Covered California Coverage Denied
Its a sign of the times in medical office buildings on the Central Coast amid the Affordable Care Act and the statewide insurance exchange known as Covered California.
Ten months into the roll out of Covered California, and the numbers from Covered California will tell you its working well.
More people than ever before in California now have access to healthcare insurance and at a more affordable price.
But a closer examination also reveals cracks in the system.
As previously reported by Central Coast News, insuring all those added people was expected to put a strain on the existing healthcare industry in California, overwhelming primary care doctors and negatively impacting the reimbursement rates they get from participating insurance companies.
“My experience is they will put stuff on their website that says doctors take Covered California and they do not”, says Leona Meyer.
Meyer went to see her primary care doctor for a routine physical and other procedures only to be told she was no longer accepted as a Covered California client
“They told me I could submit the bill to the insurance company, they could not, but it would be out of network”, Meyer says, “I don’t know how that would affect me, I met my deductible this year, so after having two other problems I’m working 4 and 5 months to correct, I don’t want to do that.”
As it turns out Central Coast News interviewed Leona Meyer’s primary care physician, Dr. Michael Schrager back in March of this year.
Dr. Schrager warned back then the reimbursement plans by the participating insurance companies under Covered California would mean he would have no other choice but to turn away patients.
“The insurance industry has taken upon itself to reduce the amount that they pay the providers drastically, I mean drastically”, Schrager told Central Coast News back in March, “so for the most part many of the patients that we see that are now covered on that can’t come to our office and be seen here, they need to go to a place for the most part I think that is going to be a subsidized entity.”
For now, its a waiting game for Leona Meyer now that Covered California hasn’t covered her.
“Now I’m hoping nothing happens until March when I will be on Medicare”, Meyer says, “I’m gonna try to stay well for five months and hope I don’t need to see the doctor”.
