Sunday, July 27, 2014

Health Care?

A couple of months ago, I was informed that I was being removed from my ex-husbands health care plan.  He'd had a "family plan" that included his 2 daughters and myself.  Since it didn't cost any extra to have me on it, he was happy to keep me there for many years.  Then his youngest daughter turned...26? and he was told that his plan automatically would revert to a single person plan.  I had a few months in which to find another plan on my own.

No big deal, right?  I went to the MA State website and filled out preliminary forms for eligibility.  Turns out that because I don't actually make any money shooting weddings, I qualified for free health care.  Hmmm.  Well, ok.

They gave me the run down over the phone, and as I recall there were about 4 different plan choices.  "What's the difference?" I asked.  The representative basically said it was the same PLAN, it's just the fringe benefits that changed...like a discount on a gym membership...a dental kit that consisted of a free toothbrush and toothpaste...those kinds of silly things.  So out of the 4, I randomly picked "CeltiCare", and thought nothing more about it. 

Problems started cropping up right away.  I had a pre-existing Primary Care Dr, and I was happy with her.  One day, I get a postcard from MassHealth informing me that my Dr had been switched.  Why?  I called and they switched it back, but I was annoyed.

Then I'd go for routine appointments and my Dr couldn't see me because my plan said something different when the checked it.  They would actually ask me to leave the offfice, call the plan, get it changed, and and maaaaybe I'd get back up in time for my appointment.  Grrrrr.  The annoyance is building.

One day, with weighty thoughts about life on my mind, I called a woman that had seen me for counseling off and on for many years.  She said she couldn't see me if I had CeltiCare, but she COULD see me if it were switched to Fallon (one of the other original choices).

Now I'm starting to get suspicious.  I thought they said all the plans were the same?  Regardless, I got on the phone yet again and asked to switch the plan.  Fine, they said, it will kick in on Aug 1st.

Yesterday was July 26th.  I have less than a week to go with CeltiCare.  Wouldn't you know it, this week I got sick.  REALLY sick.  And, knowing I had to shoot 2 weddings over the weekend, I simply put myself to bed on Tuesday, self medicated with cough syrup and aspirin, and waited for it to go away. 

It didn't.

Desperate for good health again, I decided to head to a walk-in clinic in Shrewsbury whose website stated that they accept MassHealth.  My Dr's office is closed, as it was now the weekend, and I felt I shouldn't wait until Monday.  The clinic told me they couldn't see me because I have CeltiCare.  But...you take MassHealth, I pointed out.  Yes, but not CeltiCare.  Try the clinic on Queen Street in Worcester.  Can I self-pay?  NO.

I am in no condition for this, but I shlep myself out the door and drive across the city to the Queen Street clinic.  They didn't check my insurance, but they did say I couldn't be seen until 4pm at the soonest (it was only 10am and I am feeling like crap).  Daunted, I headed out to another clinic on Plantation Street. 

The 3rd clinics sign-in info listed several plans that weren't accepted...CeltiCare was at the top of the list.  I went to the receptionist to ask about it, and offered to pay for the visit myself.  She said they couldn't let me do that, it was against the law.

I burst into tears.

Hacking, coughing, body aches, stuffy nose, exhaustion, and all that driving...it all took its toll.  My crying alarmed her so much that they took me aside, checked my vitals, and then apologized as they told me I had to go to the ER to be seen.

But my new insurance takes effect in a few days?!

Doesn't matter.  We can't see you here.

So, feeling incredibly stupid, I actually went to the Emergency Room.  They Xrayed my chest, gave me several prescriptions to help ease the racking coughs, and sent me home.  I found replacement photographers for my weddings, all is well.

But I am stymied about the insurance.  I feel I was misled when I signed up and I'm angry. 

1 comment:

Anonymous said...

Glad you could at least change to Fallon but I am upset by the fact that such misleading info is given out concerning the health plans available.