Monday, March 26, 2012

Attention New York State Empire Plan Members

I was recently a guest speaker at the Pleasant Plains, Prince's Bay, Richmond Valley Civic Association here on Staten Island. By the way, it's an admirable organization and, I'm not just saying that because I've been its vice president for quite a number of years. We do wonderful things for our community and, therefore, I was more than happy to volunteer to address the membership on the topic of Speech-Language Pathology.

After a concise but thorough presentation of the clinical aspects of my field of practice, the inevitable topics of cost for service and insurance coverage were explored. Having been in practice for thirty eight years, I was able to lend historical perspective on these two very practical areas of concern. After speaking in generalities about the insurance industry's current response to claims for speech therapy, I became more specific about a few policies that insure many residents of our little island.

This led to a much more detailed description of the Speech Pathology provision of the New York State Empire Plan which insures New York State employees who work for our state in any capacity. Here on Staten Island, there are numerous NY State facilities which employ our local citizenry, as well as numerous Staten Islanders who commute to NY State facilities in other parts of our metropolitan area. I'll enumerate some of them at the conclusion of this blog.

In my presentation, I emphasized that it has been my experience that no other insurance plan in our area nor throughout the United States contains a better Speech Pathology provision than the New York State Empire Plan (which is administered by United HealthCare). There are plans that cover most, if not all, of the services rendered by Speech Pathologists. There are also plans that have reimbursement rates that cover the full cost of such services. Additionally, there are plans that cover those services for as long as they are required for successful remediation of the communication disorder being treated.

Now, imagine an insurance plan that does all three of these wonderful things for its members. You've now imagined the New York State Empire Plan; a policy with deductibles and out-of-pocket-maximums so low that they are dwarfed by the usual magnanimous amounts contained in other policies today. My experience with the NYS Empire Plan is extensive; I have been associated with them since the early 1980's when they came into existence, and I have treated their members for the nearly thirty years since. I have come to learn that, most often, those covered by this plan can receive Speech Pathology services at no cost to them. There is, of course, an investment of time.

So, an investment of time, not money, was my theme when I delineated the Speech Pathology provisions of the NYS Empire Plan. That, again inevitably, brought me to the next logical topic in the form of a question: "Where are these Empire Plan members?" With tens of thousands of Staten Islanders insured by this one plan in particular, whose family members are equally insured, why are so many of them not taking advantage of this generous coverage if the need exists within their family? At a minimum rate of one in ten people having a communication disorder, the number of Staten Islanders with such disorders who are covered by this plan could be quite large.

Like so many of us, I have been following the current budget and pension adjustments our governor would like to dole out to New York State Civil Servants. If he has his way, state workers will be negatively effected economically. I often wonder if our governor might ever turn his attention to the health insurance his employees receive with cutting and saving in mind. I mentioned earlier that I can lend historical perspective to the topic of speech services and insurance plans based on a lifetime in my chosen profession. Therefore, I can assure you that, when insurance companies engage in cost containment, they don't cut services that save lives, they first cut services that improve the quality of life. And, as my website so eloquently points out, that is what Speech Pathologists are all about; we improve quality of life.

So the next question at my Civic presentation became: " Why not take advantage of a policy provision while it still exists?" And further: "Why not start now in an effort to prevent the usual, negative emotional, social, academic and vocational ramifications that typically accompany unresolved speech and language disorders?"

Perhaps you're a court reporter or a court officer for a NY State Court. Maybe you work at South Beach Psychiatric Center, or one of the many other State Health facilities on or off the island. Perhaps your employer is the Transit Authority or the Long Island Rail Road. You may work at a State political office or the Department of Motor Vehicles. Whatever it is that makes you a State Civil Servant, if you are covered by the New York State Empire Plan and have a need for speech pathology services, I will be happy to discuss all matters clinical and financial with you. Learn what an investment of time can do for you or your family member. I can be reached at 718 948 7381.