Medicare Insurance Hell

Discussion in 'Politics and other "Messy" Stuff' started by Goldsmithy, Dec 22, 2015.

  1. Goldsmithy

    Goldsmithy MINI Alliance Ambassador
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    I have to rant publically somewhere about the insurance hell I have been going through for the last 2 months. In November, I (we) were notified that my wife's disability insurance (handled through the PERS) was being discontinued due to her being eligible for Medicare and pers was going give a stipend toward the insurance costs. In effect, it meant that I was now faced with dealing with 'insurance exchanges'...you guessed it...Obamacare.:cryin:

    Sooo many plans...so many options. PES sent everyone to a medicare specialist to help transition insurance. And folks, it's a joke. I had a 3 hr. telephone representative of the exchange, giving her all my medications, even those I was no longer taking. And doctors, including specialists. I thought...great...she will find the best plan for me.

    Ho-HO-Ho, I was too dumb to accept that she was acting as an agent for an insurance company. I asked her if she was paid a commission, she replied she got paid hourly. OK. During our next 3hr plone call (my wife and I together) she kept referring back to a plan by United insurance. It sounded OK, I was totally confused at the time. I signed up. Here's the rub...

    The agent that gets you to agree to a plan and then she transfers you to a'payment' representative who will not be able to answer any questions about the plan. (?). This representative plays a recorded message that says the company has been compensated ON A COMMISION BASIS. So, I go back to the company website to look up the plan from United Insurance.

    There is a little red block on their site, among all the listed companies, that says if you want to compare rates and features, like the rest of the companies, you must call---THEY ARE NOT LISTED.

    And the agent kept saying this was the best plan for me and she was being paid by the Insurance company????? I feel I've been screwed.

    Thanks for listening...
     
  2. Crashton

    Crashton Club Coordinator

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    I think you may very well have been screwed. Looks like you have a fight on your hands. Good luck my friend. :fingerscrossed:

    It grinds my gears that folks who paid into their retirement are now having the rules of the game changed & now need to pay even more. While people who have not paid in get their healthcare for free. I just don't get it?
     
  3. Metalman

    Metalman Well-Known Member
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    One of the reasons I can't afford to retire.... Even though I've been paying into the pot since day 1 of my working career...:mad2:
     
  4. Friskie

    Friskie Well-Known Member

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    There's nothing to stop you from changing plan F carriers next enrollment period. I've changed twice over the past 7 years. Locate a BROKER who can show you a selection of carriers that fit your circumstances the best.
     
  5. Minidave

    Minidave Well-Known Member
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    Ok, some clarifications.....

    If you are dealing with Medicare, you are NOT dealing with "Obama care", or it's correct name - the Affordable Care Act.

    My wife and I were on ACA till I turned 65, at that point I was kicked out of the ACA and into Medicare - she remained in ACA as she's four years younger than I am.

    That's when things really got expensive, because now I'm paying my Medicare Part A,B and D but she's now paying way more than before on her ACA since only one of us is being subsidized.....don't ask me how it costs more to insure one person than two - but that's what happened.

    Goldsmithy's mistake was probably that he went to a .com site instead of .gov, and wound up with an insurance broker instead of talking to the ACA folks themselves.

    You do not have to go to a broker to get into the ACA, and you do not have to go thru a broker to get into Medicare - you can do both directly thru their .gov sites - that's what we do. Your insurance will ultimately be provided by a health insurance company but you don't need to use them or a broker to pick a plan and sign up.

    Just FYI

    One interesting note, after getting our mess straightened out (when on ACA you get a form at tax time showing how much subsidy you were paid, this is treated as a form of taxable income) with incorrect tax forms and so on, the carrier who has provided her health insurance for the last two years has now opted out of the program in Kansas, and she had to change plans yet again.

    When you retire, all you have time for is finding a provider and filling out health insurance forms! :crazy:
     
  6. Goldsmithy

    Goldsmithy MINI Alliance Ambassador
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    I can guarantee you all one thing...next year I will be an expert on retirement medical insurance, including those for a disabled wife. Realize that insurance exchanges are manned by licensed INSURANCE agents. THEY REPRESENT THE COMPANIES...NOT YOU.

    A google search revealed to me that many of the companies represented that they had 'licensed' agents. And I forgot that licensed agents act on BEHALF OF THE COMPANY.

    In another life, I worked my way through law school selling insurance. I passed the bar and practiced law for a few years. I wondered about a National Health Care Plan and how it would affect the insurance industry. They recovered quickly...using large phone rooms of 'licensed' agents for the state you are in. Absolutely no personal contact...only a phone. I am almost pissed enough to take my law license out of escrow (that's what you do when you stop practicing) with the Supreme Court and start a Federal action (Yes, I was licensed to practice in Federal Ct.) as to the sales practices of insurance exchanges.

    Well, I guess the anger shows I'm still alive...yeah for us old farts.
     
  7. Minidave

    Minidave Well-Known Member
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    Like I wrote, if you go to the .gov site you avoid all the "salesmen", you're already in the system now but you can opt out and re-up next enrollment period.

    My wife spent weeks and weeks reading and reviewing al the different plans till she finally picked one we could afford and that met our needs, then the company stopped participating and she had to do it all over again. It's a royal PITA!

    And for the most part, it's a long way from "affordable"

    I appreciate what the Pres was trying to do - create a system where all Americans could afford healthcare, but boy the system got screwed up along the way.....thank you congress, thanks you pacs and thanks to the insurance industry as well.......asholes
     
  8. MCS02

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    Sorry to hear this Goldsmithy!
     
  9. Lorenzo

    Lorenzo New Member
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    Been on Medicare for 7 years now but I'm no expert. Before choosing a supplemental, advantage, or medi gap coverage I went to the back of the Medicare booklet all retirees receive in Sept of each year. In section 12 of the booklet, "Medicare and You 20--," is an outline of all programs available in your state. Review those and call the carrier directly for a copy of the plan(s)/program you think best fits your needs and budget. Look at more than one plan also. Also most carriers usually have 2 or more levels of benefits based on monthly cost.

    If you are married your spouse's plan may not fit you and vice versa so having separate plans with different companies is not a bad thing especially if they see a different primary Dr.

    Also if you take any medications, ask the company for a copy of their drug formulary to determine the cost of your medications so there will be no surprises late in the year. If you have a favorite primary physician check with his business office to see if he will be accepting your plan, don't necessarily take the carriers word, because a lot of shuffling of approved carriers are made late in the year by Drs. While Medicare allows you to go to any Dr, the supplemental programs will have a network of various physicians/hospitals they will require you to use. Being out of "network" can become pretty expensive should you have a serious health problem.

    Picking a carrier is not rocket science but it is not difficult either with a little patience, planning, and practice. If the company says they can't sent you the information you want you can bet they will suggest a call or a "home" visit from a "Medicare Specialist" and this person will be a licensed agent working on a commission. Being paid a commission is not a bad thing but many times the rep doesn't know much more than you if you have done your research.

    Being in pretty decent health my selected plan doesn't cost me any extra over my Medicare premium deducted each month from my SS "entitlement." Over the past few years I have changed my program 3/4 times but not my carrier. Yes, I have taken my carrier to task for not paying what their evidence of coverage called for, but that is another story.

    Buying insurance is kinda like buying a car. Do your homework/research first before you sign on the bottom line and I'm fairly sure you should find something that works for you and fits your anticipated needs for the coming year.
     
  10. caseydog

    caseydog Well-Known Member

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    I agree with Minidave. I select my plan through healthcare.gov. It was confusing the first time, but choosing my 2016 plan was pretty easy. I had to choose a new plan for 2016, because I had a PPO plan in the past, and the insurance companies are ditching PPOs for HMOs.

    Also, like Minidave said, Medicare is NOT "Obamacare." They are separate programs.

    When dealing with government healthcare, you need to be careful. Healthcare.gov is an official government site, while healthcare.com is a private enterprise designed to "help" you do what you can do yourself -- and I'm sure they have a way to make money from it.

    As a cancer survivor, the ACA has been beneficial to me, but like Minidave said, congress managed to make it far from what it could be.

    CD
     
  11. Lorenzo

    Lorenzo New Member
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    The simple fact is health care insurance protects an individual during an illness with a Dr's care that may not be otherwise affordable and that person's assets by aiding with a major portion of the cost of the illness. The investment of time in selecting the right plan is a kin to protecting your saving and retirement funding and too many people have made it way to complicated for most of us to understand with the contract's definitions, terms, and conditions.
     
  12. mrntd

    mrntd Well-Known Member
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    After Obamacare got passed the cost of our insurance went up so much we didn't have a choice but to go on Obamacare. It is a total PITA. Luckily we belong to the National Small Business Association and they have a broker that kind find the best deals and plans.

    Now a number of the companies that signed up for the exchange are getting out. There are so many rules under Obamacare that made everything more difficult for people and insurance companies.

    It's a mess, it did nothing to make insurance or medical care less expensive, and it need to go away.
     
  13. Minidave

    Minidave Well-Known Member
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    Yes, but.......without it my wife and I went two years with no healthcare insurance at all - and at our advancing ages that's not acceptable.

    The last employer provided insurance we had offered a $12K deductible - for each of us. How the hell is that workable?

    Like I said, I appreciate what the Pres was trying to do, too bad greed, politics, special interests and stupidity got in the way.

    But that seems to be the American way now.......get yours and to hell with everyone else.
     
  14. Goldsmithy

    Goldsmithy MINI Alliance Ambassador
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    Well, like a lot of Americans, I was in a a place that PERS covered since my wife was disabled 20 years ago. Company coverage that was supposed to last her lifetime. This year, when she turned 65 and covered my Medicare, PERS quit offering coverage. My wife sees 4 specialists and has 20 prescribed medications and I have 1 specialist and 10 prescribed medications. I GOT NAILED...

    I went from $240.00 a year...to over $14,000.00 (est). Looks like my MINI mods have been curtailed for a while. :frown2:
     
  15. old81

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    After seeing this extreme range of dailogs I am not going to complain about the 140% increase my wife's insurance went up.

    3 years to Medicare for her, hopefully it will still be around, my Advantage program stayed level this year, but my docs are really not providing the care I received before I went on Medicare.

    Not a fan of the ACA or the gov. taking away benefits. :mad:
     
  16. Goldsmithy

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    Hey Don...when your wife turns 65 and goes on Medicare, it seems a special kind of hell opens.

    If I can help, let me know. I plan to be an expert by then.:Thumbsup:
     

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