Santa Cruz County residents drop Covered California Anthem plan to keep PAMF doctors
By Jondi Gumz, Santa Cruz Sentinel, Calif. | |
McClatchy-Tribune Information Services |
"I've been told that we are getting five to eight patients a day with the Anthem Covered California product and that most of them switch to another insurance product to stay with their PAMF doctor," said PAMF spokesman
He did not know if these patients were switching to another Covered California plan -- both
"You don't find out what insurance you have until you use it," said
"The more complex the choices are, the more likely people are to rely on a brand, a friend's recommendation or something their parents had," she said. "My guess is they don't understand what the network consists of until they use it."
WHO'S IN NETWORK?
Covered
This week, the
Perhaps these Californians got a new job providing health insurance, though this seems unlikely locally since available jobs shrink in the winter or they could have been short of cash and opted instead to pay a penalty of
It's likely they discovered their health plan didn't include the doctors they want, or they signed up for more than one plan due to enrollment snarls.
So he bought a second plan on the private market, choosing Anthem, which on
Anthem's PAMF announcement did not mention Covered California.
Whether PAMF doctors were in the Anthem Covered California network was not known until the next day when PAMF spokesman
STAY IN NETWORK
The standard advice to keep costs lower is to "stay in the network," but it's easier said than done.
"Even a surgery in Dominican, which is in network, can have an anesthesiologist that is out of network, an MRI in network, read by a radiologist out of network," said
Burns said she is curious as to why Anthem was the most popular locally.
"What attracted people? Did they get accurate information?" she asked, noting officials at
Online access may be a factor.
"If you can get on one network but not another, that may be the one you buy," Burns said.
She was a member of the
"They don't have to give it to you unless you ask," Burns said.
"This is so complex," she added, explaining how consumers could end up paying for "preventive care," like a colonoscopy, for which there is no co-pay. "If they find something and take it out, all of a sudden, that's a procedure, and you're stuck paying for that."
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