Forget the plan – let patients keep their doctors!

I think there are two important points that are missing from the intense media focus — and now the White House response – to the problem of the insurance cancellation notices on the individual market.  Both are the result of actions that have been taken by insurance companies which are now participating in the exchanges — in other words, they are barriers to acceptance of ACA created by the same insurance companies that are the chief beneficiaries of the new, heavily subsidized insurance market.

The promise that “if you like your insurance, you can keep your insurance” was essentially written into the law, by the express terms of the original ACA legislation. There was a “grandfather” clause which expressly allowed consumers to keep whatever plans they were enrolled in prior to March of 2010, subject to some requirements to strengthen those plans.

The problem is that many consumers who buy their own insurance on the market have switched plans since then, giving up their grandfathered status.  It’s not that they didn’t like the plans they had; rather, those plans got too expensive. So very often the switch was to another, seemingly better or less expensive plan offered by the same company.    Continue reading

Anthem California Provider Lists

Finding Anthem’s provider lists for California is something of a treasure hunt — you can’t do it from the home page. But, nonetheless, I found it (and no, I don’t know if these will be updated to include more providers or hospitals in the near future):

Select your plan network from the list below:
Pathway X and Pathway PPO – ON & OFF Individual Exchange – PPO Network 
Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Mendocino, Modoc, Nevada, Plumas, Shasta, Sierra, Siskiyou, Sutter, Tehama, Trinity, Tuolumne, Yuba Counties
Marin, Napa, Solano, Sonoma Counties
El Dorado, Placer, Sacramento, Yolo Counties
Contra Costa County
Alameda County
Santa Clara County
San Mateo County
Monterey, San Benito, Santa Cruz Counties
Mariposa, Merced, San Joaquin, Stanislaus, Tulare Counties
Fresno, Kings, Madera Counties
San Luis Obispo, Santa Barbara, Ventura Counties
Imperial, Inyo, Mono Counties
Kern County
Riverside, San Bernardino Counties
Pathway X and Pathway Tiered – ON & OFF Individual Exchange – EPO Tiered Network 
Los Angeles County
Orange County
San Diego County
San Francisco County
Pathway X and Pathway HMO – ON & OFF Individual Exchange – HMO Network 
El Dorado, Placer, Sacramento, Yolo Counties
Fresno, Kings, Madera Counties
Los Angeles County
Orange County
Riverside, San Bernardino Counties
San Diego County
Santa Clara County

Anthem Blue Cross

Anthem Blue Cross  is slowly getting its provider network information updated, by posting raw lists of providers for various states. Anthem is a “multi-state” provider under ACA, which means that it has made the commitment to provide policies in all 50 states within the next 4 years.

You can check this page regularly to see whether a list for your state is ready, and to download and review these lists: