"I was searching and searching and realized that you cannot, as a resident of Longmont, buy an individual plan that covers Longmont United. You can't buy it," Russell said. "Larger groups and smaller groups still have that option, but individuals have to go through the exchange. So lower-income people don't have an option to go to Longmont United unless it's an emergency. That was eye-opening."
In other words, people who have insurance through their employer or their spouse's employer can find plans that cover
For individuals purchasing an Anthem plan in 2017, the closest hospitals considered in-network would be
Felts said Anthem cut individual coverage at Longmont United as a business decision.
"In this case, we were attempting to provide quality benefit plans at the most attractive price for consumers and we had to make some decisions," Felts said. "That's why not every hospital is in-network for those who purchase insurance on the exchange."
Cigna Spokeswoman Amy Turkington Szable echoed these thoughts, saying Longmont United is only available to larger group plans.
"The reason we're not on the Cigna nor the Anthem network is that both organizations elected to build insurance networks that excluded
While Longmont United is the only operational major hospital in
Tracer couldn't say exactly what insurance plans would cover
UCHealth facilities in this area typically are not part of Kaiser's contracted hospital network, but are covered under Anthem, Tracer added.
The decision by the insurance companies to exclude the city's only operational hospital has real effects on Longmont-area residents.
Rosneck said he and his wife have had to develop a complex work-around to be able to see doctors at Longmont United who have been seeing Rosneck since he was diagnosed with deep vein thrombosis, a sometimes life-threatening condition of blood clots in the leg.
"We decided what we would do is go to Kaiser and find just the cheapest Kaiser plan we could get and for us that would cost
Because of his age and income, the health exchange does allow Rosneck and his wife to receive an
But, Rosneck said the Kaiser plan is basically catastrophic coverage -- the deductible is so high there isn't coverage until something major and expensive occurs.
"We can fund the HSA to cover our day-to-day (medical) expenses but in theory if we need hospitalization we have to go to
He also found a clinic that will give a 20 percent discount for payments in cash rather than through insurance.
So, if Rosneck goes to Longmont United to see his doctors, it is out of his insurance network and he pays out-of-pocket from his HSA. For day-to-day care, he sees the clinic doctors and gets the cash discount, again paying out-of-pocket from his HSA. Sometimes, he can ask a Longmont United doctor to recommend a Kaiser physician, which would be in-network and count towards meeting his deductible.
The whole process requires figuring out health care costs before he goes in to see a doctor, which is one extra step to obtaining health care.
"If they say 'OK you need this test' and I ask how much it will cost and they say 'I don't know' then I say no, that's not going to work. If they say 'You might benefit from this pill' I say no, we're not doing that because we don't have money for that," Rosneck said.
Rosneck said he hasn't come across something yet that would clean out his and his wife's HSA, but it's a constant uncertainty.
"We came up with a strategy that's working for us for the time being. But what would be bad is if we had two, three or four
"Well, at our age, it wouldn't bankrupt us, because we would be taking money out of our IRA. But that's stealing out of a future to pay for the health care present."
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