On Monday, April 11, 2016 at 7:31:25 AM UTC-4, wrote:
> On Mon, 11 Apr 2016 03:55:43 -0700 (PDT), Cindy Hamilton
> > wrote:
>
> >On Sunday, April 10, 2016 at 10:32:35 PM UTC-4, Doris Night wrote:
> >
> >> While we're on the topic, Americans (including you, Julie) frequently
> >> go on about not having access to doctors outside of their insurance
> >> company's group. I forget exactly what you call that. In Canada, there
> >> are no restrictions like that.
> >
> >There are hundreds (or thousands) of different health insurance policies.
> >
> >With some, you are covered only if you see doctors approved by the
> >insurance plan (unless it's an ER visit).
> >
> >With others, you are covered a lot for doctors participating in the plan, but
> >less for doctors who are not participating in the plan.
> >
> >With still others, you can see any doctor anywhere and coverage is the same.
> >
> >Typically, the first arrangement is has the cheapest premiums and the
> >third arrangement has the most expensive premiums. My employer offers
> >insurance of the first type, and my husband's employer offers insurance
> >of the second type. Our portion of the premiums is the same for either
> >one, so we buy his insurance instead of mine. Why is the cost the same?
> >Either it's because his company is a great deal larger than mine, or
> >because his company picks up a greater percentage of the premium.
> >
> >Cindy Hamilton
>
> Wow that's complicated ! It's very confusing - do they actually give
> you lists so you will know where to go or who to see?

Websites, nowadays. Used to be a big book like a phone book of
every doctor in the state that was "in network".

The trick is to pick a primary care physician who's in the network
(or vice versa, if you have a choice of insurance plans as we do),
and then make sure any referrals he makes are also in network.

In practice, because of competition, insurance companies want as
my doctors as possible in their network so they'll look attractive
when employers are shopping for insurance plans, and doctors want
to participate in as many plans as possible so they'll look
attractive to prospective patients. The downside is the stupid
amount of paperwork that doctor offices have to fill out, since
every insurance plan has different paperwork.

Friend at work has a wife who's a doctor. She says the Medicare
paperwork is the easiest. So much for the invisible hand of
the marketplace.

Cindy Hamilton