Commonwealth Snare, Continued
The saga continues.
As someone in good health who has survived twenty years paying mostly out of pocket for health care, I was skeptical that Commonwealth Care would be an improvement, or would prove an encouragement, as is so often claimed, for those without insurance to look after themselves better.
"Preventative care" was the mantra of free-market health insurance reformers who justified the state's requiring all citizens to buy health insurance with claims that paying monthly premiums would encourage the previously uninsured to get regular check-ups, reducing the use of urgent care with its catastrophic costs.
If my experience with Commonwealth Care is any indication, the difficulty of dealing with the system set up to assist those seeking a "plan" and a primary care physician will more than likely discourage them from utilizing the health care services now ostensibly at their disposal.
When the law changed I happened to be in the middle of a very involved application process for a government post overseas. It was difficult enough to get through reams of paperwork for my medical clearance without having to switch health care providers midstream, which is the situation I now find myself in.
Having missed a deadline I was not aware of to choose a primary care physician from a list of BMC HealthNet Plan's PCPs that had not yet arrived, the good folks at BMC HealthNet, a plan I signed on to thinking it might mean continuity, since I'd been going to BMC for years, chose for me.
I waited for my ID number and card to arrive in the mail to make an appointment with my new physician. In the interim I received lots of indecipherable materials, many redundant, from the "connector authority" some with requests for payment of premiums I was repeatedly told by customer service at the connector to ignore.
It gave me the impression of endemic incompetence in an organization on the verge of chaos and collapse. The operators I spoke with did not inspire confidence, either. Even the automated menu was inconsistent. Each time I called the same number—three times today—I heard a different greeting and menu.
The reason I was calling my Plan today was that in trying to make my first appointment with my new PCP, I discovered she was a geriatrician. And, according to her exasperated receptionist, I was not the only non-geriatric patient to be assigned her in recent weeks. Apparently they had been inundated.
She was also at Mount Auburn, not at BMC, which would not have been a big problem—it's closer to home—had she not been a geriatrician, but when I called BMC HealthNet to request another provider, I asked for one at Boston Medical Center. I didn't have the list of providers in front of me, but did not recall any on the list I recognized. The kid on the line asked me if I wanted a male or female doctor, and I said I didn't care, all I wanted was one at the facility on Harrison Ave., which I'm familiar with and which is convenient to get to from work.
He gave me the name of another doctor, and assured me he was at the Harrison Ave. location. He gave me his number as well.
I called to make an appointment. It was the wrong number, but the guy on the other end was friendly. He said, "yeah, I keep getting this doctor's calls—I don't know why—he's at the Codman Square Health Clinic."
In the heart of Dorchester.
Too far to go, and I don't want to dodge bullets. And anyway, it's not what I had asked for or been told I was getting.
By now it's too late in the day to resolve the issue and make an appointment to get on with my medical clearance. But when I call again tomorrow I'll have to be careful to choose a PCP from the list myself who is actually at BMC. I was told I could change PCP's three times in a year, so this will be my last chance to get it right—even though they're the ones who've gotten it wrong so far.
As someone in good health who has survived twenty years paying mostly out of pocket for health care, I was skeptical that Commonwealth Care would be an improvement, or would prove an encouragement, as is so often claimed, for those without insurance to look after themselves better.
"Preventative care" was the mantra of free-market health insurance reformers who justified the state's requiring all citizens to buy health insurance with claims that paying monthly premiums would encourage the previously uninsured to get regular check-ups, reducing the use of urgent care with its catastrophic costs.
If my experience with Commonwealth Care is any indication, the difficulty of dealing with the system set up to assist those seeking a "plan" and a primary care physician will more than likely discourage them from utilizing the health care services now ostensibly at their disposal.
When the law changed I happened to be in the middle of a very involved application process for a government post overseas. It was difficult enough to get through reams of paperwork for my medical clearance without having to switch health care providers midstream, which is the situation I now find myself in.
Having missed a deadline I was not aware of to choose a primary care physician from a list of BMC HealthNet Plan's PCPs that had not yet arrived, the good folks at BMC HealthNet, a plan I signed on to thinking it might mean continuity, since I'd been going to BMC for years, chose for me.
I waited for my ID number and card to arrive in the mail to make an appointment with my new physician. In the interim I received lots of indecipherable materials, many redundant, from the "connector authority" some with requests for payment of premiums I was repeatedly told by customer service at the connector to ignore.
It gave me the impression of endemic incompetence in an organization on the verge of chaos and collapse. The operators I spoke with did not inspire confidence, either. Even the automated menu was inconsistent. Each time I called the same number—three times today—I heard a different greeting and menu.
The reason I was calling my Plan today was that in trying to make my first appointment with my new PCP, I discovered she was a geriatrician. And, according to her exasperated receptionist, I was not the only non-geriatric patient to be assigned her in recent weeks. Apparently they had been inundated.
She was also at Mount Auburn, not at BMC, which would not have been a big problem—it's closer to home—had she not been a geriatrician, but when I called BMC HealthNet to request another provider, I asked for one at Boston Medical Center. I didn't have the list of providers in front of me, but did not recall any on the list I recognized. The kid on the line asked me if I wanted a male or female doctor, and I said I didn't care, all I wanted was one at the facility on Harrison Ave., which I'm familiar with and which is convenient to get to from work.
He gave me the name of another doctor, and assured me he was at the Harrison Ave. location. He gave me his number as well.
I called to make an appointment. It was the wrong number, but the guy on the other end was friendly. He said, "yeah, I keep getting this doctor's calls—I don't know why—he's at the Codman Square Health Clinic."
In the heart of Dorchester.
Too far to go, and I don't want to dodge bullets. And anyway, it's not what I had asked for or been told I was getting.
By now it's too late in the day to resolve the issue and make an appointment to get on with my medical clearance. But when I call again tomorrow I'll have to be careful to choose a PCP from the list myself who is actually at BMC. I was told I could change PCP's three times in a year, so this will be my last chance to get it right—even though they're the ones who've gotten it wrong so far.
Just you wait. It gets worse. MUCH worse. As someone that has had to deal with Mass (Un)Health for the past 6 years, I have never ONCE had a decent result from their 'health insurance'. Not one. Every single time my kids get sick I freak out because I know they are going to screw up something. This last time, ambulance service from my home to the hospital. How hard it THAT to pay? But I've been fighting with them for almost 5 months to no avail. They are MORONS. They hire the stupidest people they can find, put the freaking office in Revere so you can't even get there to complain in person, and then sit back and stamp "refused" on every claim form that comes across their desk.
Want a therapist? They will give you a list that doesn't have ONE doctor on it that takes Mass Health.
Need a dentist? Same thing. They will ONLY give out lists that are years old, knowing that you'll eventually give up in disgust. In order to fight with the you'll have to have the fortitude of a bull, and the staying power of a rock of cement. They're THAT bad.
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You're not alone.
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There was an article today in the glob about commonwealth care botching 950 accounts: http://www.boston.com/news/local/massachusetts/articles/2007/08/07/computer_snag_leaves_subscribers_uncovered/
Thanks for making appreciate my private health insurance that I can get through my mom (at least till the end of school). Commonwealth Care is a great example of why state run socialized health care would never work.
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As a longtime resident of the Codman Square area of Dorchester, I want to state my (and no doubt my neighbors') annoyance at yet another reference to Dorchester as a place where one is not
safe.
We chose to buy a home here 25 years ago, and have raised our children happily in this diverse and vital part of Boston.
We're not alone in our investment in this neighborhood. Numerous educators, public servants, professionals and (gasp) even NPR correspondents have chosen our to live here as well.
As for the Codman Square Health Center, Bill Walczak and his top notch board and staff have been absolutely instrumental in making our part of Dorchester what it is today, both through the medical and social services the center provides, and through the hosting of Boston's first Social Capital network (SCIdorchester.org).
Yes, Dorchester has crime. It can be dangerous, as can parts of any city. But casual comments about dodging bullets, though they may make one feel smug or superior, only serve to strengthen the thoughtless prejudice with which so many citizens dismiss vibrant and worthwhile areas everywhere.
Good luck with your health care Mr. Mennonno. Here's hoping you're doing what you can to be part of the solution.
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I applied for Commonwealth Care two months ago, and besides dragging their feet, they've been giving me the runaround about verifying my income. Initally I sent them two typical paystubs... They asked for the two latest stubs, so I called up to ask if they really wanted stubs for the weeks I was mostly on vacation. Yes. So now they think I'm well below that 150% poverty line, so I qualify for MassHealth. (I didn't get a letter about that, it just came up during Friday's round of pass-the-buck on the phone) I can see where this is going... 4 months later: "Your MassHealth application has been denied because you have too much income." I don't think so.
The latest letter said they're closing my case because I haven't provided the required (unspecified!) information within 60 days... I called them again; couldn't get a straight answer, but they seem to want proof of my (insignificant) interest income. Why do they care? Why didn't they ask 2 months ago? Aaaargh!
I also got 2 letters saying my wife's MassHealth coverage was ending (with 4 days' notice) because "You are already on MassHealth. 130 CMR 501.003"... Duplicate records, I guessed, and it seemed safe to ignore since it says right there "you are already on MassHealth". Nope. Never assume. Her doctor's office called the other day to say she had no coverage. (Nice of them to tell us 2 whole hours before the appointment, eh?) Should we even bother filing an appeal, or go straight to our elected representatives? Can we just sue them, or are state agencies immune?
How many different, redundant organizations are there? So far I can distinguish between the Connector Authority, MassHealth, MSCPA, Family Assistance?, and BMC. Their databases are brain-damaged, the people are incompetent, and none of them will give me anything but their first name, if they even speak English. I say fire 'em all!
I'm ready to raise hell.
Is there a website dedicated to fighting this beast? If not let's start one.
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