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People Using Health Exchanges Urged To Do Their Homework

People Using Health Exchanges Urged To Do Their Homework

 

Some have started off with a few computer glitches, but the health exchanges are in operation. They began taking calls and on line inquiries on Tuesday, October 1st as part of the Affordable Care Act.

If you are using these exchanges, you're urged not to pick a plan based only on the price. "It's a great idea. But if you sign up for a policy just based on the dollar amount you might have some significant disappointments," says Dr. John Vitariello, a local cardiologist and President of the Frederick County Medical Society.

He says you need to make sure your primary care physician or specialist takes the insurance carrier you're interested in. "One of the upsides of this is that you can shop around for different insurance prices, if you're self insured, to see what's a better price, with an understanding that you have to do your research to see if your primary care physician or your specialist participates in it. Many times, they don't," he says. Some of these insurance companies are from other states, and have not signed up doctors in Maryland.

Dr. Viteriello provides an example. "In Frederick, we have Kaiser Permanente. They're a great group in the big city, but in our county and our city, our hospital doesn't participate with Kaiser Permanente, nor do any of the local specialists," he says. "So if you've got Kaiser Permanente, and you're sick in the middle of the night, and you're having a heart attack, and you don't have a cardiologist or a surgeon, they have to ship you down to Holy Cross or Washington Hospital Center."

After you do your research on the company, Dr. Vitariello suggests you make a courtesy call to your physician or specialist, and ask if they participate with the insurance carrier you're interested in.

In addition, if you're using the exchanges, find out how much you would have to pay as a deductible. "Deductibles can be $5,000, and most of us never spend that much money, in our age groups {baby boomers} in the '50's and the '60's. So you might be better with a traditional plan as opposed to a bronze or silver that has a high deductible," says Dr. Vitariello.

Finally, check out any prescription plans, and what medications they cover, especially if you take medications for a chronic illness, says Dr. Vitariello.

The Maryland Health Connection opened up last week with a few computer glitches as a number of people tried to sign up on line. But Executive Director Becca Pearce said on Monday that the technical team has added server capacity,and plans to update the system's software.

 

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