The Human Cost of Coverage Gaps, Pt. 1
Pattie McCluskey had long relied on her doctors at the Mount Sinai Health System—until an insurance dispute with Anthem Blue Cross Blue Shield suddenly threw that care into jeopardy. In this episode of The Vitals, Pattie shares what it means when a patient with an established care team must confront chaos around appointments, medications, and procedures already tied to her health, daily life, and well-being.
Guest host Dr. Raja Flores speaks with Pattie about the real-world consequences patients face when longstanding medical relationships are disrupted: the stress of navigating dozens of calls to the insurance company, the fear of losing life-saving treatments, and the confusion and frustration that arises when medical procedures are inexplicably canceled by insurers.
Together, the pair discuss what happens when access to trusted specialists becomes uncertain, how patients can advocate for themselves in times of hardship, and why continuity of care remains so critical—especially for those with chronic medical conditions.
If you’re a Mount Sinai patient with Anthem insurance and need more information, please visit this website: keepmountsinai.org
00:00:00:08 - 00:00:34:05
Dr. Raja Flores
Hello and welcome back to the vitals. The Mount Sinai Health System's groundbreaking roundtable video podcast. I'm your guest host, doctor Raja Flores, a thoracic surgeon here at Mount Sinai Hospital. On this episode, we're discussing the consequences of contract disputes between anthem Insurance and the Mount Sinai Health System from the perspective of a mount Sinai patient. If you need some background on the anthem situation and just how absurd some of their claims are.
00:00:34:07 - 00:01:00:00
Dr. Raja Flores
Check out the previous episode of this show, titled When Coverage Breaks Down the Hidden Cost of Health Care Disputes. To walk us through her experience as a longtime Mount Sinai patient who holds Anthem Insurance. We're joined by fellow New Yorker Patti McCluskey. Before we start, I want to give a disclaimer that we haven't told miss McCluskey what to say.
00:01:00:02 - 00:01:14:07
Dr. Raja Flores
And I'm only just meeting her for the first time. She's here simply to share her story. And you can decide. Miss McCluskey, welcome.
00:01:14:09 - 00:01:29:23
Dr. Raja Flores
So welcome. Patti. I appreciate you speaking to us and giving us some insight from a patient's perspective about, what you've been dealing with with anthem now. If we can just learn a little bit about you. Are you from New York? Where are you.
00:01:29:23 - 00:01:32:12
Pattie M.
From? New York. I live up in Croton, New York.
00:01:32:14 - 00:01:38:23
Dr. Raja Flores
All right. And, And so when were you first diagnosed with peripheral artery disease?
00:01:39:01 - 00:01:56:02
Pattie M.
I think it was, it started off actually with a diagnosis or going to a new going to a cardiologist. I'd never been to one. So I went to, a doctor who was very helpful of telling me about my genetic predisposed to heart issues.
00:01:56:02 - 00:02:00:10
Dr. Raja Flores
And so you go to a cardiologist just for a routine. And were you feeling any symptoms?