Tuesday, November 8, 2011

I'VE GOT A BONE TO PICK... Medicare Complaints Anyone?

Have you noticed the zillion commercials about Medicare insurance? I can’t wait for December 7th to come and go. The holiday season is not the only reason for the high death rate this time of year, it’s the dang stress of open enrollment. (LOL)

Having poor health for many years, I’ve had to deal with the rigmarole of Medicare. I’d just like to apologize to all the seniors out there. What a pain. Why do we let the Government do this to them? Even in my thirties, I couldn’t navigate or understand the laborious task of Medicare disability applications or the insurance game.

I just want to share an experience I had with AARP/United Healthcare. In all my years of dealing with insurance companies, this company was so frustrating to me that it actually impacted my health. On multiple medications, I soon reached the donut hole (as it’s so affectionately known among seniors). That’s when Medicare insurance will no longer pay, and you’re on your own until you’ve paid out a certain amount of money. Then, Medicare is SUPPOSED to pay everything.

According to my records, I’d reached my portion of payments while in the hole, and Medicare should’ve taken over. However every time I called United Healthcare, they told me a different amount that I’d paid. Just to make sure it wasn’t my mistake, I called them back within ten minutes and got a different figure. I waited ten minutes and got a different figure again. How could that be? I never could get a straight answer from this company, and I never got out of the donut hole. If you're a senior or on disability, have you EVER reached the other side? I’d really like to know.

I finally went through the appeals process, but still got the run around. I never did receive compensation for what I OVERPAID and the calls and stress became too much. I think government organizations count on a person getting so frustrated that they give up. That seems to be the procedure I’m going through with my disabled son.

I understand having to “weed out” people from the system, but this seems like the wrong way to go about it. I know plenty of people on disability and welfare that shouldn’t be and others who should that have been denied.

One last bone to pick. When you sign up and PAY for insurance, does it bug you that they can decrease your benefits? How can they do that?

Are you a senior, on disability, or a caregiver? What problems have you had with the system, and what do you think would help to improve it?  

Cindy A. Christiansen
Sweet Romance, Comedy, Suspense...and Dogs!
Fly into a good book at: www.dragonflyromance.com

5 comments:

  1. I do understand that one hand doesn't know what the other is doing. Everything in this fouled up world is cock-eyed!

    BUT, since I have no insurance at all, I'm praying Medicare will still be around when I reach that age, because I know I'll sure need something.

    I understand the stress you went through, though, and sure hope things are better for you now!

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  2. As someone on disability, I certainly share ur stress. By the time I wade thru the medicare book they send me every year,I've already forgot what I read in the first half. I usually just pay for medications and don't deal with their open enrollment, but I only take a couple of routine meds, when I take more in the future, I'm sure I'll need more insurance. But for now, I deal with them as little as possible and pray I get a real person on the line and not a robot...lol...Tabs

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  3. Cindy,

    My first husband and I married when we were 17. His father died two years before I met him, and my mother in-law was getting a death benefit from social security. She was supposed to turn it in that he got married but never did. She continued to draw the money until his 18th birthday.

    Needless to say, two years later, social security said my husband was legally responsible for pay back the money his mother received that we never saw a dime of.

    Now, my husband turned 65 last year. He had to sign up for Medicare Part A. Part A pays for when you go into the hospital, and it’s free for everyone who turns 65
    But it only pays 80% of approved charges if you go into the hospital. We the consumer pays for whatever they don’t approve, plus 20% of your hospital bill.

    This year my husband reached his full retirement age. Meaning he can work without paying a penalty (for every two dollar you earn, SS takes a dollar, if you retire before your full retirement age) and we are in the mess of trying to figure out what “plans” we need.

    They give you an inch thick book with all the different plans to choose from. Plans A-Z, ZZ.

    Here’s what you have to have:
    Part B pays for doctors.
    Part D pays for prescriptions

    Other parts of the alphabet pays for the differences you have to pay that these Parts A & B do not cover. These are offered from other insurance companies who have agreed to SS terms.

    You almost have to be a rock scientist to figure all these different plans out. Our government doesn’t make it simple for any of us!

    And in case you didn’t know, each one of these plans you pay for.

    When you retire, they take the premiums out of you SS check. If you retire early, you have to mail in your Part B payment to the SS, and pay all the other plans to the insurance company you choose.

    The commercials remind me of a political campaign. It’s supposed to help the senior decide which one is best for them. They give so many choices you don’t know which one is the best. Very overwhelming!

    We also get about six pieces of junk mail a day, from all of them during this enrollment period, every year.

    Plus pushy insurance salesmen call you constantly trying to sell you their plan.

    This happens when you call them and asking questions about their company, what they cover and don’t cover.

    I don’t know why it has to be so complicated, I think they do this so we don't understand it all!

    Kim

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  4. For my mother on Medicare: I called Medicare to get info on a good drug program for the meds she takes. They narrowed it down to three insurance companies and I then checked all of them.
    My mother has Medicare as her primary insurance and BC/BS as secondary. No drug money from secondary, but the Medicare drug program we choose works very well. Check the Walmart option.

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  5. The way big drug companies try to scare folks away from natural alternatives really angers me.
    If it weren't for some of those my health would have taken a plunge years ago.

    Really! How many deaths have been caused by Licorice Root or Ginger? On the contrary, look at all those commercials inciting those who have taken certain "prescription" drugs to sue because of the awful side effects.

    The large pharmaceutical companies' agenda is to find a way to patent herbs and other supplements so we will need a prescription to buy them. That way they get a cut.

    Like Miss Mae, I have no health insurance, but am hoping medicare is still around when I get of age, in case I am forced to resort to a doctor and/or hospital...but only if my stash of natural remedies doesn't quite do the trick.

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