Guest Author - Bonnie Sayers

Living in Los Angeles I am quite aware of Hospitals being shut down and closing their doors for financial reasons and through State contracts. I had Blue Cross health insurance through the State Medi-Cal system for many years. Last year I was in the Transitional stage of the Insurance since I started working as a Home Health Care Provider for my son through the State IHSS program, known as In Home Supportive Services.

Just about one year ago, late November of 2004 I received a disturbing letter from Blue Cross of California and the L.A. Care Health Plan I was enrolled in through Medi-cal. The letter informed all members, parents and guardians that as of 2/1/2005 two Adventist Health hospitals would no longer be a Blue Cross of California Medi-Cal provider.

My son was born at one of these listed Hospitals with the other one the location he had been Hospitalized three previous times due to dehydration and anemia issues. This letter did not directly affect my children and their insurance plans since Matthew has another provider through L.A. Care Health Plan and Nicholas has straight Medi-Cal.

I was told I had to pick another primary care doctor within the Blue Cross Network. It went on to say that The Department of Managed Health Care is responsible for regulating the activities of health care service plans. There was a choice to contact the Department if you were receiving care and wanted to keep your provider for a designated time period. The website to the Deparment of Managed Health Care has more resources.

The options were to continue with the provider until the date, switch providers or the health plan. If members continued after the date with the same provider they would have to pay for services. The letter also listed a number for Blue Cross Customer Care Center at 1-800-407-4627 if you are pregnant, have a child under three or are going to have surgery.

When I had called Blue Cross of California I was led to believe that this type of practice takes place often and not to worry. The gentleman I spoke with told me it would all be settled once they agree on a contract. I was not pleased with this information and kept the insurance provider and plan intact.

I did order a new Directory of Providers to find one, but I really wanted to stay at the same building where my children's Pediatrician is located. I did not want to find a Provider in downtown Los Angeles or have to travel to the west side to see a Doctor.

I only see the Doctor once a year to get my prescriptions and an annual checkup, usually around my birthday in April, so I never did change Providers because I wanted one that speaks English and did not have the time with kids home from school holiday to search out new Providers.

I received another letter dated February 4, 2005 from the same Manager of Customer Care Operations at Blue Cross of California. This letter mentioned a recent letter being sent out, although the time between 11/23/2004 and 2/4/2005 is more than two months.

This letter stated they were happy to inform members that the two Adventist Hospitals would continue to provider healthcare services. There was a phone number to call to change back to your previous provider or stay with the new one. The last paragraph was a real kicker, " We hope this has not caused you any problems."

I want to alert people that this same type of letter may be going out this coming week from Blue Cross of California or maybe other Health Insurance Companies relating to another provider or Hospital having issues.

My current insurance through my Union only covers County Hospitals, so I have been searching around for another policy, but the costs associated with such a plan run $200 per month. Now I have five dollars taken out month and have yet to visit the provider they selected for me. While it is good that I am covered with some sort of Health coverage, there is no way I will deal with a County Hospital in any emergency. The areas they are located in are not where I would typically drive to.

The only quotes I have obtained are from Blue Cross of California for the HMO plans. I will now start looking into Kaiser Permanente since they are close to where I reside and start from there. I will be sharing my findings in future articles. Please do be aware of closing Hospitals and Hospitals no longer associated with Providers. This hurts the consumer the most with having to change their plans, providers and choose unfamiliar Doctors to care for them regularly and in case of an emergency.

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