posted October 30, 2009
I received my 2010 package from Blue Cross Blue Shield the other day, and as I suspected, rates are up, benefits are cut. Being over 65, I have Medicare, and I also have Blue Cross Advantage Platinum plan which covers (most) of the 20 percent Medicare doesn't cover.
My premiums are currently $117 per month with a co-pay of $10 per doctor visit including specialists visits for the plan. This does not include premiums for Medicare Parts A,B and D which will increase January 1.
My 2010 premiums are increasing to $133 per month and my co-pay to specialists increases from $10 to $25.
Also increasing for 2010:
Inpatient hospital care: $0 this year, $100 next year
Inpatient mental healthcare: $0 this year, $100 per day for first 3 days
Chiropractic services: $10 this year, $25 next year
Podiatry services: $10 this year, $25 next year
Outpatient surgery: $0 this year, $100 next year
Outpatient diagnostic tests, services and supplies, imaging, radiology: $0 this year, 10% coinsurance next year
Vision care/Eyewear: $100 annual allowance, $100 allowance every 2 years
Hearing services: $200 allowance every 2 years., $0 next year
Dental services: $150 annual allowance this year, $100 annual allowance
If you have seen that beautiful shining, gleaming blue and white monument sitting on that hallowed civil war hill called Blue Cross (non profit) all brightly lit up at night, well somebody has to pay the electric bill. Wonder who? But, I also think about all those 3 or 4 thousand who are fortunate enough to have jobs in this depressed economy, and I'm thankful I can afford those premiums so I quit complaining.
Well, not quite. I have plenty to say about healthcare reform, and it's not good. The Feds are not really addressing the real solutions for reform. What about tort reform? What about the billions wasted on Medicare by corrupt billings and mismanagement by the regulatory agencies paid to stop it?
I have in my storage room somewhere a pair of crutches provided free through Medicare due to a sprain many years ago. I also have somewhere an expensive piece of equipment used for a sore neck years ago that I used only two times. Someone could use those items, and I would gladly give them to anyone that could use them. First of all, Medicare was billed a lot more than if I had bought them somewhere else, and if you multiplied all the medical equipment (scooters, wheelchairs) given away by the thousands it adds up to real money.
I received a letter from my primary physician yesterday informing me he was regretfully leaving private practice in the first of the year to seek another job in the medical profession so he could spend more time with his family. I hate to lose him. He is the most caring and passionate doctor I have ever known. He's still a young man. I am sure there are other reasons too.
The federal government has never run a program or anything else cheaper or better than the private sector can and never will. Get ready for higher costs.
Bill Watkins
* * *
I would really like to just make a comment on my family’s experience with the Blue Cross Blue Shield Blue Advantage Plan supplemental insurance. Earlier this year, my beloved 77-year-old grandmother fell extremely ill and had hospitalization after hospitalization over a period of approximately six months. I knew that my grandmother would be unable to care for herself and that my grandfather would be unable to care for her needs too.
Her doctors were agreeable that unless I was able to take her home and care for her full-time that placing her in some sort of rehabilitation facility or a long-term care facility was my family’s only option to make sure that she had her medications, meals, insulin, etc. Once we attempted to place her in facility after facility, denial after denial we were made aware by one of the BCBS representative that due to the way some of the “notes” had been written in her medical charts that Blue Advantage did not deem rehabilitation or long-term care necessary, therefore denying her coverage.
We were also told by another BCBS representative that we could not change her supplemental coverage until the end of the year. My grandfather and I talked to so many representatives of BCBS it was ridiculous, really.
Unfortunately, we were forced to take my grandmother home knowing what was going to happen. The family got together and decided to pay the facility that we had initially wanted her placed in. The facility that we placed her in advised us that they no longer accepted BCBS Advantage Plan because they had not been paid by Blue Advantage for the residents they currently had in the last six months. They knew who we were when we came begging for them to help my grandmother.
During all of this chaos, my grandparents were under the impression that if they fell ill, needed help, or admitted to a facility (whatever the case may be) they would be there for them. I asked one of the BCBS representatives how they could contact these elderly people, feed them this line of bull about how the coverage would be better and so on, then when they need them the most they deny them. She didn’t really have a response when I made the statement that BCBS gladly took their $117 (each) premiums out of my grandparents account each month and I felt horrible for all the elderly people that they had done this to and for the ones that didn’t have family to help them when they couldn’t even help themselves.
After my grandfather made about four trips to their office they finally allowed him to change my grandmother’s insurance. This was seven weeks after she was admitted to a long-term care facility.
Sadly, my grandmother passed away on Sept. 25. Do I blame them for her death? No, but do I blame them for denying her the care that she desperately needed, most certainly.
Amber E. Holbert
Soddy-Daisy
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