Mulgrew raises copays; Bronx gets hit

UFTers were just notified. I got a letter from Emblem this weekend. It says they are raising copays. I didn’t get a note from the UFT.

Emblem is what I call GHI. New name. But it’s what most of us (UFT teachers) have.

Montefiore used to have services without copays. They took those away. Montefiore is huge in the Bronx. It’s bigger than what most people think – up by Gun Hill, but also over by White Plains Road (Misercordia), huge complex on Eastchester (Einstein) and at Westchester Square (I think that’s new stuff), and on the old Mercy Campus (Waters Place, two towers). That’s a lot of Bronx health care service for UFTers, in September without copays, in October with copays.

Also, they doubled copays for CAT scans and MRIs, except at Sloan Kettering, Hospital for Special Surgery, and something called RadNet. I’ll talk about this more, later. (spoiler alert, we all get screwed, but Bronx teachers get screwed the most).

Do you know what health care savings are? They (insurance companies, Michael Mulgrew, the New York Times) call it savings when 1) you think about going to the doctor, and decide not to and 2) when you pay more (and they pay less) for your visits.

So what do they call it when your copay goes from $50 to $100? Or from $0 to $30? That’s right – the MLC and the UFT leadership call that SAVINGS. Doesn’t feel like savings when it costs me more. How about you?

Last month, we told you of several changes that would impact City of New York GHI CBP Plan members. There have been some minor changes since then. Here is the current guidance:

On Oct. 1, 2022, the following went into effect:

• All Montefiore providers will have a $15 primary care provider (PCP) copay or a $30 specialist copay.
• ProHEALTH Urgent Care centers will have a $100 copay. All other participating urgent care centers will continue to have a $50 copay.

Beginning Nov. 1, 2022, all high-tech radiology imaging procedures received at participating RadNet facilities, Memorial Sloan Kettering Cancer Center, and Hospital for Special Surgery will continue to have a $50 copay. All high-tech radiology services received at other participating facilities in New York State will have a $100 copay. Services include, but are not limited to: 3DI, CT Scan, MRA, MRI, Nuclear Medicine, and PET Scan.

https://www.emblemhealth.com/providers/news/cny-benefit-updates-202210

While we are trying to stop the insurance companies, Unity/Mulgrew, and Adams from pushing our retirees into an inferior system (or ransoming us $2300/year to stay in REAL MEDICARE) – don’t forget they can squeeze us in other ways. They can raise copays (this is not the first time), limit access to doctors, limit access to plans. $15, $20, $30, $50, $100, $150. This is not nickel and dime. They are looking to take real money out of your pocket.