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Covered California Q&A

Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.


Medi-Cal Excess Charges?

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Question: I recently scheduled an appointment with a doctor for a physical. This was a new doctor under Medi-Cal Anthem Blue-Cross that I had never seen before. The doctor had me sign something saying that no matter what my insurance was I had to pay extra to the doctor for whatever the insurance didn't cover. I was surprised they had a medi-cal patient do this as I thought the doctors agreed to accept what medi-cal paid. Now I am afraid to go back as I know I will not be able to pay anything out of my own pocket. Is this even legal? BTW I waited 3 weeks to see the doctor and was given the doctors PA to talk to. Never even saw the doctor at all.

Answer: Since you are enrolled in a Medi-Cal Managed Care Plan through Anthem Blue Cross, you need not worry about the "excess billing" language in the standard Doctor/Patient Agreement. If your doctor orders a test or procedure that is not covered by Medi-Cal, he will tell you in advance. If you feel you have been taken advantage of, you can file a grievance against the physician with Anthem.

1 Comment

I am over 55 and on expanded Medi-Cal from coveredca. It is my only option for health insurance. Is the California Legislature considering waiving the asset collection for repayment since this was our only option for insurance? Other states- OR and WA have already waived this for this age discrimination ACA loophole. sedonars@yahoo.com

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