General Discussion
In reply to the discussion: Here I am in a new city, embarking on trying to find an Obamacare doctor. [View all]taught_me_patience
(5,477 posts)The reason why doctors are not taking those plans are twofold:
1) BC ACA plans reimburse 20% less than non-ACA BC plans of a similar nature. It's very hard to find a doctor (or anybody) what will work for 20% less for the same amount of work.
2) BC HMO plans are utter crap. For each visit, the doc might be reimbursed $7-$10, depending on the contract, and the maintenance fee is crap too. HMOs also require a huge amount of paperwork too.
3) BC HMO ACA plans are truly terrible from a reimbursement standpoint.
My wife is a primary care provider, so I'm very familiar with the economics of insurances. She only takes PPO and was taking ACA PPO BC plans until this year, when she stopped because the reimbursement was just too low to justify. When a doctor owns their business, a 20% reduction in reimbursement can easily result in a 40-50% reduction in profit after expenses are accounted for.
*********
If you have to see a doc for a physical... one option would be to pay a cash price. I'd call around and offer $175 for a physical and see if any doctors would take it. Typical reimbursements here in CA for a one hour physical are 175-220.