Covered California Means Less Choice of Doctors

It’s becoming an every day occurrence.

I begin a conversation with someone looking for individual health insurance.  They either lost their insurance from their job or maybe they are just looking for a better price.

We start talking about what they’re paying now, what kind of coverage they have versus what they need, and what they might pay for a new plan.  So far, so good.

But then I ask the question.

“Do you use any doctors now that you just can’t live without?”

“Oh yes”, they say.  “There’s Dr. Jones in Long Beach and my wife loves Dr. Williams in Los Alamitos.  And don’t forget our pediatrician, Dr. Brown who has been seeing our kids since they were born.”

I thought so.

So what’s the problem?

The problem is that when it comes to individual health insurance in California, having a wide selection of doctors to choose from just isn’t possible.

According to a new study, 75% of California’s Obamacare health plans have narrow doctor networks.

That’s higher than 46 other states.

A narrow doctor network is a tool insurance companies use to keep their premiums down.  They cut the number of doctors and hospitals patients are allowed to use, thereby controlling medical costs.

So when I search each insurance company for Dr. Jones, Dr. Williams, and Dr. Brown, I am likely to find 1 or 2 listed in any one insurance company directory.  The other doctors may accept a different insurance company’s plans or they may not accept individual health insurance altogether.

That means my new customer has a decision to make.

They can do one of the following, depending on their circumstances:

• Accept COBRA if they lost their insurance from a previous job and continue seeing their previous doctor
• Buy an individual plan and see their previous doctor and pay out of pocket
• Purchase a PPO that provides out-of-network coverage, usually at 50%
• Find another doctor

Whichever path they choose, it’s important that they have the information up front.  Going to a doctor who is outside of their network and paying for the visit completely out of pocket could be very expensive.

There is no right or wrong choice, only a preference.

If you’re looking for individual health insurance in California, you can get online health insurance quotes right here, right now.

We can search each insurance company’s doctor networks for you, saving you time and any unexpected out-of-network medical bills.