Published: July 18, 2009 11:36 pm         

STEPHANIE SALTER: They’re scared as hell and they can’t really take it anymore

We sincerely regret any inconvenience this situation may cause you.

— from a July 13 Anthem insurance letter

TERRE HAUTE — My mother was pale. Her hands were shaking and her voice was choked. She was standing in her kitchen holding a one-page typed business letter.

“I don’t know what to do about this. I got it yesterday from Anthem,” she said. “They’re telling me I have to go to Clinton — or Sullivan. For a hospital!”

Her eyes were as frightened as I can remember seeing them in many years. Tears welled up.

I put my arms around her and tried to sound reassuring.

“Mom, Mom, it’s just part of this stupid fight with Union Hospital,” I said. “Both sides are sending out stuff to make the other side look bad.”

Her eyes blazed with frustration. “Yeah, well, I can tell you, this is scaring me to death,” she said.

My mother is 79 years old and one of thousands of Hoosier seniors who pay Anthem Blue Cross and Blue Shield for Medicare Part A and B supplemental insurance. Like many elderly women and men, my mom has a slew of health issues she and her dedicated primary care physician work to manage. Mom’s retired brother-in-law in Ohio helps her navigate the annual rocky shoals of Medicare Part D, the confounding drug “benefit” program.

All this said, compared to many elderly, my mom is pulled together. Or as she puts it, “I’ve still got at least half-a-brain left.” But the letter dated July 13 from an Anthem vice president in Kentucky — a letter that arrived Thursday — made her confused, afraid and … sick.

“Can you imagine what this letter is doing to old people who aren’t all there?” Mom said. “Or who are all alone with nobody to help them?”

Even if a person has been following the contract dispute between Union Hospital Health Group and Anthem, the five-paragraph letter from Terri R. Swanson, vice president and general manager of Consumer Business for Anthem, begins with a two-by-four to the face:

“Effective August 1, 2009, Union Hospital will no longer participate in the Anthem Medicare Select Network.”

No, “We’re still negotiating, but it looks bad,” just, you’ve got two weeks, old gal, then it’s, “The following facilities in your service area are still in the network for Anthem Medicare Select: West Central Community Hospital … Clinton, IN … Sullivan County Community Hospital … Sullivan, IN …”

By the time Mom got to those boldfaced hospital names — which turned out to be wrong — she barely comprehended “you do have the option of switching from your Anthem Medicare Select Policy to one of Anthem’s Medicare supplemental products of equal or lesser benefits without answering health questions or serving another waiting period.”

Huh? What good would that do if Anthem and Union Hospital get a divorce?

In January, when word first began to ooze out about the Union-Anthem contract disagreement, that’s all it seemed to be — a disagreement. I remember telling a distraught colleague here, an Anthem Medicare Select subscriber like my mom, “Oh, don’t worry. They’ll never let it go that far. You won’t lose your access to Union.”

Silly me, I thought that Anthem’s status as the largest private insurer at Union Hospital guaranteed a slam-dunk contract agreement. Didn’t they both need each other?

In the ensuing months, as the July 31 contract expiration loomed larger, the rhetoric from the hospital group and the insurance giant heated up in equal proportion to the freezing of their negotiations. Throughout the Wabash Valley, among Union-Anthem patients, concern turned to anxiety, and anxiety to white-knuckle fear.

Union, which hired an East Coast consulting firm to manage its negotiations, has been most active in the propaganda wars, urging Anthem subscribers to write, call or e-mail the insurer to demand its executives come to terms with Union Hospital Health Group. Last month, Union conducted a phone “survey” of some of its patients that featured the kind of questions meant to win an argument, not elicit real information.

But Anthem’s short July 13 letter to the Medicare Select folks (and to Medicare Advantage folks) packed more fire power than six missives from Union.

Worse, it turns out that vice president Swanson’s information in that letter was “incorrect.” For in-patient care other than emergencies, Anthem Medicare Select subscribers in the area apparently have but one option beginning Aug. 1: Not Clinton, not Sullivan, but St. Vincent-Clay in Brazil. (Medicare Advantage subscribers go to Sullivan.)

I learned about Brazil when I called the 866 number provided in my mom’s letter. I wanted to know why Terre Haute Regional Hospital was not mentioned in the Anthem Medicare Select Network alternatives.

Tribune-Star reporter Arthur Foulkes wanted to know that, as well. As he reported in Saturday’s paper, Anthem has approached Regional to pick up the Medicare Select program and, according to Regional, “we’re working with Anthem to get an agreement in place as soon as possible.”

But no one at Anthem customer service was aware of that. A nice Anthem phone rep (whose name I will not divulge) went looking for the answer to my question about Regional. She, too, couldn’t understand why this city’s other hospital, which contracts with Anthem, would not be an option for my mom’s particular group of Union rejects.

As she searched, the rep confided, “We keep getting e-mail updates on this, so I need to double check.” Sure enough, there was a July 16 advisory about Swanson’s July 13 letter and its “incorrect information.” Reading from the advisory, the customer service rep said, “This communication is in the process of being corrected and remailed.”

Great. Another letter and another opportunity to see if my mother’s blood pressure and heart medications really work.

Not that they weren’t tested by the final declaration in Swanson’s letter: “Your health care needs are our primary concern. We appreciate the opportunity to serve you and look forward to a long and satisfying relationship.”

To which I — and my mom — say, “Bull----!”

Stephanie Salter can be reached at (812) 231-4229 or stephanie.salter@tribstar.com.

     

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