Illinois has become one of the most non-competitive states in health insurance, according to a new American Medical Association report. It’s in the Top 10 of least competitive, and it showed the biggest drop between 2011 and 2012. The good news, says Illinois State Medical Society president Dr. Bill McDade, is that the Affordable Care Act has taken effect since then.
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“Over the summer, it was announced that there were going to be eight companies seeking to offer a 504 plan under the Affordable Care Act exchange. Last year, just six insurers were there, offering 165 plans. Now they are going to offer a 504 plan, so that will give you a lot more options.”
An example of how things go wrong, McDade says, is when you have a hospital procedure done, and the surgeon is in-network and the anesthesiologist is not. “The patient is going to be responsible for paying that other physician. Even though the patient thinks they’re paying tons of premiums in insurance, if the insurance company does not enroll that physician in its network, then you won’t be covered, and you’ll have to pay that separately. And that’s really the situation that disturbs us as a state society. Has that happened? Yes.”