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Valued Social Butterfly
Posts: 8,793
Registered: ‎08-18-2008

Re: Is AARP United Healthcare Medicare supplimental insurance as bad as the customer reviews say??

Message 21 of 89 (438 Views)

rker321 wrote:

Gail!!!!!!!  I just want to see the eligibility questions. for a Supplemental. or are they secret to the general public?  just the questions Gail  just the questions.? 


Here is some more info on the application for Medigap coverage from Medicare 

 

 Medicare.gov - Buying your Medigap policy

Valued Social Butterfly
Posts: 8,793
Registered: ‎08-18-2008

Re: Is AARP United Healthcare Medicare supplimental insurance as bad as the customer reviews say??

Message 22 of 89 (427 Views)

rker321 wrote:

Gail!!!!!!!  I just want to see the eligibility questions. for a Supplemental. or are they secret to the general public?  just the questions Gail  just the questions.? 


These are private companies so there is no reason why the general public has to have access.  Medigap policies are sold by area to a select group of people - not the general public.

 

Do like john258 said and contact an independent agent in your area and he probably has access to all the insurers in your area that offer a Medigap policy.

 

There are qualifiers -

age and/ or other access to Medicare

original Medicare - Parts A and B

your status as an enrollee - Medigap Open enrollment period or Guaranteed issue rights - if neither, you health history and probably the right to get some medical records.

 

There Are also things that are illegal -

Medicare.gov - Illegal Medigap Practices

 

Why is what's on the application so important to you ?

 

Like I said, you are not being denied Medicare - you have Medicare.

 

 

Valued Social Butterfly
Posts: 22,426
Registered: ‎03-04-2009

Re: Is AARP United Healthcare Medicare supplimental insurance as bad as the customer reviews say??

Message 23 of 89 (428 Views)

Gail!!!!!!!  I just want to see the eligibility questions. for a Supplemental. or are they secret to the general public?  just the questions Gail  just the questions.? 

Valued Social Butterfly
Posts: 5,681
Registered: ‎07-20-2010

Re: Is AARP United Healthcare Medicare supplimental insurance as bad as the customer reviews say??

Message 24 of 89 (446 Views)

rker321 wrote:

What I want to find out is where  can I see the questioner that you have to answer when you apply for a Medicare Supplemental plan. To  be able to see illegibility to a Supplemental program? any ideas? have bee looking in the Internet and cannot find anything that I can see on this issue.


Suggest you see a local expert on the subject then talk to your Insurance Agent. You will not get complete advice from anyone in here.

Valued Social Butterfly
Posts: 8,793
Registered: ‎08-18-2008

Re: Is AARP United Healthcare Medicare supplimental insurance as bad as the customer reviews say??

[ Edited ]
Message 25 of 89 (442 Views)

rker321 wrote:

What I want to find out is where  can I see the questioner that you have to answer when you apply for a Medicare Supplemental plan. To  be able to see illegibility to a Supplemental program? any ideas? have bee looking in the Internet and cannot find anything that I can see on this issue.


Medigap coverage is ONLY supplemental coverage to Medicare.

 

It is sold by private insurance companies and thus unless you buy it when you have (Medicare ruled) GUARANTEED ISSUE RIGHTS, they don't have to sell it to you.  PERIOD.

 

They can choose to deny you.

They can choose to underwrite you.

They can choose to underwrite you, approve you and charge you more.

They can choose to underwrite you, approve you, charge you more and not cover any pre-existing condition for a set time period.

 

UNLESS you have Medicare-ruled GUARANTEED ISSUE RIGHTS, it is up to the individual health insurer as to what they want to do with you - yea/nay/or with price and other conditions.

 

If you are thinking this is similar to the ACA in denying you because of a pre-existing condition - think again, because MEDIGAP coverage is NOT full insurance, in fact, it is not even health insurance - It is supplemental coverage to original Medicare.

 

I am assuming that you told your agent that you wanted to change your coverage to original Medicare but ONLY IF you could get approved for a supplemental Medigap plan, knowing beforehand what price and conditions you might have to abide, if approved at all.

 

You have the right to go back to original Medicare if you want because that is just another choice in how you want to receive your benefit.  A Medigap policy is outside of this realm of coverage because it is supplemental, meaning something extra.  

Original Medicare = Medicare Advantage, they are one in the same.  Medigap is NOT, it is something extra.

 

 Medicare.gov - When can I buy a Medigap ?

 

The best time to buy a Medigap policy is during your 6-month Medigap open enrollment period. During that time you can buy any Medigap policy sold in your state, even if you have health problems. This period automatically starts the month you're 65 and enrolled in Medicare Part B (Medical Insurance). After this enrollment period, you may not be able to buy a Medigap policy. If you're able to buy one, it may cost more.

 

. . . . Medigap insurance companies are generally allowed to use medical underwriting to decide whether to accept your application and how much to charge you for the Medigap policy. However, even if you have health problems, during your Medigap open enrollment period you can buy any policy the company sells for the same price as people with good health.

 

. . . . If you apply for Medigap coverage after your open enrollment period, there's no guarantee that an insurance company will sell you a Medigap policy if you don’t meet the medical underwriting requirements, unless you're eligible due to one of the situations below. (See the above link)

 

. . . . During the Medigap open enrollment period, an insurance company can't use medical underwriting. This means the company can't do any of these things because of your health problems:

Refuse to sell you any Medigap policy it sells
Make you wait for coverage to start (except as explained below)
Charge you more for a Medigap policy

 

In some cases, an insurance company must sell you a Medigap policy, even if you have health problems. You're guaranteed the right to buy a Medigap policy:

When you're in your Medigap open enrollment period
If you have a guaranteed issue right
You may also buy a Medigap policy at other times, but the insurance company can deny you a Medigap policy based on your health.

 

. . . . If you buy a Medigap policy when you have a guaranteed issue right (also called "Medigap protections"), the insurance company can't use a pre-existing condition waiting period.

 

. . . . The insurance company can't make you wait for your coverage to start, but it may be able to make you wait for coverage if you have a pre-existing condition.

In some cases, the Medigap insurance company can refuse to cover your out-of-pocket costs for these pre-existing health problems for up to 6 months (called the "pre-existing condition waiting period"). After these 6 months, the Medigap policy will cover your pre-existing condition.

 

Coverage for the pre-existing condition can be excluded if the condition was treated or diagnosed within 6 months before the coverage starts under the Medigap policy. After this 6-month period, the Medigap policy will cover the condition that was excluded.

 

When you get Medicare-covered services, Original Medicare will still cover the condition, even if the Medigap policy won't cover your out-of-pocket costs, but you're responsible for the coinsurance or copayment.

 

I have already given you the link to Medicare - Guaranteed Issue Rights -

 

To answer your question, a Medigap insurer, if you do not have guaranteed issue rights, can ask you detailed questions on your health conditon(s).  And they can make their own decisions about whether or not to cover you at all or with stipulations in price, may cost more, and in coverage for a specified amount of time.  It is up to them if you do not have guaranteed issue rights or Medigap Protections.

 

 

 

 

 

 

Valued Social Butterfly
Posts: 22,426
Registered: ‎03-04-2009

Re: Is AARP United Healthcare Medicare supplimental insurance as bad as the customer reviews say??

Message 26 of 89 (438 Views)

What I want to find out is where  can I see the questioner that you have to answer when you apply for a Medicare Supplemental plan. To  be able to see illegibility to a Supplemental program? any ideas? have bee looking in the Internet and cannot find anything that I can see on this issue.

Info Seeker
Posts: 1
Registered: ‎06-21-2015

Re: Is AARP United Healthcare Medicare supplimental insurance as bad as the customer reviews say??

Message 27 of 89 (587 Views)

Every Plan F must offer exactly the same benefits. So, the ONLY difference is the premium.

Info Seeker
Posts: 4
Registered: ‎07-14-2012

Re: Is AARP United Healthcare Medicare supplimental insurance as bad as the customer reviews say??

Message 28 of 89 (1,707 Views)

It might be difficult to understand as a new enrollee with "Medicare" regarding drug coverage. Plan F is by far the best as you never see any co-pays, decutibles and if aprovider charges more than what Medciare allows as approval Plan F pays for everything. Now regarding the drug part d, which is mandatory as an addition to any of the Supplemental Plans (under the Government rules :not just AARP or United Healthcare), ALL prescription drug coverage no matter what company you are with, by law, must substitue name brands for generic (unless your doctor writes a valid reason why the generic will no work for the patient) This rule also applies to any "complete plans that will replace name brands for generic (unless a doctor writes of letter of needed approval). 

I have never heard of a doctor bad mouthing any memeber of the healthcare profession (doctors or providers) so if the doctor in question did such a commnet and is reluctant to write a necessary letter, which I am sure he has needed to do numerous times (I would question the doctor and not the insurance provider).Note: As my memory serves me as when I did have private insurance before 65 (and not Medicare) name branded drugs were simple to get with a simple script But Medicare has strick government rules that must apply for cost savings accross the board. If you do not like United Healthcare and the Plan F and drug coverage you can shop around (but honeslty my fear is that all the providers will be the same)


GailL1 wrote:

r58721w wrote:

United Healthcare is the worst!

Since just starting Medicare, I was told that Plan F was the best.

However, the perscriptions was a separate plan,, no problem, got that throught them as well.....BIG MISTAKE.

I take only 2 meds,,,Protonix & Zetonna (an inhaler) thats it..

My PC had to stop his work and dedicate time to write why I needed the name brand as other products previously tried never worked and resulred in many hospital visits, The generic does not work, as well...

They finally accepted the doctors orders and decided to pay a portion of this drug, that I have taken for years.

Now we get to the Zetonna, another drug they still refuse to help cover.

My ENT doctor just phoned me, on a Sunday no less, to see if I was all set in getting ths covered,,,,

He was very upset when I told him once again it was denied.

He said this group is nothing but "smoke & mirrors" and he's right/

5 times this man has filled out paperwork and sent it in and still, whoever makes this decision in UHC  to decline this med, better have a doctorate degree,

I think its disgusting that some office worker decides what a patient is in need of.

So right now for this spray I pay 750.00.

I am sorry I ever got involved with UHC and I am very sorry that AARP is involved with them...


I believe that your problem may have less to do with any particular Medicare Part D insurer and more to do with the meds which have been prescribed for you.

 

Since you have decided to stay with Original Medicare (with a supplemental policy to pick up the cost slack), you do have to pick a free standing Medicare Prescription Drug Coverage plan (Part D).

However, you can pick from several different insurance companies that are offering this coverage in your area.

 

Your selection criteria should be based on medicines which you use which are offered on their formulary.  

 

I am not sure that you are gonna find Protonix on a Medicare Part D Insurance plan in brand form since there is an equivalent generic.  Medicare Drug plans would cover the generic of Protonix ( pantoprazole ) - FACT: FDA requires generic drugs to have the same quality and performance as brand name drugs. FDA: Understanding Generic Drugs

 

You will find generics used in the place of brands on many medications and if you really want the brand, then you will have to have your doc ask for the exception as you did and pay the extra cost.

 

GoodRx.com indicates the difference in price in generic vs brand and states that Medicare only covers the generic form.

 

However, you can always check other plans by going through the Medicare Plan Finder (link below) for the brand name to see if any Part D plans do offer these meds on their formulary in brand form.

 

When Open Enrollment opens in the fall of this year, go to this  Medicare site and do personalized search for a better / different Part D plan if there is one, to suite your needs better.

MEDICARE Plan Finder

 

There is a video on the right side of the page if you need to see how to use it.  But here you will be able to list your meds and see what all the companies offering these meds in a Medicare Drug Plan in your area offer - then you can pick the best one for your current needs.  Remember, you can change companies for Part D coverage yearly so it is always good to do a review during the annual open enrollment period.

 

You may want to talk over these meds with your doctor(s) since it is the philosophy of Medicare that Part D plans encourage the use of generics to keep down cost.

 

 

 

 

 


 

Valued Social Butterfly
Posts: 985
Registered: ‎01-02-2012

Re: Is AARP United Healthcare Medicare supplimental insurance as bad as the customer reviews say??

Message 29 of 89 (3,503 Views)

GailL1 wrote:

john258

I looked the thread up and read all the comments.  YOU changed the subject of the thread when you responded to byrondennis without giving any description.  IMO, you sought to confuse the original poster when they were speaking about the donut hole of Part D Medicare - which was the subject of the original post.

 

Personally, I will now only ignore your post.  


Thanks for the taking the time to do that, Gail. Who knows what's going on there?

Valued Social Butterfly
Posts: 5,681
Registered: ‎07-20-2010

Re: Is AARP United Healthcare Medicare supplimental insurance as bad as the customer reviews say??

Message 30 of 89 (3,588 Views)

GailL1 wrote:

john258

I looked the thread up and read all the comments.  YOU changed the subject of the thread when you responded to byrondennis without giving any description.  IMO, you sought to confuse the original poster when they were speaking about the donut hole of Part D Medicare - which was the subject of the original post.

 

Personally, I will now only ignore your post.  


You better re read the post. The only thing you are correct about is it was about the donut hole and I commented on his answer which was bad using my own plan which has none either. I could care less what you ignore, but the one thing neither you nor Dennis can ignore is that you give advice to people which is usually incomplete, or incorrect, and they can be hurt by it. There is no state that would allow this to happen face to face because they have seen the pain and suffering it causes. Dennis did not have to answer me but he did telling me where to go for a cheaper rate. If I had followed what he said and got a cheaper part D rate it would have cost me over $1,000 per year. That is what happens when people who  do not know the subject give advice. Someday I think you might find a person who you  guys hurt badly by bad advice gets a lawyer and sues you, and would include AARP for allowing it on their website. I can not understand for the life of me how people can be so cruel to others just to make themselves look good.