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I've noticed a nasty little trend with NJ doctors, many are NOT taking health insurance anymore. I think it's their way of sticking it to the insurance companies who negotiate the rates down.
I think alot depends on who your health insurance company is- I've got United Healthcare, and we hoave no problem finding doctors who accept our plan. I have seen signs in a number of offices noting that the doctor is no longer accepting certain plans, but it's usually either BlueCross/BlueShield, or some small company I've never even heard of.
While the plans generally pay less than the doctors would like to charge, I think it'd be virtually impossible for a doctor to say "I'm not accepting any health insurance plans"- who would his patients be? The majority of people without insurance can't afford it, and also couldn't afford to pay a doctor what he'd charge them.
I have found numerous doctors who do not accept ANY insurance. Of course there are still plenty of doctors out there who accept insurance, and there will always be those who only take select plans, but I find it odd that so many don't accept it at all. I just cancelled an appointment with a podiatrist whose office called to let me know they don't take insurance of any kind. I would agree that you would think the patient pool would be much lower if the doctor didn't accept insurance but apparently they are surviving. Take a look at ratemd.com and you will see some listed who don't accept it. I think it used to be uncommon to see this.
I think that is really weird, and it makes me think you are calling some very small practices. I work in healthcare, and also my husband has a condition that has required a LOT of doctor visits in the last few months. We have gone to specialists in NJ, PA, and next week, to Maryland. Everywhere we have gone, our Aetna policy has been accepted.
The easiest way for you to find a doctor, is to call your insurance company or go to their website, and see what doctors are in their network. If you are in Mercer County, I would be happy to recommend a doctor, if I can.
Thank you, I still have plenty of selection although Aetna isn't too popular with some of the doctors by me - too bad since that is my insurer as well. I do know of one larger family practice that takes no insurance, they have been doing this for many years and are still around, much to my surprise. Mostly I notice this with smaller, one doctor offices. It's something I have noticed...maybe it's just my area.
Actually it is not uncommon at all for Physicians to not accept any insurance product. If you think about it, why should they? The health insurance industry has been cutting doctors payments for years yet at the same time the expense incurred to run a medical office goes up every year. Could imagine being an OB/GYN and having to pay close to $100,000 a year for malpractice insurance. The physicians have been getting screwed everywhere they turn. Malpractice rates are out of control, Insurance companies are making millions by raising insurance premiums and at the same time cutting doctors fees, office expenses always go up, and patients frequently don't pay their bills. Imagine you owned your own company and you charged $100 for a particular service yet the customer says that he/she will give your $52 take it or leave it. That is what the insurance companies are doing to physicians. If the Insurance companies would actually pay a reasonable fee you would see physician fees come down. In addition, imagine the amount of paperwork needed just to deal with insurance companies. Prior authorization for tests and medications, referrals, denied claims and a 2-3 month wait just to be paid. HMO's are the absolute worst thing ever created. They are destroying healthcare in this country. The primary interest of an HMO as well as all other for-profit insurance companies is to make as much money as possible. They put up a front that they actually care for you and your health however the exact opposite is true. If I were a physician I would not work accept insurance, why would I? I would reduce my fees to a reasonable level and require the patient to pay at the time of service. I would then submit the claim and have the insurance company pay the patient. The patient will get paid what the physician would have gotten paid. I wonder how well that would go over with the public. What is good for the goose should be good for the gander. After all, it is the patient's insurance not the physicians. If you sign up with an insurance company that pays lousy rates to physicians why should you expect your physician to accept such fees? After all, it is the doctor that went to Medical School. Spent 12-15 years in school and in training, accumulated $250,000 of debt. Only to start his/her career at the age of 30 when most others have been earning equal or better salaries starting at the age of 21. Works 14 to 16 hours daily and subject to a country full of out of control malpractice lawyers. All that just to take care of us. What should a Doctor be paid?
This has been the trend in the wealthier suburbs in North Jersey for the past 10 years. The doctors with the biggest practices with the best reputation don't take insurance. The ones just starting out don't have a choice, they need the patients. The previous poster mentioned many of the reasons why this is happening. Any doctor with a good reputation around here is busy enough WITHOUT taking insurance. If he/she started taking it, the practice would be overwhelmed with patients that are paying half his rate or less. Not exactly a good business plan.
Most offices will help the patient submit the claim to their own insurance company and whatever portion they pay, the patient will get back. So the doctor may charge $200 for the visit, and insurance might pay the patient back $100 of it. It is basically causing the insurance companies to screw the patient rather than the doctor. Perhaps one day this will trigger enough of an outcry about the $50 mil bonuses the insurance company CEOs get every year while the company nickle and dimes the patients and doctors, so that someone actually does something about it.
BTW this is even worse under a socialized medicine model. The best doctors in these systems only take cash, and there is no insurance company to reimburse even a portion of it. So if you want the best heart surgeon doing your surgery, prepare to mortgage your house.
Thank you, I still have plenty of selection although Aetna isn't too popular with some of the doctors by me - too bad since that is my insurer as well.
Yeah, Aetna of NJ is one of the worst. They recently wanted to stop paying for anesthesia for colonoscopies, stating that "patient comfort is not a medical necessity."
Then they wanted to cut the rate for surgeries done in outpatient centers to a level that would make it impossible to do the surgery because you would lose money on every surgery. The regulating body not only denied them this, but they actually fined Aetna millions of dollars for attempting this.
The insurance company doesn't decide what treatment is covered, it's the plan your employer (or you) purchases. Your employer purchases a package (sometimes several) from an insurance company and offers it to their employees. The more/better coverage, the higher the premiums.
I have several family members that are doctors. One takes no insurance; the others work for hospitals. They're all doing extremely well. Doctors that accept no insurance have less patients (possibly) but they get their full rates. When they accept insurance, they get less per patient, so they need more patients to make up the difference (so to speak).
Yes, this is a trend in the wealthier communities and not just n NJ. It's a HUGE trend in NYC - especially for doctors affiliated with some of the best private hospitals, like NY Presbyterian Hospital. I had my first child there and every referral I got from my OBGYN was to a doctor who did not accept insurance. Seriously, it felt like they have some kind of mafia there. All these doctors got together and decided not to take insurance.
One thing I found helpful was that they all give you forms that you could submit yourself and get reimbursed directly by the insurance company, provided they reimburse out-of-network. They don't pay as much as in-network but I got about 70% back, which wasn't too bad.
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