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The Affordable Care Act (Obamacare) and Your Care at CFP

To Our Dear Patients,

With the new health care reform, we all have questions about how this will work.  Many of you will finally have the “golden ticket” insurance card for the first time in your self-employed life!  We understand that you will want to use that card if and when you can. Congratulations, it is about time. Having been self employed most of our entire adult lives, we really understand what that means.  A visit to the emergency room with a broken arm that does not put you down financially for the rest of your life is a wonderful thing and should be covered for everyone.

When this practice opened in 1998, it was with the intention of having a practice where insurance companies did not dictate the care we provided. With insurance company involvement, there are many hoops to jump through for health care providers, and we found that it took all of the creativity and joy out of the art of health care.  In keeping with our philosophy of providing care without third parties dictating what that care looks like, we will continue to be a practice that does not contract with insurance companies. We will continue to care for the uninsured, those with high deductibles, and those who want to file their own claims for out-of-network reimbursement.

Vaccines are one way this will impact our families with children, because the vaccine inventory we carry is provided to us through the health department, to be given only to children without insurance or other funding that covers them. In the past, prior to the new reforms that required insurance companies to cover this service, most insurance plans did not cover vaccines, so they could still be used by those with insurance. Offices that take insurance plans purchase an inventory of private vaccines for this scenario. They are very expensive to stock and you must have a large volume of users to compensate for that.

We are attempting to figure out a way to provide insurance-refunded vaccinations, but we can never be sure exactly what insurance will reimburse and what they will not, which could leave you with an unforeseen expense.

This will mean that if you now have insurance that covers childhood vaccines, you will need to have a provider who accepts your insurance and can give your child those shots. An alternative to this for children over the age of 7 is that at that age, pharmacies will give vaccines as long as you have been provided with a prescription – which is something that we can give you along with your well check.  We understand for many of you who do alternative vaccination schedules that this will create significant stress. We are sorry for this. We will continue to help you with the decision making process on this important part of your child’s healthcare.

We will continue to be here for all other childhood health care needs – to have a dialogue about your child’s health, to support you with your alternative choices, to have our triage nurse answer your questions – all the other things that you have always come to us for will still be here at Central Family Practice, and we hope that we will be able to continue to be involved in your care.

Connie, Dr. Trester, Kate and Dr. Pugh



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