Apr 25, 2014 9:05 AM by Ryan Haarer
TUCSON- A Tucson woman in desperate need of a knee replacement won't be getting that knee from the surgeon she wanted. When she called the office to set up an appointment she was told the doctor doesn't see patients who have "Obamacare."
Julie Miller has Blue Cross Blue Shield, which she purchased through the healthcare marketplace. Her plan lists this doctor as a covered provider. So, you can imagine she was shocked to hear the doctor wouldn't see her because of where she got her plan.
"I said, isn't Dr. Martin a Blue Cross Blue Shield provider? I thought he was? And she said, well he doesn't like Obamacare. And so he won't accept your insurance. That was pretty surprising to me," said Julie Miller.
News Four Tucson called the office twice to corroborate Julie's story. An appointment scheduler confirmed this doctor does not accept "Obamacare" patients.
Dr. David Martin did not want to answer any questions. Blue Cross Blue Shield says his reimbursement rate would be the same regardless of where the plan is purchased so Julie thinks this is a political statement.
"I wasn't acceptable to this particular doctor and I kind of felt bad!," said Miller.
Dr. Daniel Derksen, director of the Center for Rural Health says physicians can deny a patient for whatever reason. With the third lowest premiums in the country, Arizona doctors may become more selective in who they take on as a patient.
"There is a pent up demand. We will see an increase in the demand on hospitals and clinics and physicians. I think most of the provider groups are trying to prepare for that," said Derksen.
While providers try to educate their consumers and providers Julie says she is stuck searching for a new doctor and for a new knee, with a bitter taste in her mouth.
"If you are in this business to help people then you are going to help people and you are not going to discriminate based on where they get an insurance plan," said Miller.
Dr. Derksen urges people to check with their physicians before buying a plan to make sure they are covered. This is an odd case but going forward Dr. Derksen says you can expect changes in coverage and payments as the system works itself out.
Derksen expects new Arizona enrollee numbers to come in any day now. He estimates 100,000 of the 1.2 million uninsured in Arizona will now have some sort of coverage compared to before the rollout.
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