A reader learns cost of UPMC-Highmark split.
I read the Feb. 8 article about state Attorney General Josh Shapiro filing a petition against UPMC relative to the UPMC-Highmark consent decree, and I thought it important to share what I have been told recently by UPMC and Highmark. The issue revolves around in-network versus out-of-network access. It is apparently more complicated than just being "out-of-network." Most of us might assume that if we went out-of-network, we could choose to pay a higher co-pay for using an out-of-network provider. That is not quite the case.
At my last visit to one of my doctors, who is now a UPMC provider, I saw a small card holder in the examination room that said: "Questions about in network access to UPMC in the Erie area? Call 1-855-7-GO-UPMC (46-8762)." I took one of the cards to call UPMC since, currently, I have a Highmark Medicare Advantage plan. I called the number. I asked what will happen after June 30 since rumor had it that Highmark patients would no longer be able to use UPMC providers. That rumor is not completely true. However, I was told that when a Highmark patient goes to a UPMC provider, the patient will have to pay up-front for any services that are to be provided and then the patient would need to go back to his or her insurance for reimbursement.
I then called Highmark to see how this would work. Highmark confirmed that this is probably what will happen, but all of the "details" were not firm as yet. When I asked by way of example how any reimbursement would work, I was told that the patient would be reimbursed at the Medicare rate for the service provided, less the out-of-network co-pay. Therefore, the difference between the Medicare rate and the up-front charge remains as money out of pocket for the patient.
So beware, this "arrangement" puts the patient in the middle between the two competing insurance/hospital networks with each apparently trying to maximize profit, or whatever you would call it, for entities that are theoretically "nonprofit." It sure doesn't appear that the interests of the patients are a first priority. Hopefully, Shapiro will be successful.
— Steve Drabant, Erie
You can support new War
on Terror memorial in Erie
I am working with a group of post-9/11 veterans who want to recognize the impact the recent wars have had on our region.
The aim of the project is to build a monument and collect stories to commemorate and honor the members of the U.S. armed forces from Erie County who fought and died in our nation's longest war — the Global War on Terror, which includes operations in Afghanistan, Iraq and elsewhere.
Our all-volunteer team has come together to lead the fundraising, design and construction of the memorial. There is plenty of room around the table, so please consider this an invitation if you're interested in this cause.
So far, we have a growing seed fund that is residing with the Vietnam Veterans Memorial fund at the Erie Community Foundation. We are also in touch with the national GWOT Memorial in Washington, DC.
The Erie chapter of the Vietnam Veterans Association has and continue to be an incredible source of inspiration and guidance as we carefully take the steps needed to successfully formalize memorial development and management.
Future goals include the development of a website that will make publicly available all financial and decision-making information and allow us to meaningfully engage the community in the design process.
Contributions can be made to VVA Chapter 435, c/o the Iraq/Afghanistan memorial, 4808 E. Carver Ave, Erie, PA 16511.
If you would like to join us or help out in other ways, please contact me at 814-490-6872 or firstname.lastname@example.org.
— Jay Breneman, Erie
Facts about climate change
are not difficult to find
At the risk of possibly being an unwitting participant in J.E. Casella's monthly epistolary performance art, a comment must be made concerning his letter of Feb. 3 equating seasonal changes with climate change and then later doubting that the planet is warming. Mr. Casella, innocent of information, could with a basic search learn the rudiments of both phenomena. An additional search could also update him of the sphericity of the Earth.
— Jerome Swabb, Erie
Reconsider active shooter
drills in our schools
Erika Christakis' article in the March edition of The Atlantic magazine should be required reading to balance the headline of Feb. 10.
"Active shooter drills are terribly misguided" illustrates the profound psychological damage we are doing to children by asking them to prepare for extremely rare events far beyond their control, while simultaneously attempting to eradicate very common circumstances even young children can be expected to overcome, such as hard surface playgrounds or bullying.
— Lawrence Heberle Jr., Glade Township