The Insurance Gap: When Coverage Isn't Enough

"If I'm not able to access the care I need, having insurance means nothing," said Cynthia Eggert, a college professor, writer, and small business owner living in North Adams, Mass.

Eggert was among a number of people who testified at a public hearing at Pittsfield City Hall regarding Gov. Deval Patrick's payment and delivery reform legislation. The Joint Committee on Health Care Financing is holding regional hearings and the Massachusetts Campaign for Better Care has played a prominent role to bring the consumer voice to the forefront.

Eggert was forced to change insurance plans after her monthly premiums doubled. She needs physical therapy for her knee, and although the provider is listed in her insurance network, the insurer is not yet covering her appointments at a new location. In the meantime, she has been paying out of pocket, relying on the insurance company to reimburse her for her visits.

"The insurance company assures me I will be reimbursed, but it is not easy to continue to issue large checks when I have other bills piling up. This past winter, my partner and I went seven weekends without heat," she said. "Exploding health care costs are forcing us to forego treatments and make financially driven decisions regarding our health."

The Campaign for Better Care works to ensure that care is accessible and available to patients when they need it. The Campaign's goal is to fundamentally change how health care is delivered and ensure that care is coordinated and patient-centered.

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