When Madison Farrell was diagnosed last year with a rare autoimmune disorder called pemphigus vulgaris, he found dermatologists at the Medical University of South Carolina who could treat the disease, which causes his skin to slough off in large patches.
“It’s a horrible disease,” the 46-year-old Colleton County psychologist said. “It looks like you’ve been burned.”
Unfortunately for Farrell, the Affordable Care Act insurance plan he purchased from a subsidiary of BlueCross BlueShield of South Carolina was useless at MUSC. At the time, services there weren’t covered by BlueCross BlueShield or BlueChoice plans sold on HealthCare.gov.
“I offered to pay out of pocket and they won’t take out of pocket,” Farrell said. “I couldn’t believe it. I thought maybe I heard them wrong.”
Farrell was forced to look for health care outside the Lowcountry. Now he routinely makes an eight-hour round trip journey to Wake Forest University for treatment through a clinical trial.
“It’s insane,” he said.
Luckily for Farrell and other patients like him, MUSC and BlueCross BlueShield recently reached a deal that allows thousands of patients covered by the Affordable Care Act and the low-income Medicaid program to access treatment at the Charleston hospital.
Previously, patients covered by a BlueCross BlueShield plan or a BlueChoice plan sold on HealthCare.gov or offered through Medicaid did not qualify for services at MUSC outside the emergency room.
This created a particular hardship for patients who needed treatment only offered at MUSC, such as organ transplants. Other hospitals in the state don’t perform those procedures.
In a prepared statement, Scott Graves, president of BlueCross and BlueShield division, said, “We are pleased to add MUSC to our provider network. Increased access and greater choice adds value for our members.”
Patrick Cawley, CEO of Medical University Hospital, agreed.
“Most importantly,” Cawley said, the deal “keeps South Carolina’s citizens connected to the health care expertise they need to live better, healthier lives.”
The terms of the new contract became effective Oct. 1. Enrollment for the 2017 Affordable Care Act plans opens next month.
S.C. Department of Insurance Director Ray Farmer applauded the insurance company and the hospital for reaching an agreement.
“I’ve been getting several calls, as you would expect,” Farmer said. “This is the best news I’ve had all day.”
Reach Lauren Sausser at 843-937-5598.
