I enrolled in the Anthem Blue Cross Plus plan through my husband’s workplace earlier this month, during his period of initial enrollment (PIE). We had just moved from Monterey to Oakland for his new job, and I had previously been seeing a doctor in Monterey through my company’s PPO plan. It made sense to subscribe under my husband’s new plan, as I was 3 months pregnant and wanted to ensure I had coverage in the event that I lost my job (as my company was in the process of being acquired). We selected the most expensive plan that looked like it offered the best coverage.

About two weeks after enrolling, I received my membership card and a notification specifying that the company had automatically assigned me a medical group and PCP, and that I was welcome to call the customer service line to select a different provider/medical group if this caused any inconvenience. I did so immediately, as I had been referred to a specific medical group in Walnut Creek by the doctor I trusted in Monterey. When I called the customer service number to designate my PCP, I was told that because I was “already in the course of treatment” for pregnancy, I would not be able to select my choice of a PCP or medical group! I would have to see the physician that Anthem Blue Cross had automatically selected for me. When I tried to explain that I was new to this plan and was not in the course of treatment with the doctor they selected, they told me that it didn’t matter…that I had no choice.

How is it possible (or even legal) that they can deny me the privileges that all the literature I received when subscribing for the plan specified that I was entitled to? No choice when I’m 3.5 months pregnant about either my designated medical group or my PCP? The PCP can only refer me to an obstetrician in the medical group the insurance company pre-selected, so I can not give birth to my baby at the hospital I had chosen for myself…even though it was clear from the literature that I would be able to select my PCP initially. This is false advertising! You can’t make claims in writing and then once a member has enrolled say “Oh, sorry, you were already in a course of treatment for pregnancy, so you no longer have the right to choose like we said you did…”

Pregnant ladies (or anyone with a pre-existing condition) beware! The Blue Cross Plus Plan is not for you! I will never subscribe to Anthem Blue Cross again based on this experience, unless they can rectify this situation after receiving my grievance letter.

Another plug and kudos goes to Dr. Richard Alexander’s office in Monterey. Dr. Alexander is fabulous. He really takes the time to listen to his patients; he is smart, analytical, and has a great bedside manner. All members on his staff are friendly, efficient, and extremely professional. I’m always seen in a timely manner and am very satisfied with the quality of care I’ve received at this office.

I wanted to post a plug for the team at Dr. Stricker’s office in Los Gatos. They are really working with me to get essential tests performed and to tailor their standard protocol to my individual needs. I’m extremely grateful to them.

My blood cortisol levels actually came back high (JavaOne STRESS); so I decided to take the Dexamethasone .5mg as prescribed this cycle. I also received a positive ANA result with a 1:320 titer, so perhaps the steroid will help reduce the NK activity.

I’m still debating whether or not to take the Arixtra 2.5mg…it seems so scary. I wish someone could give me simple a yes or no answer, but it seems that a lot of this stuff is voodoo–and no one really knows. I hope I make a good decision…

…so pray tell why I (@ 42 kg) was just prescribed this?

[The trailer doesn't do it justice.]

A few of my photos will be published in B&W Magazine, Special Issue, August 2008:

© 2008 Gwen Coyne. All rights reserved.

© 2008 Gwen Coyne. All rights reserved.

…to L’Inverno/The Four Seasons/Vivaldi, performed by Pinchas Zukerman & the Saint Paul Chamber Orchestra.

It inspired me to buy this book, by Roy Malan, with whom I once had the great opportunity to study with.