• This is a political forum that is non-biased/non-partisan and treats every person's position on topics equally. This debate forum is not aligned to any political party. In today's politics, many ideas are split between and even within all the political parties. Often we find ourselves agreeing on one platform but some topics break our mold. We are here to discuss them in a civil political debate. If this is your first visit to our political forums, be sure to check out the RULES. Registering for debate politics is necessary before posting. Register today to participate - it's free!
  • Welcome to our archives. No new posts are allowed here.

"Free" preventive annual exams, but no coverage for treatment if they find cancer?

JumpinJack

DP Veteran
Joined
Aug 19, 2013
Messages
6,628
Reaction score
2,971
Location
Dallas, TX
Gender
Female
Political Leaning
Independent
In looking over the awful provider list for the BCBS HMO policy that is offered under the ACA (the only one I can afford), and noting that there are almost NO providers in my area that will accept it (or any HMO), I looked at the provider list for the bronze level BCBS PPO. Bound to be better, right? After all, that PPO policy (there are two, but all the policies are the same, as you know, except for shifting of deductible to out-of-pocket max and such) costs a whopping $520-$550/month (bear in mind these are HIGH deductible plans that provide NO coverage until you fork over the full deductible).

The provider list for the BCBS bronze level PPO is much better. My main drs accept them. However, I noticed the NO oncologist accepts them. Huh?

So...does that mean you get an annual exam ostensibly for "free" (ain't nothin' free, you know), but if they find cancer, you can't actually get treated for it? Is that what that means?

I have not checked other provider lists for other PPOs by Cigna, etc. And I of course didn't check higher than bronze level, since the cost is out of this world. So I haven't verified that this ironic effect is across the board.

But for those with low level PPOs, it sure looks like that is the case. That no oncologists will be accepting many of the ACA plans. I checked on that because a friend of mine who sees an oncologist told me that he told her that he would not be accepting ANY of the ACA policies. I assume he meant individual policies, not realizing that most group policies are also ACA. But maybe he did mean that, too. There are govt and self-insured policies that maybe he meant he'd accept.

Ironic, isn't it? You can find out what's wrong with you, but the insurance won't actually pay for you to get treated for it. So...what's the point of an annual exam?

The fed didn't realize, I guess, that they need the cooperation of the medical community, in order to provide services.
 
Re: "Free" preventive annual exams, but no coverage for treatment if they find cancer


Well, then I guess the only reasonable thing for the feds to do, is force them to provide services. (which will likely be what happens eventually, if I were to take a guess)
 
Re: "Free" preventive annual exams, but no coverage for treatment if they find cancer

Well, then I guess the only reasonable thing for the feds to do, is force them to provide services. (which will likely be what happens eventually, if I were to take a guess)

You can't force anyone to provide a service. They can simply close up shop (they're rich) or change professions.
 
Re: "Free" preventive annual exams, but no coverage for treatment if they find cancer

So...does that mean you get an annual exam ostensibly for "free" (ain't nothin' free, you know), but if they find cancer, you can't actually get treated for it? Is that what that means?

My understanding is that the free annual exam under the ACA covers zero treatment of any nature whatsoever except preventative things like flu shots. If you need treatment, you have to come back for a follow up and pay whatever it is you are required to pay under a normal doctor visits. That said, it really isn't a criticism of the ACA in particular. My existing non-ACA policy has the same "wellness visit" provisions as well and has for longer than the ACA has existed.
 
Re: "Free" preventive annual exams, but no coverage for treatment if they find cancer

You can't force anyone to provide a service. They can simply close up shop (they're rich) or change professions.
Oh, I wouldn't bet on that.
 
Re: "Free" preventive annual exams, but no coverage for treatment if they find cancer

To get folks to want (demand?) UHC you must first destroy the "private" system. PPACA was designed to do that.
 
Re: "Free" preventive annual exams, but no coverage for treatment if they find cancer

To get folks to want (demand?) UHC you must first destroy the "private" system. PPACA was designed to do that.

You do know that most people want universal single payer coverage, don't you? Even with full private coverage system? We're the only industrialized country in the world without it. And one of the least healthy.
 
Re: "Free" preventive annual exams, but no coverage for treatment if they find cancer

You can't force anyone to provide a service. They can simply close up shop (they're rich) or change professions.

Eventually, I expect that the feds will, indeed, force doctors to accept patients that they don't want to accept, based on poor reimbursement. As reimbursement levels fall, doctors will leave the profession, and fewer new docs will be coming into the profession. That will create an even bigger problem than we already have, and will lower the quality of care. None of this is a surprise to those of us working in that field.
 
Re: "Free" preventive annual exams, but no coverage for treatment if they find cancer

You can't force anyone to provide a service. They can simply close up shop (they're rich) or change professions.

Nonsense. They already mandate that "emergency" medical care be provided, regardless of one's ability to pay, not much of a stretch to require accepting any gov't approved insurance payment, no matter how much below the actual cost service, for "needed" medical care. That is precisely what UHC is.
 
Re: "Free" preventive annual exams, but no coverage for treatment if they find cancer

You do know that most people want universal single payer coverage, don't you? Even with full private coverage system? We're the only industrialized country in the world without it. And one of the least healthy.

Most people do not pay federal income tax so of course they want more taxpayer funded benefits. Ask them what flat, from the first dollar, percentage of their own income should be required and the story changes.
 
Re: "Free" preventive annual exams, but no coverage for treatment if they find cancer

You can't force anyone to provide a service. They can simply close up shop (they're rich) or change professions.

Yes you can.

We will do to Dr's what was done to all of us in Manufacturing.

Replace with cheap foreign criminals or outsource.

Revenge will be sweet...................
 
Re: "Free" preventive annual exams, but no coverage for treatment if they find cancer


Hmmmm....I think you misunderstand. Oncologists are the doctors that treat for cancer. NO oncologists in my area, it seems, will be accepting ACA policies. A primary care physician or gynecologist doesn't treat cancer.

The preventive exam discovers that you might have cancer, among other things. THEN you to a specialist (oncologist) for it. But you can't actually go to an oncologist, unless you can foot the bill for cancer treatment out of your pocket. Because no oncologist will take that ACA insurance.

(Note: If you can pay for cancer treatment out of pocket, then you don't need to pay for insurance in the first place.)
 
Re: "Free" preventive annual exams, but no coverage for treatment if they find cancer

Yes you can.

We will do to Dr's what was done to all of us in Manufacturing.

Replace with cheap foreign criminals or outsource.

Revenge will be sweet...................

No one forces Dow Chemical to manufacture products.
 
Re: "Free" preventive annual exams, but no coverage for treatment if they find cancer

You do know that most people want universal single payer coverage, don't you? Even with full private coverage system? We're the only industrialized country in the world without it. And one of the least healthy.

Now that you don't pay taxes you favor that idea even more.
 
Re: "Free" preventive annual exams, but no coverage for treatment if they find cancer

No one forces Dow Chemical to manufacture products.

Dr do not control medican. They are as replaceable as the workers at DOW or any other Mfg or service provider.

US Dr refuses to work for "puny" $80k, then import an Indian that will enjoy the "fortune" of $80. And since he gets a free state (in india) education, all the better.

Just like happened to all us Engineers and Machinists.

revenge will be sweet.
 
Re: "Free" preventive annual exams, but no coverage for treatment if they find cancer


I was responding to the question related to the annual exam not treatment, so no I did not misunderstand. Sorry but I seriously doubt no oncologist in all of Dallas will take any patients who have an exchange policy.
 
Re: "Free" preventive annual exams, but no coverage for treatment if they find cancer

I was responding to the question related to the annual exam not treatment, so no I did not misunderstand. Sorry but I seriously doubt no oncologist in all of Dallas will take any patients who have an exchange policy.

Why would you doubt someone who is vigorously shopping and examining policies and provider lists to buy an individual policy?

Look for yourself. Go to ehealthinsurance.com. Put in my stats (over 50, F, no tobacco, 75220). Look at the two lowest plans (they're the same plan, just with the deductible and out of pocket flipped). Click on "Find A Provider." You get a cupie doll if you can spot "oncologist" listed.

Then go up and look at the two next highest plans (still bronze). These are PPOs, so have more providers. You get two cupie dolls if you can find an oncologist who will accept those plans.

It's possible that some oncologist will accept a high level plan, but that makes no difference to me, since there's no way I can get one of those.

Bear in mind that where I live, I have FIVE major hospitals with major medical groups within 10 miles of me. There is ONE gynecologist within 10 miles of me that will accept the two lowest plans. And that person isn't close to me. Since that is the only gyn that will accept the lowest plan, I'm guessing s/he is desperate for patients, and I would have a heck of a time getting an appointment, since everyone will have to go to that gyn. But no oncologist at all.
 
Re: "Free" preventive annual exams, but no coverage for treatment if they find cancer

Now that you don't pay taxes you favor that idea even more.

I pay taxes. Everyone pays taxes. Ever since I became aware of the health systems of other countries, I have fully supported universal care. There's a reason other countries do it, and their citizens are healthier. Some of those countries have both a universal system and a private system. No one goes without health care. Which is a good thing. It's part of their national budget.
 
Re: "Free" preventive annual exams, but no coverage for treatment if they find cancer


This is something I think doesn't receive enough criticism. Are their citizens really healthier because they get universal healthcare? I would present the argument that universal healthcare might be workable in other countries because they are healthier. Their citizenry could easily have been healthier before having universal health insurance.
 
Re: "Free" preventive annual exams, but no coverage for treatment if they find cancer


Everyone does not pay federal income tax. That is exactly why we do not have UHC - we don't have a budget, we have a deficit. These countries with UHC spend far, far less on defense and education than we do - try getting the votes to cut those (or raise taxes) to pay for UHC. Even the demorats will not suggest that, that is why we got PPACA instead.
 
Re: "Free" preventive annual exams, but no coverage for treatment if they find cancer



I clicked the third one down, the first BCBS PPO (Blue Choice Bronze PPO 006). Oncologists start on page 4 of that "all providers" directory for that plan. All of the names below are located in Dallas, TX and accept that plan.

Charles J Deur MD
Oncology; Medical Doctor

Granger R Scruggs MD
Radiation Oncology; Medical Doctor

Jeffery E Greenberg MD
Radiation Oncology; Medical Doctor

Thomas C Anderson MD
Oncology; Medical Doctor

Claude A Denham MD
Oncology; Medical Doctor

Robert B Berryman MD
Oncology; Medical Doctor

Kartik Konduri MD
Oncology; Medical Doctor

Michael R Spivey MD
Oncology; Medical Doctor

Vinay K Jain MD
Oncology; Medical Doctor

Estil A Vance MD
Oncology; Medical Doctor

Merrick Reese MD
Oncology; Medical Doctor

Joseph G Kaczor MD
Radiation Oncology; Medical Doctor

Karen Nielson MD
Radiation Oncology; Medical Doctor

Charles L Cowey MD
Oncology; Medical Doctor

Douglas Orr MD
Oncology; Medical Doctor

Moshe Y Levy MD
Oncology; Medical Doctor

Neil N Senzer MD
Radiation Oncology; Medical Doctor

Kesha R Harris Hender MD
Radiation Oncology; Medical Doctor

Sandeep Gill DO
Oncology; Osteopath

Victor Horadam MD
Oncology; Medical Doctor

Houston E Holmes MD
Oncology; Medical Doctor

Robert G Mennel MD
Oncology; Medical Doctor

Thomas E Hutson DO
Oncology; Osteopath

John J Nemunaitis MD
Oncology; Medical Doctor

Michela Caruso MD
Radiation Oncology; Medical Doctor

James M Turner MD
Oncology; Medical Doctor

Berchmans John MD
Radiation Oncology; Medical Doctor

Allen C Stringer MD
Oncology; Medical Doctor

Andrew D Mccollum MD
Oncology; Medical Doctor

Robert P Scruggs MD
Radiation Oncology; Medical Doctor

Amir A Faridi MD
Oncology; Medical Doctor

Christopher M Maisel MD
Oncology; Medical Doctor

Scott A Stone MD
Oncology; Medical Doctor

Barry N Wilcox MD
Radiation Oncology; Medical Doctor

Mark W Walberg MD
Oncology; Medical Doctor

Joyce Oshaughnessy MD
Oncology; Medical Doctor

Cynthia R Osborne MD
Oncology; Medical Doctor

Stephen Sorgen MD
Radiation Oncology; Medical Doctor

Brennen S Cheek MD
Radiation Oncology; Medical Doctor

Edward D Agura MD
Oncology; Medical Doctor

Alan M Miller MD
Oncology; Medical Doctor

Kenneth C Hancock MD
Oncology; Medical Doctor

Eric S Nadler MD
Oncology; Medical Doctor

Carolyn M Matthews MD
Oncology; Medical Doctor

Joseph W Fay MD
Oncology; Medical Doctor

Barry Cooper MD
Oncology; Medical Doctor

Janice K Tomberlin MD
Radiation Oncology; Medical Doctor

Edward D Agura MD
Oncology; Medical Doctor


Did I win something?
 
Last edited:
Re: "Free" preventive annual exams, but no coverage for treatment if they find cancer


Texas Oncology has not yet made a decision on which if any plans they will accept Insurance loophole jeopardizes cancer treatment | wfaa.com Dallas - Fort Worth
 
Re: "Free" preventive annual exams, but no coverage for treatment if they find cancer

Let me wrap my head around this thread. Conservatives have been griping that Obamacare mandates this and mandates that and forces one to pay for service one may not want. So the OP is griping now that the ACA mandates exams but doesn't mandate treatment.

Please figure out which side of the fence one wants to be on.
 
Re: "Free" preventive annual exams, but no coverage for treatment if they find cancer


I think its rational to show the inconsistencies of this law.
 
Cookies are required to use this site. You must accept them to continue using the site. Learn more…