The wrong plan

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Thanks to the Affordable Care Act, I was able to obtain health insurance coverage at an affordable amount, much less than the COBRA amount from my employer when I retired in mid-January, and without the worry of pre-existing conditions. The coverage I picked was Highmark’s Community Blue plan. Silly me thought that Highmark and UPMC had an agreement through December 2014. Well, they do, but not for Highmark’s Community Blue plan.

I’ve been seen by a UPMC rheumatologist for the last 12 years. UPMC will not allow me to be seen by my UPMC rheumatologist any longer even though I am willing to pay out of pocket. UPMC’s reasoning: “It appears that your personal clinical needs may be met by providers not within our UPMC system.”

Highmark has no objections to me paying out of pocket. Since UPMC will be paid regardless, why do they object to me paying out of pocket? Who really cares about patient medical needs? Surely not UPMC.


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