To the Editor:

I am writing this letter in response to the recent article published in your paper, regarding the current Humana PPO [Preferred Provider Organization] Employer-Sponsored Plan referenced by Anne Rose [“Changes to Guilderland’s health-care provider rankle former supervisor,” The Altamont Enterprise, Jan. 11, 2024].

Ms. Rose is one of our retired town supervisors. I have been a retiree of the town since April 6, 2006, and retired very young due to an injury.

In the article it stated, “The town disputes the claim, and says the switching of providers is a good thing for retirees and saves the town money.”  This claim is absurd for the town to make, as switching health-care providers at a retired age is not a good thing.

It is disruptive to our lives, our medical care, and stressful not to mention deceptive on the town’s behalf.

The article addressed that Community Care Physicians (CCP) was dropping Humana and becoming an out-of-network provider; this simply means we pay out-of-pocket for services rendered; as a courtesy to their patients, CCP agreed to soft bill Humana.

I have spoken with the patient-relations manager at CCP and she has stated that as of Jan. 31, 2024, CCP has no signed contract with Humana, no verbal agreement with Humana to accept co-pays, and no contract will be formalized in the future.

CCP established a payment policy for persons on Humana Medicare Advantage along with the town of Guilderland retirees to be billed the maximum allowed amount under the Federal Medicare Payment Guidelines.

After a medical visit, the retiree would submit this receipt to Humana for full reimbursement for the allowable amount per federal guidelines. These amounts vary for each and every diagnosis code and different levels of treatments received. 

That, to me and many other retirees in the town that I have spoken with, is not in the best interest of the retiree who may live and survive on a fixed budget.

I reference a statement made by the Town Comptroller/Director of Human Resources Darci Efaw, who said Ms. Rose needn’t worry and “retirees with CCP doctors will see absolutely no difference after March when this happens.” Efaw continues to say, “There’s no change.” 

We, as retirees, who go to a hometown doctor’s office, that being CCP, have lost our primary-care physicians. Some of the retirees have been with CCP since their children were born and have been cared for there for many years.

So, a decision made only in the interest of the town and its finances has now disrupted many retirees’ lives, not to mention their budgets. I am being told that NYOH [New York Oncology Hematology] and Memorial Sloan Kettering will be treated as “out of network” and will no longer be accepted.

A close friend of mine and a retiree of the town, who is battling Stage 4 cancer and for his life, now has no PCP, no MSK, and no NYOH. For those retirees who are facing the same health issues, you are and will remain in my prayers for this situation to be resolved in a prompt and efficient manner.

Many of us have received a letter from Albany Medical Health Systems that states, effective July 1, 2024, Albany Med will no longer be accepting any type or form of Humana insurance. This includes all facilities, but not limited to AMCH, Glens Falls Hospital, Columbia Hospital, and Saratoga Hospital. I included a copy of this letter with this writing [posted online].  

In the words of the broker who sold this plan to the town, “This is a fabulous plan and it works.” How is this not “a change?”

What value do we place upon a human being’s health and life? Is this the way we say thanks to the many who dedicated their lives to the town, and to the ones who lost parts of their lives? This is the way you say thank you?  

On Friday, Jan. 26, 2024, it was brought to my attention that the largest school district in this area is having the same problems as the town of Guilderland retirees; Humana is not working for them.

In closing, this situation needs to be resolved. We, as retirees, cannot accept empty promises, “verbal agreements,” or smoke and mirrors anymore. This is not a decision about someone’s commission check, friendship, or the bottom-line finances of a municipality. It is about human life.

For all retirees out there who see this, please reach out to Ms. Darci Efaw at 518-356-1980, extension 1032 or email her at , or Tom Augostini, who is the broker who sold Humana to the town to let them know this is not working. His phone number is 607-206-0929 and his email is taugostini@haylor.com.

If we do not make our voices heard, then no change will occur. We together can and will make a change to this.

Daniel P. Cocca

Guilderland

Editor’s note: See editorial