Originally Posted by
lynn
I am not a fan of Obamacare but I do not understand why these people can no longer see their doctor. I have many years of experience working in the medical field especially with contracting doctors with health insurance companies. The contracts for participation allows providers of care to choose what plans they want to contracted for. For example, most of the big health insurance companies will allow the provider to be a HMO, or PPO, and other additional choices to participate in.
They can participate in all plan options or can decide to participate in one or more of their choice. It doesn't matter where the consumer got his insurance from whether it be from an employer, or through the exchange for individual coverage. What matters is what plan option the consumer picked with a health insurance carrier that determines what providers of care are in their network.
People complaining that their provider of care is not in their network is because they are no longer insured through their previous insurance and had to switch health plans. Doctors cannot refuse service based on where they purchased their coverage. Providers of care would lose a great deal of their patients if they decided not to contract with any of the health insurance companies that participating on the exchange.
All of those carriers on the exchange are not limited by that pool of consumers. They all have contracts with the government for their medicaid and Medicare Advantage population as well as the big corporations who are self-insured which they only administer to for their employees. networks of participating providers of care is determined by who participates with that particular plan product of the health insurance carrier.