Healthcare Is Broken will be a series that chronicles my journey as a patient in Massachusetts. It has become necessary to document what has become a stressful and dangerous journey.
Once again, I am at odds with the healthcare system. I pay for both Harvard Pilgrim Health Plan and Medicare. Medicare is no longer a primary, and that’s been the case since last year, but not many know. Even Dartmouth-Hitchcock, who administers both insurances, did not know since they kept telling me Medicare was the primary. So bills are going to ‘collection,’ and neither insurance wants to pay for my healthcare. What can I do? Who do I call?
Massachusetts is supposed to be the mecca of healthcare, but not for this Black doctor who became a patient.
A good rant, dear Angela — I empathize, but that doesn’t do you any good.
I’m currently in a “conversation” with my HMO’s optometry department. My (now passed) wife and I have been members of the HMO for 50 years, and we’ve had the same PCP optometrist for at least 25 years; my Medicare monthly goes direct to the HMO, and my retirement system sends the monthly HMO health premium direct to the HMO…big bucks. But obtaining decent, TLC service is near-impossible since the CoVID environment set in, and it all now seems an entrenched mechanism to avoid conscientious patient care.
Good luck and fortune…Bob S. (in case my comment is accepted as “Anonymous”)
Hi Bob. I need some good luck, Thanks. I am not sure why that keeps happening to you. But I appreciate your comments despite the inconvenience. Sounds like you have a HMO instead of Medicare. What is the premium? I pay about $120 a month for Medicare and $210 a month for Harvard Pilgrim Health Plan. And neither one wants to pay the bulk of my healthcare visits. I am working on a piece about my blood pressure and how the insurance company and my PCP drop the ball.
Had my own go-around with several HMO and insurance companies. In my experience getting a Lawyer requires a large bank account unless you have a very large claim. I don’t have any good advice other than to tell you that in my time, the only asset they couldn’t take to settle medical debt was my house. Knowing that, it was easy to determine which bills to pay first. The situation may have changed so check legal before doing the same thing. Hope you can find a way to change your situation.
Hi Onno. How are you? Long time no see. Well I lost my house after the water leaks and the contractor left my house in an unlivable condition so no asset there to lose. How was your medical debt settled? I hope I can change my situation. Problem is finding someone with the power to do something who cares or gives a shit.
Often collection agencies can be negotiated with. Thing to know is that they purchased your debt for pennies on the dollar (they are not actually collecting for company X and the price company X charged you is greatly inflated) and might be willing to take $50 or $100 a month for an outstanding debt of $10k that they purchased for $1 or $2k. This doesn’t help settle the debt, but may get them to back off enough to where they don’t go after other assets you may have. As to making the insurance companies pay what they should pay was a lost cause to me, litigation would cost more so I had to sidestep the issue. I stopped paying for health insurance, that was my first step. I paid my Dr. in cash and found a pharmacy that supplied medications at a reasonable price even though that meant an hour’s drive to another town. This cost me less than the insurance premium.
Good morning Angela!
Perhaps your state insurance commissioner office can help you sort it out, particularly to the extent of private insurance.
ThisIsKoo
Hi Carleton, I was in clubhouse and someone made that suggestion as well as speaking with my Senator because Medicare is federal. Thanks!
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