"The healthcare marketplace is open once again, but if you look closely at the offered insurance plans you might find something lacking: coverage for specialized treatments.

Preferred provider organizations, or PPOs, often cover specialized treatment like care for cancer patients. But the loss of individual-market plan PPOs will affect tens of thousands of people who buy their insurance privately rather than through an employer. Before the Affordable Care Act, it was the way most people who did not have employer insurance got coverage.

Jenny Deam, with the Houston Chronicle, investigates the disappearance of these plans. She says there will no longer be any plans, by any carrier on the federal exchange for the Houston area, that cover treatment at the MD Anderson Cancer Center. How the marketplace got that way, she says, is a little unclear.

"The PPOs had started disappearing a couple of years ago," she says. "The last one in Houston was Blue Cross Blue Shield of Texas and they announced in the summer that they were getting rid of them, that they were no longer sustainable. PPOs with their wider range of network and hospitals... are very expensive."

What insurers have done instead is shift people in the individual market and on the healthcare exchange to HMOs, which are usually less expensive. The downside, Deam says, is that patients with specialized and complex medical needs will have limited coverage.

In her investigation, Deam profiled one cancer patient, Martha Gardenier, who was told by a doctor that she needed to start making end-of-life preparations. She sought a second opinion from MD Anderson, and began to see her situation improve from Stage 3 to Stage 1 cancer. This experience showed Gardenier that not all doctors who treat cancer are created equal ? that she was getting better care at MD Anderson.

Now, it's as if that carpet is being pulled out from under her. Gardenier will no longer will have a PPO that will cover the costs as it once did. She's going to have to pay out-of-pocket for care that could reach $10,000 a month.

"Since that article appeared, I've had just dozen of emails, many from other patients who tell the same story," Deam says. "They specifically got an insurance plan that covered MD Anderson.... [Gardenier is] a pretty stark example of somebody who had been pretty much told 'There's nothing more we can do for you,' and she entered a clinical trial, highly experimental, at MD Anderson. And it worked. People like that don't want to hear that cancer treatment is interchangeable."

What happened to "If you like your Doctor, you can keep your Doctor" 

On the surface. No insuarance ever wants to cover these types of facilities. Call them up though when you need to use them and you will find out that you can.

Try learning something for a change. 

On the surface. No insuarance ever wants to cover these types of facilities. Call them up though when you need to use them and you will find out that you can.

Try learning something for a change.

Ok know it all, why don't you tell us which ACA offered plans cover care at MD Anderson OTHER than medicaide 

And that leaves how many other cancer treatment centers in Houston and elsewhere that ARE covered? 

In her investigation, Deam profiled one cancer patient, Martha Gardenier, who was told by a doctor that she needed to start making end-of-life preparations. She sought a second opinion from MD Anderson, and began to see her situation improve from Stage 3 to Stage 1 cancer. This experience showed Gardenier that not all doctors who treat cancer are created equal ? that she was getting better care at MD Anderson.Now, it's as if that carpet is being pulled out from under her. Gardenier will no longer will have a PPO that will cover the costs as it once did. She's going to have to pay out-of-pocket for care that could reach $10,000 a month.

MD Anderson is the best, you should have that choice. 

It's also a SHAME when you LIVE right here and they dont cover a local, specialty care treatment center, when you're DYING. UGH 

Call up your insurance company when you need that care and you will get it. It just happened to a friend of mine. 

So is this really a surprise? Not to some of us... 

Or you can continue to wallow in your hatred if it suits you.

LMFAO 

Call up your insurance company when you need that care and you will get it. It just happened to a friend of mine.

No that didn't happen.

So, which ACA plan covers MD Anderson? 

There aren't any plans sold through the ACA that cover care at MD Anderson.

None, nana~, zip ... 

Obama lied to the people. 

When we lay blame, let's be honest about it. This is Obama's idea BUT the insurance companies decide who they participate with as far as docs and facilities. The whole idea is starting to blow but it is the insurance companies "adjusting" their coverage to compensate for having to participate IMO. 

When we lay blame, let's be honest about it. This is Obama's idea BUT the insurance companies decide who they participate with as far as docs and facilities. The whole idea is starting to blow but it is the insurance companies "adjusting" their coverage to compensate for having to participate IMO.

You're exactly right ...

Blue Cross / Blue Shield said that their PPO Plan(s) were not "profitable" and, therefore, discontinued them.

So instead of selling a PPO, they only offered HMO's on The Marketplace and MD Anderson does not accept HMO plans.

As the result, cancer patients who were being treated at Anderson were forced to find new doctors. 

I think I'll choose Methodist, if the need arises. They've been pretty darn good for other issues.

If they're good enough for President GHW Bush, they're good enough for me.

They accept most ACA plans.

I'm betting there are a LOT of treatment centers/hospitals that accept most ACA plans. 

MD Anderson is the best, you should have that choice

Who's going to pay for it? On one hand, republicans scream that there shouldn't be universal healthcare, and then they complain when they don't get the best coverage for free.

Go figure. 

While it is true that Obamacare is having an impact on narrow networks, it's also the case that the law dramatically increases access to care for cancer patients. The law's provision outlawing discrimination against pre-existing conditions arguably benefits cancer patients more than any other group. The law also provides premium protection for people with health conditions, removes lifetime and annual limits on benefits, and expands cancer screening and other preventive measures. The American Cancer Society endorsed the law and has written extensively on the benefits of the law for cancer patients, including listing six ways Obamacare "will meaningfully improve the health care system for people touched by cancer." 

https://www.mdanderson.org/patient-and-cancer-information/cancer-information/cancer-topics/prevention-and-screening/health/healthcarereform.html 

But go ahead karass, continue to have daily fits of rage and try to convince everyone around you that the sky is falling. 

That's so original and very substantive to the conversation turd goodman. I can't fathom how you came up with it. 

That's probably one of the best postings that Turd has ever made. 

they complain when they don't get the best coverage for free.


ACA is not free! It would not be free for me if I had it. 

They expect more expensive treatment at the same premium. They want the more expensive treatment "for free" 

The following is a deliberate digression:

Donna Douglas..
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Enjoy. 

This would look so cool as a custom paint job on my trailer or motorhome. 

Anyone who has ever had to deal with cancer, doctors, and hospitals that specialize in cancer know MDA is the best. It is shameful the ACA does not allow for the best. 

What did they expect when you allow people to go without insurance and then when cancer strikes they can go sign up? That isn't the definition of insurance. I have used MD Anderson and would hate to not be able to go there if I needed treatment. I know originally people were able to use the hospital, even if they had just signed up. They just had to pay a higher premium. No insurance company would stay in business for very long if that continued. 

I totally own you. 

Who do you own?? I hope you don't believe that junk....You need to get a real life, and interact with physical people instead of social media 

...says the volunteer worker.

Hate to break this to you honey, you live here... I don't. 

Wow. Just wow. You get sadder by the day turd 

These people are all doing just fine:


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Let's look at the wait times in those counties to have a procedure

Since we have fuzz on the board let's look at Canada:

Wait time 18.2 weeks in Canada  

Aren't several of those countries either bankrupt or near bankrupt due to their entitlement programs? 

Remind me how many trillion in debt to China America is again? 

Quote:

fuzz81 --- 2 min ago - quote - hide comments Remind me how many trillion in debt to China America is again?

Remind me who's president? 

Bush policies. But yeah, keep whining and blaming Obama. You're unwavering in your turdbag glory. 

Bush's fault. That's original.

implosion in 3... 2... 1... 

Who controlled the purse strings when bush was president .. The president only signs budgets that congress passes.

You can thank the republican congress for clintons surplus