[Jackie07]

I received a letter from my health plan (affiliated to the hospital）that my Medicare Advantage plan will not change (except the premium which they won't know until next year when all are enrolled). Hubby received a notice from Blue Cross/Blue Shield that he needed to shop for a new plan. But the Website was down when we tried to check it out. Glad the deadline had been extended ...

The affordable care act seems to be something similar to HMO. All the insurance plans offered by my (ex-)employers had been HMO except once or twice when I was offered Blue Cross / Blue Shield. I did not choose the HMO plan of that hospital when I was first insured through my job in the late 80's. I thought the other plan had offered more choices of doctors and hospitals (not realizing the one in town is a top-notch hospital/clinic) After I had had my brain tumor surgery done in the big hospital in town (was fortunate that a Johns Hopkins trained neurosurgeon happened to be there - he stayed there for only 4 years and I was 'lucky' to be his patient. We had to do a special contract [was pushed around by the insurance company clerks until my boss called the Vice President of the Insurance Company and hinted about possible law suit] After that horrible experience, I switched to the HMO offered by the big hospital in town. It now has plenty of clinics spreading in the region and I know I can get top quality care here (My Gamma-knife Radiosurgery in 2001 was contracted out to a facility two hours away in the big city.)

The insurance rules and regulations were pretty good except that patients weren't told of their rights. My neurosurgeon, who happened to be a friend of mine through the local Chinese Club, had told us that "They should pay!" when we mentioned perhaps we needed to try a fund-raising since we couldn't even get through the receptionist on the phone to talk about the special contract (to have the surgery done locally). Yet none of my doctors (including the neurologist who'd told us he would only recommend this particular neurosurgeon and the ones whom I'd known through the Club) would get themselves involved in the process. Hopefully the Affordable Care Act will help resolve some of the issues. The preventive clause/choice of doctors looks very much like an HMO plan to me. I'm wondering whether the 'contracts' between hospitals can still be done when necessary?