Family Opts Out Of Obamacare Plan After They Say Doctors Told Them They Didn’t Take Their Insurance
DALLAS (CBS Houston) – A family opted out of their Obamacare plan after growing frustrated with the website and miscommunication with the insurance company.
Nick Robinson signed up for Obamacare after he lost his job last summer as a youth pastor, which included benefits that covered his wife and two daughters. He told NPR that he became nervous about not having insurance when he found out his wife, Rachel Robinson, was pregnant with their third child.
“It’s one of those times where you hear the news and there’s this immediate sense of joy and excitement like, ‘Yay, a new kid. That’s awesome!’ ” he shared with NPR as concern settled in about the baby news. “What are we going to do? How are we going to pay for this? This is intense.”
He found a new job as an account manager in retail sourcing, but it did not have benefits. His wife also does not have benefits working as a wedding photographer. So they decided to look around at their options.
The couple applied for Medicaid but did not qualify in Texas. They thought about paying out of pocket, however, the quotes they received for a basic hospital birth, up to $15,000, scared them.
Nick Robinson started hearing the positive news about the Affordable Care Act and decided that the new insurance was going to be their answer.
“I was like, ‘Oh, here’s the answer! This is simple!’ ” he told NPR. ” ‘It’s a cheaper insurance plan, there’s no pre-existing condition stuff.’ “
His wife, however, was skeptical as he went online and started shopping around for insurance. He began to have trouble trying to get through the glitchy website, but eventually he was able to pick a plan. Nick Robinson chose a gold plan HMO through Blue Cross Blue Shield that would cost about $375 a month.
When the plan began in January, he printed out a list of obstetricians from the plan’s website for his wife.
“I handed it over to Rachel, fully confident, fully feeling like I had accomplished something for her, I had come through for my wife,” he said to NPR. “This whole Obamacare thing was going to work!”
But his wife sat down and two days later called every doctor on the list of 28 and was shocked to find that most of the practices in one way or another did not take the plan.
“Some would just come right out and say, ‘We don’t take Obamacare,’ ” she told NPR. “Or the best one was, ‘The doctor takes it here at the actual practice, but whatever hospital you use … does not take that insurance.'”
That wasn’t the only issue. She explained that some of the doctors told her they wouldn’t see her because she was too far along in her pregnancy at the time, roughly 30 weeks. The practices that did take the insurance operated as a rotating clinic meaning she wasn’t guaranteed to see the same doctor every visit.
“It was mind numbing,” she told NPR. “Because I was just sitting there thinking, ‘I’m paying close to $400 a month just for me to have insurance that doesn’t even work. So what am I paying for?’ “
Her husband grew even more frustrated after he called Blue Cross to be told that the doctors should take the plan.
“How could this not be working?” he explained to NPR. “The United States government has set this up. It’s this whole big deal; there are commercials everywhere saying we need to use this. And they’re just saying, ‘No, no, no,’ and that just made me so mad!”
Louis Adams, a spokesman for Blue Cross Blue Shield of Texas, said that he checked the same list a month after Rachel Robinson had checked it and found that most of the 28 doctors do take the HMO insurance.
“We’re committed to helping our new members understand how to get the most from their coverage, and also [are] working with doctors and hospitals to inform them of the range of coverage options we have available,” Adams told NPR.
The family felt extremely lost especially with their baby being due in April and at that time it was January. Friends had suggested using a midwife, but they had rejected the idea previously.
“Our answers to that were, ‘Absolutely not,’ ” Nick Robinson said to NPR. “That’s insane. We’re not going to go to some crazy witch doctor lady, and make us get in a giant tub. Those are the crazy people. We’re the normal people. We want to have our birth in a hospital!”
His wife had two cesarean sections for their two daughters and both parents thought it was risky to have a home birth with a baby being delivered vaginally. They changed their minds, though, after Rachel Robinson met a midwife who she loved and an out of pocket home birth would only cost them $4,000.
They decided to stop paying the premium for Obamacare and completely drop the insurance plan.
“We’re so happy with where we are now, but this is not okay. And I’m extremely confident that, that’s not what the architects of this plan had in mind,” Nick Robinson said to NPR.
His wife gave birth at home in a huge tub with zero pain medication to a healthy baby boy they named Cash, after Johnny Cash, on April 28.