CA Doctors Bailing on ObamaCare Patients?

Recently I saw some numbers for reimbursement rates on the spiffy new Obamacare 'stuff' from a large insurer in California. 

For CPT code 99213 (routine office visit)

Old Legacy Network pays doctor: $71.00
New Off Exchange Network pays doctor: $66.00
New Exchange Network pays doctor: $45.50

Article published today in the Visalia Times and Tulare Advance-Register.  

Doctor Networks Opt Out of New Plans

Insurance agents and doctors agree — call your doctor before the end of open enrollment (March 31) to confirm whether your doctor accepts your new plan. The alternative, they say, is boarding what can become a frustrating insurance merry-go-round.

 To add insult to injury, her doctor — whom she’d seen for years — informed her that his  office no longer accepted individual Blue Cross insurance plans, regardless of whether they were purchased from Covered California or not

 In many cases, private physicians who don’t practice in a federally qualified, hospital-owned or rural clinic are only paid $20 per patient visit — hardly enough to cover the cost of electric bills, front office staff, rent, supplies or malpractice insurance, Sine said.

Before open enrollment for 2014 ends in 2 weeks, be sure to check with your doctors and make sure that they accept the plan you have enrolled in for this year.



  1. A friend of mine who just got on Medi-Cal (California's version of Medicaid) says it is nearly impossible for him to find a provider that takes Medi-Cal right now. He has spent hours calling providers who have taken Medi-Cal in the past but have since dropped coverage. He's having a nightmare of a time, and I told him about people who have Obamacare-sponsored plans who may be having similar issues. It's a mess right now but hopefully it'll get cleared up.


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