According to an article in today’s USA Today, many more doctors will not be accepting medical insurance plans offered through Affordable Care Act exchanges. The reason cited is that these plans often have lower reimbursement rates than the commercial plans. The article indicated that “some doctors are limiting how many new patients they take with these policies, physician groups and other experts say.”
In some cases some commercial insurance contracts require that their physicians accept their exchange-plan patients along with those on commercial plans. However, the lower rates are making some doctors reluctant to sign on to the plans in the first place.
“The National Association of Insurance Commissioners is developing a new standard for what is an adequate number of doctors and hospitals in insurance networks,” and starting next year the CMS will be certifying that these networks for exchange plans are big enough.
In the Daily Caller (10/28, Hurtubise, 475K) there was also a report that the number of physicians nationwide that are refusing to accept health plans from ACA exchanges are growing. They came to this conclusion based on a study from the American Action Forum (AFA). According to the AFA as of May 2014, “over 214,000 doctors wouldn’t participate in Exchange plans. Exchange plans on average pay doctors “significantly less than plans in the private market and even Medicare, according to AAF.”
If you are in an exchange plan and want to see a doctor who you have not yet seen now is a good time to make that first appointment. Doctors who decide not to take patients from the Exchanges might be willing or be required to keep existing patients, so become an existing patient while it is possible.
Joel T Nowak, M.A., M.S.W.