I also got my cards with an agent. I felt good to be among the insured but now I'm learning that MOST doctors (I have BS) are not accepting Covered California. I'm sad when I call for an appointment and hear, "we aren't accepted Covered California."
I just learned last month I need a TKR, a revision of a PKR that is intact but the lateral side is worn. I was certain the pain was tendonitis. My GP (cash pay) said it was bone to bone. Both knees are making lots of noise! I backpack alot so it's understandable that my parts are worn out. I see the local OS (cash pay) Friday to get his opinion.
Looking into a TKR, I've learned BS isn't accepted by any of the local OS. Hospital charge is 20% of the cost as is surgery (if it's accepted). The deductible is $6350 here. It would be costly if approved.
So, I'm going to India again for my surgery. I had my PKR there as I was uninsured and it would've cost $30K here. I paid $5200, including hospital and was treated well. I had to buy an plane ticket. U.S. docs marveled at the beautiful job the surgeon did. There was a program on 60 Minutes I saw about 10 years that gave me the idea.
I'll find out Friday if I need a BTKR. I've already contacted India and will go within the next month or two. I wish I could stay home (it's a long flight) but it's cheaper for me to go abroad. I know things will go well. I want to get it done so I can backpack again, maybe by next summer. And just go for a walk for longer than 1/2 hour.
Good luck to everybody with the new ACA insurance. It isn't going to cover what I need without lots of co-pay. I won't spend months awaiting authorization and risk being rejected. (I don't think there's that problem with Kaiser.)
I really hope everyone can get their surgery approved. Maybe if I stuck it out I could eventually find a good OS and hospital that would work. But I've decided not to wait. It's best for me financially and medically. I trust the OSs there and I won't be disappointed.
I've read all these posts and have gained confidence and courage and learned lots for post op. I know I'll be okay.
Medicare with be a wonderful thing for older ladies like me (gents too.) But, I won't wait 3 years. Sorry, I really rambled. Good luck to all of us!