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Related: About this forumInsurers restricting choice of doctors and hospitals to keep costs down
As Americans have begun shopping for health plans on the insurance exchanges, they are discovering that insurers are restricting their choice of doctors and hospitals in order to keep costs low, and that many of the plans exclude top-rated hospitals.
The Obama administration made it a priority to keep down the cost of insurance on the exchanges, the online marketplaces that are central to the Affordable Care Act. But one way that insurers have been able to offer lower rates is by creating networks that are far smaller than what most Americans are accustomed to.
The decisions have provoked a backlash. In one closely watched case, Seattle Childrens Hospital has filed suit against Washingtons insurance commissioner after a number of insurers kept it out of their provider networks. It is unprecedented in our market to have major insurance plans exclude Seattle Childrens, said Sandy Melzer, senior vice president.
The result, some argue, is a two-tiered system of health care: Many of the people who buy health plans on the exchanges have fewer hospitals and doctors to choose from than those with coverage through their employers.
Read the rest at: http://www.washingtonpost.com/national/health-science/insurers-restricting-choice-of-doctors-and-hospitals-to-keep-costs-down/2013/11/20/98c84e20-4bb4-11e3-ac54-aa84301ced81_story.html
JimDandy
(7,318 posts)postulater
(5,075 posts)bemildred
(90,061 posts)SheilaT
(23,156 posts)or what authorization was needed to see a specialist. Never. The only completely free access to medical care was the old fee for service one, where you paid in full for whatever. And even then, there were times I knew of when particular doctors weren't taking on new patients because they had as many as they could handle.
flamingdem
(39,313 posts)In this case it looks like the insurance companies are playing games to screw the consumer. Do they decide on payment amounts?