Who is getting helped by Commonwealth Care? Here are statements by new Commonwealth Care enrollees who signed up by contacting HCFA’s fantastic Helpline (1-800-272-4232 — or click here):
“I have a cataract in my left eye and I’m losing my vision because it needs to be removed. I’ve been uninsured for four years and I couldn’t afford surgery or health insurance. I feel absolutely thrilled that I now have health insurance that will cover this! You have no idea how incredible this is.” – New Commonwealth Care Enrollee Joanne
“I haven’t had health insurance in years. Last time was probably fifteen years ago when the place that I worked closed down. I still owe my doctor for things he has done throughout the years. They just told me I have high blood pressure, and I haven’t been taking the pills because they are too expensive. The first set of pills is like $20 every couple of weeks. I can get those now.” – New Commonwealth Care Enrollee Irene
“I’ve been going without coverage for probably 5-10 years. I was told that I have a cyst on my kidney, but that was over a year ago. They said to check back with them when I have health insurance. I’m definitely going to get that checked out now.” – New Commonwealth Care Enrollee Kevin
“I have severe medical conditions and I have had no insurance for about a year. I have really bad asthma attacks and I let myself get really, really sick because I didn’t have health insurance. I’ve had to go down to the hospital and it’s a lot of bills. I feel wonderful relief [because of her new insurance coverage]!” – New Commonwealth Care Enrollee Joan
“This is a weight off of my shoulders! I can get this hammer nail on my feet taken care of. It hurts me to walk. I wanted to take care of it before, but I just can’t afford it. I went to this clinic and they just cut the toenail, but it grew back weird again. I’m a security guard and I do a lot of walking and my feet hurt very badly. I’m going to get it taken care of now.” – New Commonwealth Care Enrollee Arthur
“I have let a number of things slide while I’ve been uninsured the past 3 years. I haven’t had any physicals or treatment for my divaticulitis. There just hasn’t been the money to get the appropriate stuff done to help with this. My first plan [now that he is covered] is to have a complete physical examination so that I can have the proper treatment for my conditions.” – New Commonwealth Care Enrollee Timothy
“Having health insurance would make the greatest difference in the world. I have diabetes and really need yearly MRIs and my testing supplies covered. I haven’t had any of these things for close to a year.” – New Commonwealth Care Enrollee Allison
E.P., did you find an oral surgeon to extract the wisdom teeth? I am having the same problem finding an oral surgeon who takes my insurance.
I’m on Network Health Forward, Commonwealth Care Plan Type 1. I need to get my 4 wisdom teeth extracted ASAP. I have having constant pressure on my jaw for a few months as I’m trying to make an appointment. According to the network health website, and a large book I was provided, AND the 800 number assistance line, there are over a dozen oral surgeons within 30 miles (including all Boston Area) who accept my plan. Sounds great…!
The problem is I call every single one of these places, and those where the number is actually correct (or after I’ve been transferred multiple times to the correct dept.) they all say that my insurance isn’t accepted. I’m at a loss, and don’t know what to do. The insurance tells me to insist that my insurance is accepted at these places, while the businesses tell me to instruct the insurance company to update their list of providers who accept their insurance. Shouldn’t they be in touch with each other, rather than relying on the customer to sort things out between them?
Why is this such a problem? Even one of the operatos I spoke with stated that others are having this issue. Currently I have three separate appointments made at the only place I have found to accept my insurance in Mass – about a 2 hr drive, where I would need to miss a week of work total, AND they are not going to be using anesthesia. I was strongly advised by my former dentist to be put under for the procedure, so this makes me uncomfortable.
I do not want to keep these appointments. If anyone has ANY suggestions, I am trying to find an oral surgeon in the Boston area who does accept my health insurance, I am willing to drive an hour if need-be. The insurance company has not been any help whatsoever, and while I’m thankful for the insurance, if I can’t use it then there is no use in having it.
Network Health cares about and values our members. We take Mr. Dollard’s concerns very seriously and are anxious to help him resolve his issues. It’s unfortunate that he received some misinformation from a source outside of Network Health, and on behalf of Network Health, I would like to correct some of that information, and offer our assistance in helping him to access his Network Health Forward benefits.
As noted by the blog administrator, members of products of Commonwealth Care, like Mr. Dollard, are assigned to a Primary Care Provider (PCP) in or near their city of residence upon enrollment. Network Health currently has 14 primary care providers contracted for Commonwealth Care in the city where Mr. Dollard resides. Network Health Forward members can change their PCP up to three times a year.
I encourage Mr. Dollard to call Network Health Customer Service, Monday through Friday, 8:30 a.m. to 5 p.m., at 888-257-1985 (TTY: 617-806-8196). We welcome the opportunity to assist him with any questions regarding benefits and services or doctors, specialists, and hospitals in our network.
Mr. Dollard,
This has been a continuing problem for a number of people. There are two issues here:
1. The Connector requires people to enroll in a plan that covers their place of residence. Yet some people choose to get care where they work, or where relatives live, or other places. For example, someone who lives in the North Shore may want to get coverage through a Boston-Cambridge area plan, even though that plan doesn’t cover their home address. We have been urging the Connector to allow individual exemptions for this reason.
2. People who are auto-enrolled into plans have 60 days to switch, but often don’t know enough about providers to make the switch in time. We have been asking the Connector to allow people to make a one-time switch even if more than 60 days have passed.
Mr. Dollard, please call our helpline and we can try to work with the Connector to get you the best plan for you. The number is 1-800-272-4232.
Since October of 2004, I have recieved the benefits Mass Health and the free-care program. Being forcibly enrolled in the “Network Health” plan (I was out of town for two months) has caused many problems. Thank God I am not seriously ill.
I recieved a letter from the clinic I visit: “You need to be made aware of the fact that there are very few providers in this area that accept that insurance….”(Network Health).
The letter advised that I “try to get them to switch you to…BMC HealthNet or Neighborhood Health Plan.”
After calling the “Connector” and relaying this information, I was advised to go to a city where Network Health was accepted. I then talked to a supervisor who informed me that it will take 60 days for them to review my case and make a decision as to wether or not I will be transfered to one of the plans that is accpted in my area.
So, where are we?
At the present, I am not covered because of being enrolled in Network Health and won’t have any other coverage for two months; at the end of which, I still may be stuck with a plan that “very few providers in (my) area accept..”.
This does not bode well.
Good point. Let us dig into this and get back soon.
While it’s great that these people now have health insurance and can get the care they need, it looks like adverse selection to me. Where are the testimonials from people who say something like: I’m healthy now and don’t really need much care, but I’m greatful for the peace of mind that comes from knowing I have affordable insurance in case I need care in the future? Or, are those folks waiting until they get sick and expecting to sign up for insurance then?