Dennie and Kathy Wright sift through a stack of medical bills at their home in Indian Valley, Calif. Pauline Bartolone for NPR hide caption

Dennie and Kathy Wright sift through a stack of medical bills at their home in Indian Valley, Calif.

Dennie Wright lives in Indian Valley, a tiny alpine community at the northern end of the Sierra, close to the border with Nevada.

Wright works as a meat cutter in a grocery store and lives in a modest home overlooking a green pasture. He also lives in one of the 250 ZIP codes where Blue Shield of California stopped selling individual policies in 2014. As his insurance agent explained it, Wright had only one choice of companies if he wanted to buy insurance on Covered California, the state's health insurance exchange. That lone option was Anthem Blue Cross, so Wright bought one of the Anthem policies.

"That was new to us, you know, Covered California," Wright says. "Anthem Blue Cross was the insurance carrier. Then of course, three months later, I have a heart attack."

More than once, he was flown across the state line to Reno for care. Wright and his wife, Kathy, now have piles of medical bills and insurance paperwork. Though Anthem Blue Cross covers emergency care out of state, it doesn't cover routine doctor care outside a patient's home state. But Wright says traveling from his home to doctors on the California side of the mountains is not as safe or as convenient as going to Reno.

He continues to see the Nevada doctors who put a defibrillator in his chest and saved his life. Anthem Blue Cross will pay some of the bills, but the Wrights still don't know if everything will be covered.

There are other insurance options for Wright, but not through Covered California. Although he didn't need a subsidy, he was left in the same position as people in his area who do need financial help to buy insurance. People with lower incomes can't readily take their business to a competitor, because the state exchange is the only place customers can use federal subsidies to help them buy health insurance. So for these people who are pinched financially, Anthem is the only option.

"I mean, you should have some choices, especially if you're going to have one that's not going to cover you in the places you choose to go," Wright says.

Last July, Covered California Executive Director Peter Lee offered a different impression of choices the marketplace would offer.

Follow this link:

Limited Insurance Choices Frustrate Patients In California ...