Insurance? You better shop around

Published 1:49 am Saturday, September 28, 2013

To the editor:

Probably the No. 1 question in the county right now is “How will Obamacare affect me?”. There are so many unknowns associated with this law that one’s head could explode just thinking about it. About the only thing we can be sure of – “change, it’s a comin’,” and I’m afraid it ain’t gonna be purty!

I want to state a disclaimer before I begin my rant. I have not read the entire law (followed Congress’s example), but having worked in the medical insurance field for about 35 years, I have a very strong feeling about what is about to happen to our country. I truly believe that his one law, if it continues as written, will bring down our entire economy. It will be almost impossible for such a monumental change in an industry that contributes to approximately 17 to 19 percent of our economy to not have a profound negative effect.

Even though Obama has chosen to pick and choose which parts of the law he wants to enforce, and Congress has allowed him to do so, there is one saving grace to the delay of the employer mandate. Hopefully, this will allow people to keep their full time jobs and insurance for up to a year longer, before employers will be forced to cut workers to part-time or let them go altogether and/or stop supplying employee health insurance completely. Because of this delay, the full impact of Obamacare will be postponed until Jan. 1, 2015. I can’t help but feel that his decision has a two-fold purpose: keep the economy limping along without the inevitable downward spiral that it will take after Obamacare is in full swing and keep the Democrats in power after the 2014 mid-term elections. Again, full disclosure forces me to state that I am a registered Democrat, a fact at which am very embarrassed to admit (I just haven’t taken time to change my status), but am about as conservative as one can get. I truly believe that BHO’s ultimate goal is to have socialized medicine with a single-payer system, the U.S. Government. I believe that every decision he makes is based on whatever will harm our country the most. OK, that’s as far as I will go in stating my feelings about the POTUS.

The point of my letter is to say that as the search begins for health insurance, both by individuals and businesses, be careful which plan you choose. Everyone has probably heard the phrases “participating provider” or “network provider.” What that means is your doctor of hospital has a contract with an insurance company to accept its fee schedule and certain rules for treating patients. After talking with several offices around town, doctors are not going to be expanding their participating status to any new companies right now. There are just too many questions to which nobody has answers. As people are doing their homework on this, be sure to check with your doctor and make sure you either choose a plan with which he is contracted, or be prepared to pay more out-of-pocket. Along this same subject, although it has nothing to do with any new rules under Obamacare, people who have traditional Medicare who are thinking to a Medicare Advantage Plan, the same rules apply. Just because your doctor participates with Medicare doesn’t’ mean he participates with all of the Medicare Advantage Plans that are being offered. Again, if you have one with which your doctor and hospital do not participate, you will have more out-of-pocket expenses.

Everybody needs to buckle up and get ready for a bumpy ride!

Cindy Pollock