This gets a little bit complicated, but usually, a contracted provider has agreed to accept a (typically higher) negotiated non-par provider amount as payment in full, and many insurance plans will process the claim under out-of-network benefits, but still apply the amounts for a contracted provider to the patient’s deductible. He participates in exactly four PPO networks, none of which are included in the exchange plans available to Harris, but he is a “contracted provider” with 15 insurance companies’ PPO networks. Wians’ insurance status (which is the same as it was before Obamacare took effect). Without knowing the exact plan he’s getting, it’s tough to test that claim, but here are a few facts about Dr. The report does fall somewhat short in examining Harris’ claim that his care will be “really out of network,” and won’t apply to his deductible. Eitches “says 10% of his patients must find new doctors, or pay steep out-of-pocket costs.”Īs far as it goes, though, Wians’ reporting appears to be accurate, a refreshing change in Obamascare media coverage. Wians points out that Eitches has already stopped taking Medicare, and adds that Dr. You can leverage demand for your services to make the maximum amount of money possible, or you can wax melancholy about your “bond” with your patients. Eitches has a sad, because what control does he have over which insurance he takes? Aside from “complete control,” that is. I have a lot of patients who have been seeing me for over 20 years, and we have a bond. Eitches, who says “I’ve had many patients say do whatever you can do, because I don’t know if I’ll be able to see you after December 31st,” later adding that “what I may think about is not taking any insurance at all. “I know if i go see him, it’s completely out of network, and it does not apply against my deductible,” Harris says. Robert Eitches at the prestigious Cedars Sinai Medical Center in Los Angeles.” “Harris suffers from debilitating allergies,” Wian reports. Harris is actually going to be paying $5 a month less under Obamacare, but he’s not happy. Next up was CNN’s Casey Wian, with the “other” side of Obamacare, 62 year-old Tom Harris, a “self-employed handy man who had high hopes for Obamacare.” On top of that, they’re paying a third less than Kate had been paying when she last had insurance.
Kate’s husband also has a preexisting condition that kept insurers from covering him at all, which is no longer an issue under Obamacare. That’s important, because before Obamacare, if the insurance company could trip you up a little during the application process, they could then use that later to cancel your plan retroactively if you ever got really sick, or just pregnant.’
She says it was “not just paperwork, but trying to remember every doctor’s visit you’ve had for the last year, and every procedure or major issue you’ve had for the last ten years.” The report glosses over it, but when Kate Leeper describes the old application process, she’s also describing one of the Obamacare benefits that affects everyone. To that end, New Day anchor Chris Cuomo showcased two Obamacare stories Tuesday morning: a success story about an uninsured couple, and a “failure” story of a man who will pay less for health insurance under Obamacare.Ĭuomo introduced his report by pointing out that “The affordable care rollout has been terrible, but what is the reality of the law? Are there successes with Obamacare, or is it just about failure?”ĬNN’s Miguel Marquez then told the success story of Kate Leeper and Justin Leeper, a married couple who are uninsured now, but will be getting health insurance Jan. In the too little, too late department, CNN has finally decided that their job is no longer to “counter” President Obama‘s health care message with deliberately one-sided and suppressed reporting, and has now decided to show “both sides” (that’s not really their job, either, but it is an improvement).
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