Since you have unilaterally decided that those retirees 65 and over will be forced to into Mulgrewcare for their golden years, I have several questions and concerns that I would like you to answer. I turn 59 in April and soon to retire. I will be eligible for your plan in six short years.
I have type 2 Diabetes. Fortunately for me my A1c is pretty darn good. What keeps it good is a sensor that I wear on my arm. This, and the app on my phone, monitors my blood sugar. It is expensive. Currently, thanks to Emblem I pay nothing for a 3 month supply. I can pay $35 for a three month supply but I like freebies. This is a much better way to check blood sugar than pricking my fingers. There are those that are not so fortunate. My endocrinologist (Castle Connolly ranked her among the top in Westchester County) shared with me how fortunate I am. She told me that many health plans won't cover this sensor unless one is taking at least three shots of Insulin a day. As of now, no insulin for me. Will I still be covered for this under your plan? Will my doctor be on your plan? Diabetes is a progressive disease. Will I die?
One of the medications I take is a name brand. Not only has it helped me manage my diabetes I have lost a lot of weight (It's not Ozempic!). I pay $35 for a three month script. Will this medication still be covered?
In 2019 I had my right shoulder replaced. I did not need to go through a gatekeeper. I just went to the doctor, he said my shoulder is fucked, and I need to replace it. I scheduled the surgery and that was that. Another person I know, not with the DOE, had their shoulder replacement turned down. Why? The reason their insurance gave was, "PT has not been tried." Some hack on a phone made that decision? You can't fix bone on bone. Will this be something Mulgrewcare will do? Plus, as my surgeon told me I was somewhat on the young side for a shoulder replacement. Shoulders last 10-15 years. Will I be able to get a another shoulder? Will my shoulder surgeon be part of Mulgrewcare? Will NYU Langone be part of Mulgrewcare?
I had a inch and a half tear of the meniscus of my right knee in 2009. The surgeon told me that down the road I will need a knee replacement. My left hip has been acting up of late. I can foresee a new hip in my future. Will Mulgrewcare be there for my knee and hip? Will I become physically disabled?
As we know Emblem has horrible mental health care. Luckily, I have a good therapist. I have anxiety issues and ADHD. Hopefully, Mulgrewcare will do better than Emblem. I doubt it. Imagine retiring from the DOE and needing and looking for mental health care and Mulgrewcare doesn't deliver. What to do with all those teachers suffering with personality disorders, PTSD, etc...? Will I go insane?
But I will put it to you succinctly and directly mi presidenté. Which doctors, hospitals, providers, medications, etc... are on Mulgrewcare? What is the hold up in sharing? We should be told post haste.
We all want to know. Not sometime soon, but now.
We are identifying the hospitals and providers that don’t take Aetna. We understand Stony Brook doesn’t, we also understand there’s many providers in many counties around the country where Aetna is a desert. One of the things the Aetna rep told the MLC meeting is at 88% of our current doctors are in the plan. Why didn’t they say how many doctors in America except their plan? he likes to tout that he rescinded 70 something percent of the prior authorizations. Did he acknowledge to you that they are only for the first two years and that they can be put back in and more added? No I guess he forgot to tell you that, and there’s more. But, since the unions voted to do this, without ever reading the contract, I guess they’re gonna have to find out about it in our lawsuit.
ReplyDeleteWhat are the 30 percent that will require pre authorization? Probably the most serious.
ReplyDeleteWhy do people keep voting for this shill as their union president?
ReplyDeleteThat's the gazillion dollar question.
ReplyDeleteBut people always vote against their best interests.