork..

So the October appointment with the cardio, & the colonoscopy in Sept and the ophthalmologist appt in January, may or may have to be with new doctors somewhere else..

What's happened to us is not unusual, and happens all over the place, every day.

Employers can and do change carriers when the monetary reasons present themselves, so the myth of "keep what you want" is just that... a myth.

If we chose to stay with Pacificare, we would surely be denied coverage because of pre-existing conditions, and even if they accepted us, there would be no way on earth we could afford coverage on our own.

We have no idea what co-pays are coming along with the new coverage, or the limits.. we have just been "sold" into a new group, and the only options we have are , "Take it or Leave it".

Don't get me wrong, we are happy to HAVE coverage, but this is an issue that none of the me-me-mobbers, or any of the media ever really covers. They assume that "most people" are like them...making shit loads of money, and having the ability to choose whatever we want, whenever we want.

[DeepBlueC]

1. sounds like you don't want it any more

you might be interested in a federal govt pool.

[SoCalDem]

2. I'm hoping something like that is there for ME when my husband retires

He's 6 yrs older than I am, and unless he keeps working until I turn 65, I'll be "naked" for the years after he retires, until I qualify.

and , it's not about "not wanting" the new coverage..It's about the total lack of any control that workers have. The media rarely covers that fact.

If business is bad, or if a company closes up,and the insurance goes away, the people who had coverage through their employment, are left high and dry.. and not just the employee..the whole family.

The crisis in medical insurance is about the part of the coverage that is currently not being paid by the employee. The part that is paid by them is expensive enough for most, but COBRA or individual coverage is crushing, except for the very rich.

[DeepBlueC]

5. What Obama is talking about will take care of you in those years

I know that my mom's friends who had insurance supplemental to Medicare were always having to find new carriers because one after another dropped the plan they had signed on for. Always looking for some way to collect premiums and pay no benefits.

The plan is to offer a package of plans like congress gets and to offer insurance for the federal government insurers have to agree to certain terms, no pre-existing conditions exclusions I know is one but I know they are thinking about people like yourself.

My employer offers supplemental insurance to my Canadian health care (prescription drugs, medical devices, travel insurance, vision care) and we have had several carriers over the decades, Blue Cross, Liberty Health, and now Green Shield, but the plan has stayed the same. What they do is try to fulfill obligations more strictly, not allowing you to pick up a new script before 80% of your old one is used up (to keep people from piggybacking uninsured people I guess or selling medication). Initially I could get a script for any OTC thing like vitamins and I'd be reimbursed. No more. There are certain cases where you can be prescribed OTC things and get reimbursed now but I have not looked into it. But I feel lucky. My driug benefit has an annual deductible of $25.00. I pay less than $40 a month.

The only part of te insurance where you have to jump through hoops is the travel part. As soon as I hit the US I have to call an 800 number to tell them I am going to the doctor, what the problem is, where I'm going etc etc. PITA but more like US HMOs.

[redqueen]

3. But when you're forced to switch caregivers by the free market, that's ok!

It's only when a public option coems into the picture that it becomes a bad thing.

See? It all makes perfect sense!

[Veruca Salt]

4. Aetna is EVIL.

Until my company also switched I had BCBS and they were good, actually paid for stuff. Aetna on the other hand nickles and dimes you to death and everything is 'experimental' which therefore they don't pay for it! It's such a load of bull.

I want out so bad and can't wait to bail on those assholes.