Hello,
I am contemplating moving to the Bay Area. Not a single ACA plan covers Stanford, yet Medi-Cal does. Why does California give Medi-Cal recipients better coverage than people who are actually paying into the system? Why do they devalue the lives of ACA recipients? It’s almost impossible to get care at UCSF, so ACA recipients in the Bay have to go to community hospitals, no matter how complex their issues, while Medi-Cal recipients can go to the mecca of Stanford…Why?
Stanford primary care and urgent care do not accept Medi-Cal. While the hospital and specialists do accept it, you need a referral from a Medi-Cal participating PCP, and everything must be authorized by Medi-Cal.
From my experience, Medi-Cal has limited options for PCPs and urgent care. For primary care, you might face long wait times for appointments or go through several screening calls before getting into a community clinic. For urgent care, you’d likely drive to a county hospital, wait for hours, and see a physician’s assistant instead of a doctor.
With my ACA plan, I can see my PCP within a couple of days and visit a local urgent care center with no wait, where I see a doctor.
This matters because most of your healthcare interactions will be through primary or urgent care.
Those are positives. For me, accessing specialists is crucial. Not having access to specialists at Stanford (and the same issue at UCSF) is a major problem.
Regarding primary care, my partner in the Bay Area has excellent federal health insurance but found that no practices were accepting new patients in his area. He was advised to call back in three months.
I also called UCSF Allergy, but they refused to accept my referral. They simply don’t provide care. This makes access to Stanford even more critical, but it’s not an option. UCLA, UCSD, and UC Davis do accept ACA plans and have better access, but they are very expensive.
A lot of major medical centers take Medicaid because they are non-profit organizations and that is a condition of their tax status.
Medi-Cal recipients often receive poor care. I felt a huge relief when I finally left the system. I had to wait five months for an urgent colonoscopy because only one gastroenterologist within 80 miles accepted Medi-Cal. My regular eye doctor could no longer accept Medi-Cal, and I couldn’t find a gynecology surgeon for my wife who would take it.
Now, with ACA coverage through BCBS PPO, we can go anywhere and get the care we need. I was grateful for Medi-Cal as it kept me alive for four years, but I’m relieved to be out of it now.
It’s a mixed situation. I’ve had excellent ACA coverage in my state, but Covered California is terrible.
You can’t go everywhere with BCBS PPO because Stanford isn’t in-network.
I tried to get appointments for primary care, allergy, and ENT at UCSF, but they had nothing available. Where are people supposed to get care?
Edit: It seems like no one in Northern California has good healthcare access. Southern California appears to offer better care and coverage. The Bay Area is a disaster for healthcare.