According to an article in the Miami Herald, several South Florida doctors are refusing to accept new patients covered by lower-tier health insurance plans procured through, i.e., so-called “Obamacare policies”.

Finally Able To Afford Insurance – Just To Get Turned Away

After being without health insurance for two years, Miranda Childe of Hallandale Beach found a plan she could afford with financial aid from the government using the Affordable Care Act’s exchange.

Childe, 60, bought an HMO plan from Humana, one of the nation’s largest health insurance companies, and received a membership card in time for her coverage to kick in on May 1st.

But instead of being able to pick a primary care physician to coordinate her healthcare, Childe says she repeatedly ran into closed doors from South Florida doctors who are listed in her plan’s provider network but refused to see patients who bought their coverage on the ACA exchange.

“I just felt that I wasn’t being treated like a first-class citizen,’’ said Childe, who eventually found a doctor with the help of a Humana counselor. “Nobody, I don’t care what kind of degrees they have, should ever be treated that way.’’

Nearly one million Floridians enrolled in a private health plan through the ACA exchange but some, like Childe, are finding that some physicians refuse to honor their coverage — even when the doctors are included in the plan’s provider network.

Late /Missing Payments Worry Physicians

Some physicians say they’re concerned they won’t be paid for their services by either the insurer or the patient, and that insurers are not adequately informing doctors of their inclusion in exchange plan networks.

“You don’t want to be in a situation where you provide service, and turn around and there’s no contract in place to reimburse you,’’ said Jay Millson, executive vice president of the Florida Academy of Family Physicians.

For some patients, though, the elation they felt about being insured has been tempered with rejection at doctors’ offices.

Sal Morales, 48, of Kendall, said a physician and her staff humiliated him when he tried to make an appointment at her Hialeah office earlier this year.

“They made me feel really bad,’’ said Morales, who bought a Florida Blue plan in March and qualified for subsidies to help pay his monthly premium and out-of-pocket costs. “I felt, seriously, like I had a horrible disease that they couldn’t, or wouldn’t, or didn’t want to cure, or at least see and examine.’’

Morales, who lost his employer-provided health insurance in October when he was laid off from his job as a TV producer, said he has been turned away by at least three primary care physicians who are in his plan’s provider network.

“I actually went to a doctor,’’ he said, “and in the lobby they had an 11-by-14-inch sign in bright yellow that said, ‘We do not accept anything from the marketplace [Obamacare]’.’’

But Morales said the worst experience was standing by at another doctor’s office as the receptionist called Florida Blue to verify his coverage.

“They got into a screaming match,’’ he said…

Read the rest of the article here

Speak with a licensed Florida health insurance agent today to learn more about your options.


Leave a Comment