Rising Costs and Declining Coverage For 2016 in Texas Marketplace – Story

When I first enrolled in the Marketplace I was able to get a Silver PPO that I could afford with the subsidy, that offered what I needed. The second year that plan went up, but there was a lesser Silver PPO plan that I could apply for and afford that still offered the basics I was looking for, which were office visit copays and low or no cost generic prescriptions. I even told people that Obamacare was allowing me to have insurance I could have not afforded otherwise. Then came the plans for 2016.

This year Blue Cross Blue Shield of Texas has done away with PPO plans. It is now all HMOs. I checked the provider network in the city where I live and, of course, my long time doctor is not on that plan.

In fact there are only 23 primary care providers in network for that plan where I live. I live in a city of well over 100,000 with another city of over 100,000 only 20 miles away. This is the number listed for BOTH CITIES!! Two of them were listed twice so that makes it 21. Of those 21, 8 are pediatricians and now I am down to 13. Of those 13, 4 work exclusively out of low income clinics for which I am not eligible and now I am down to 9. Of those 9, one is leaving the network, down to 8. Out of those 8 there are 4 that I am familiar with having worked at the local hospital that I wouldn’t ever consider going to and now I am down to 4 providers that I know nothing about.

Can you imagine how many people are going to be trying to get into these providers? How long will it take to be seen? If you need a specialist you have to pay for an office visit to your PCP, then pay for another office visit to the specialist. It is horrible!! I should have known it would come down to junk like this when the government gets involved! And don’t try to tell me that the insurance companies and the government aren’t in bed!

The loser is always the individual. I am a cancer survivor, I don’t want another doctor who knows nothing about me! I can’t wait to see how they are going to screw me over next year!