Blue Cross Blue Shield of Texas Sending Letters That the Bronze Plan Has

[DhhD]

deductibles and cost sharing requirement greater than what is required by the Texas Insurance Board. BCBS of Texas wants the insured to know that the benefits MAY have specific benefit reductions as this plan has lower monthly premium costs. Does this mean that a person would have to pay the cost of an MRI on their knee before getting an injection that lubricates between the knee bones? Most people who can only afford this type of Bronze Plan can not afford to pay for an MRI. So they would have to apply for Medicare, become temporarily disabled, then go back to work on the Social Security, Ticket to Work Program. Texas has over ridden the ACA on this one. Texas State Government chose not to set up a market place through the ACA, for some reason. Could moving people off ACA Market Place Plans and on to private insurance plans be the reason?

The letter also says that BCBS of Texas wants you to call their Consumer Health Benefit Plans at
888-697-0683. Wonder how many Texans are getting this letter. This could be a private profiteering plan, to remove the protections of ACA to Texans by selling new private plans. Here is their web address also:
http://www.bcbstx.com/coverage/individual

[Rstrstx]

1. I'm confused

I thought an ACA market place plan WAS private insurance.

[DhhD]

2. ACA arranges for Affordable Patient Protection until the State comes in to place a new meaning on

specific benefits; redirecting the assumed public law specific benefits to private benefit reductions AFTER the person buys the policy.

The federal Health and Human Services ACA came in (2013) and moved the poverty line up to 138% from the Texas Medicaid poverty line. Are Texans receiving Silver Plans, Gold Plans, and Platinum Plans receiving a like letter in the case of those persons just over the 138% poverty line and Bronze Plans? Why did persons not receive this notice before paying for the private policy? Is it Patient Protection for the State to refuse to set up their private policy ahead of Jan 1, 2014? Did the State set up the reduced benefits after Jan 1 and FORGET to tell ACA? Is this retaliation for raising the poverty line to 138% being taken out on the poor? Is this retaliation for Texas refusing to set up its own Market Place being taken out on Texans? The GOP Texas style government is horrible to its citizens. Does Greg Abbott approve this message?

IMO, Texas Insurance Board is redirecting health care back to Medicaid services using some Bronze Plans through private insurance carriers. The Texas Insurance Board also redirected the federal ACA Navigators to receive additional training. Was this benefits reduction a part of the additional state training? Are there statics comparing the annual income of Texans to the number of all four Plans purchased? Cost of Silver Plans is a hugh jump in premium costs from Bronze.

Texas; State of schemes and scams.

[yellowdogintexas]

3. benefit reductions generally mean the negotiated rates are lower

OR the co insurance (%patient responsibiliby) is higher..not that the service isn't
covered.

The patient could still get the MRI; it would most likely apply to deductible. Let's say the MRI is $3000 retail; however the negotiated rate for it with BCBS might be $1400. If deductible isn't met, then $1400 would go to deductible, and patient is responsible. Provider writes off the remaining $1600.

It is still a lot of money for someone in an income bracket that low. The big crime here is the failure of Texas to accept the expanded Medicaid.

Not quite sure what BCBS is up to with this. ACA Market plans are private insurance plans. It would seem they are trying to get people to look at some of the other plans they offer... which means they are probably more profitable for BCBS.

[DhhD]

4. Doctors taking patient with minor care needs as cash and referring insured patients to specialists

for tests.

“We have to find ways of stretching the current number of primary care doctors to meet that demand,” said Dr. Clare Hawkins, president of the Texas Academy of Family Physicians. “Direct primary care goes in the other direction.”

Read more: http://medcitynews.com/2014/04/texas-doctors-drop-insurance-move-cash/#ixzz31b8lrAaF

Apparently, private insurance has everything to gain by using this model to moving up into HMO care for patients on low cost Bronze Plans. The federal government pays approximately $470.00 per month as a subsidy. Yet BCBS of TX wants more! And sends out letters to tell the poor that they MAY be charged the co-pay that the TX Legislature proposes instead of accepting the Medicaid Expansion. In 2015 the Texas Legislature meets again to set up a cash pay system along with private insurance paying out less and less therefore overriding the ACA 20%/80% Rule. Families making, let's say $35,000.00 a year will be paying on a $6,000.00 bill. Then next year another trip to the emergency room is another $6,000.00 enough to declare bankruptcy over.

Where is affordable nationalized health care for America? Coming soon, I hope.

[DhhD]

5. Disclosures made, after, lower cost Plans were presented and bought, leads to suite against

Blue Shield of California.

http://news.yahoo.com/california-consumers-duped-blue-shields-limited-obamacare-plans-194137220--sector.html