I want to start by saying working with Blue Cross was great. They aren’t the cheapest service (or the most expensive), but they know how to run a medical plan. They approve requests for medication immediately and if you need to call them, a human answers and spends as much time as necessary dealing with your issues. They are patient, intelligent, and care about their clients.
So why change? Because MassAdvantage is new plan. It’s hooked to the hospital and doctors we already use. Since it’s new, it offers a lot of perks including a dental plan that gives you a couple of thousand dollars (minus a 20% deductible) with two free cleanings, x-rays, fluoride treatments. Their eye care isn’t much — a piddly amount compared to the cost of eyeglasses, but there’s one thing they have agreed to do that made them an instant winner.
I won the battle to have Garry’s hearing apparatus covered under prosthetic devices which means that though we’ll have a deductible, that can be arranged as small payments. We won’t have to worry that we’ll never be able to pay for new equipment.
I’ve said from the beginning that it was absurd to perform this surgery which REMOVES all the hearing parts in the ear and replaces them with an electronic device. This device is inside Garry’s head and his hearing machinery attaches to his skull with magnets. So this is not a standard hearing aid by any means and without it, Garry has no hearing at all.
I said that to assume that elderly people living on fixed incomes could come up with a huge amount of money is unrealistic and wrong. Lack of hearing makes communications with the rest of the world impossible. Garry has no knowledge of Brail or sign language. Without being able to hear, he can’t respond. This matters. That I somehow managed to get the hospital to reclassify this equipment is probably my top achievement of the past five years. And I did it using logic and explanation of why I felt that the system was broken and should be fixed. In this world, that’s such a rarity I can hardly believe I did it.
This also means that everyone who needs to use such hearing machines will benefit from this decision. When I went to Blue Cross with this issue, they said “no” without any wiggle room.
MassAdvantage said YES.
For us, this made a HUGE difference. They have other nice touches including free visits to ones primary care doctor, no monthly payments other than what you normally pay to Medicare for parts A, B and D (prescriptions). They have low prices for generic medications and even the more expensive tier medications are less costly than what I’ve been paying. Things like CATscans and MRIs are $200 — not $2000. And, of course, all our doctors, except one of mine, are part of the UMass medical system already. We aren’t going to have to change much of anything, not even prescriptions.
How good a job will they do? I’m sure it will be bumpy at first. But the up side is they have excellent doctors and top quality facilities. If they can’t deal with a problem at one facility, they also have major hospitals in Boston, Amherst, Dartmouth, and Lowell. UMass Worcester is a hospital, but it is considered part of the UMass Medical School complex in Worcester. UMass is huge and occupies miles from downtown Worcester to the river. That’s miles of huge buildings for various things from hearts to eyes.
I did my homework. I realize it’s a new program. They have hired a specialized company to run it which might make it work out better. And they will enable Garry to get his hearing apparatus repaired and if he needs to replace something, we might be able to really do it!
Now, if only my teeth will hold up until we switch plans next January!