[biker1]

Any concern about requiring or not requiring a referral is a bit of a mystery to me. The only provider I directly make appointments with is my PCP (annual visits to the dermatologist notwithstanding). If I have an issue, I talk it over with her and she provides the referral to a specialist. I look upon her as the conductor of my health care. Now, there can be issues of which provider is referred. I have Medicare with a Supplemental Plan so she can refer me to anyone who accepts Medicare but I am not trying to schedule visits to anyone without talking to her first.

Originally Posted by Blueblaze

Yeah, I did the Obamacare thing too. Unbelievable. And nothing like my Advantage plan, which is almost identical to my old employer's PPO plan, except for the cost. Like everyone else who complains about Advantage plans, you seem to think they're all HMO's. They are not, and that is my point.

My PPO Advantage plan does not require referrals and I can see any doctor I want. It just doesn't pay as much if I go out of network, and then the doctor is not limited to negotiated rates. But it also has an annual out-of-pocket limit, after which it picks up everything -- even out-of-network. Yes, the limit is high, but insurance is for disasters, not groceries. The high limit is still within my means, and until the disaster hits, I pocket $400/month.

It worked as expected with my wife's recent stroke. But it was a small stroke and we didn't need to go out of network. My plan documents say I'm adequately insured against a real crises, like cancer.

But, of course, it all depends on how honest the players are, regardless of what kind of insurance you have. I'm sure the insurance company will fight like a pitbull to get out of paying what they contracted to pay, and the doctors' crooked back office operations will bill crazy amounts for things they either didn't do or we didn't need -- just like they did with the stroke. Six month later, we're still getting bills. But that doesn't have a damned thing to do with the fact that we have Advantage PPO insurance.

Like I said -- every one's a crook, these days. Look no farther than your neighbor's new roof and your latest home insurance bill to see what I'm talking about. We're at the mercy of crooks, regardless of what we do, because moral behavior is no longer the standard in this country.

Which is why I see no reason to give the crooks one penny more than I have to, until the day when I need to.