Tuesday, August 07, 2012

My Mother Jinxed Me

And then doubled over with laughter.  She had to grab one of the kitchen chairs.

Humph!

I was, once again, on the phone with my favorite people at Commonwealth Choice and Blue Cross.

You see when I was first diagnosed, we had one of those cadillac plans from Blue Cross.  It had $5.00 co-pays.  I remember that my physical therapist for the Achilles tendon was agog.  But it was really overkill and wicked expensive for my boss.  So they we found another, more reasonable plan for everyone but me.  Instead of joining them, they payed me what the premium would have been for me and I could shop elsewhere.

Now here is an aspect of Romney Care that is a very good idea and should be replicated in every state.  There are three tiers to coverage.  Mass Health for those who truly can't afford insurance.  Commonwealth Cares for those who made to much to qualify for Mass Health, but would still be struggling.  It's a plan whose costs are supplemented by the Commonwealth.  The third option is Commonwealth Choice.  This is for people who have the money to buy their own coverage, but for one reason or another they are buying on their own.  The Connector gives the Commonwealth Choice people group buying power.  You can review the plans and pick what fits you.

So I picked a top of the line plan.  No lifetime max.  No calendar year max.  No deductible.  No co-insurance.  $25 co-pays and a good pharmacy benefit.  I knew what was coming and I didn't want to be left holding the bag.  $515 per month and my boss paid half.  I had a good job and had no problem affording it.

But then in June, 2010, I stopped working.  Slowly it became difficult to keep up on disability.  People asked why I struggled to keep it, especially when the premium jumped to $800.88 per month. My response was that I was getting top of the line care and I should do my part.

Then last summer, I realized that I could get a grant from the Leukemia & Lymphoma Society to cover my premiums.  Back before I chemo, I would have realized this a lot faster.....but...whatever.

Now though, even that's a problem.  the premium has jumped to $845 and every single month except May there is some kind of problem.  Even with a good pharmacy plan I am still shelling out $200 to $300 per month in co-pays.  So finally I filled out the paperwork for Mass Health.  In June there was a problem that caused me to be cancelled and now, even though the Connector has all the money they won't reinstate me.

This month, like every month, I call.  And call.  And call.  First the Connector, 20 minutes, no result.  Then nearly 30 minutes with Blue Cross.  It seemed the person at Blue Cross was going to fix it.  He kept putting me on hold.  My mother saunters out into the kitchen where I am sitting. 

"Are you on hold?" she asks.  "Yes" I reply.  "You know there's no reason to be on hold.  He's not doing anything."  I protest that Ryan can take all the breaks he wants because he said he can fix the problem.

"He's lying." she says.

Ryan comes back on the line at this point and starts to apologize.  I stare daggers at my mother and jab my finger in her direction.

That's when the laughter started.

I hang up and call Mass Health to check on my application.  The girl is unhelpful, dull and breathing noisily in my ear.  She says new applications are sent to Charlestown.  I already know this from work.  Mass Health is in the Schraffts Building down the street.  The Mass Health clerk asks where I am.  "Charlestown" I reply.

"What?"  Charlestown I repeat.  "What?"  "C-H-A-R-L-E-S-T-O-W-N."  "Where?"  "The place they send all the new applications." I say, taking a different tack.  "What are you doing there?"

"I live here!"

My mother enjoyed that one too.

2 comments:

Kanani said...

I'm so glad I came by because I wasn't picking up any new posts --Facebook, go figure.

Anyway, I'm glad you're in MA where they have the tiered system. I'm very sorry things are a bureaucratic nightmare, and I do have an understanding of how companies like BC work with governmental contracts. It only adds layers and layers and the result is well.... having to explain you're in Charlestown to a heavy breather.

Hope you've gotten reinstated. XO K

diƤtplan said...

very good post