Medicare & Insurance

I'm coming up where I'll be adding Medicare part B soon.   One of my concerns is that I'm on Trelegy and it's a bundle without having a prescription plan.  I've been considering Blue Cross Blue Shield's advantage plan to get the prescription coverage.  I'd appreciate any advice people can give.   Thanks!    

To: United Healthcare, Optum, the South Carolina Department of Insurance, AARP, BBB, Current & Prospective Future Enrollees in AARP UHC Medicare Advantage Plans I am writing to make the entities above aware of the experience that my wife and I have had with United Healthcare (UHC) and Optum over the past 3 ½ years relative to their Medicare Advantage Plans. To say the least, it has been a VERY frustrating and disappointing experience.   When I retired in January 2021, my wife and I enrolled in one of the AARP United Healthcare Medicare Advantage Plans offered in South Carolina, where we live. I retired as an executive with over 40 years in the managed healthcare industry, so I am very familiar with Medicare Advantage plans and how they are supposed to work. (The company from which I retired is not currently licensed in the state of South Carolina). My prior Group Plan coverage terminated on January 31, 2021. As I have said over and over again to representatives

LOL - what’s the world coming to ?  But I guess crime has been around as long as civilization -     APNEWS 06/27/2024- Justice Department charges nearly 200 people in $2.7 billion health care fraud schemes crackdown   

FROM THE ARTICLE - SEE ARTICLE FOR MORE! By Kimberly Lankford, AARP. Published June 14, 2024. Medicare has never been a family plan, in contrast to employer-sponsored health insurance. Each spouse pays separate Medicare premiums, and married couples don’t get a discount. If both spouses are enrolled in Medicare Part B, they each pay $174.70 a month in 2024; more for couples with high incomes. https://www.aarp.org/health/medicare-qa-tool/does-marriage-affect-medicare.html

  Is AARP doing anything to address the doughnut hole in Medicare, and how to eliminate it completely? I just spent almost $500 for insulin to keep me alive.  I am on Social Security and Medicare and I do not   know in I will be able to afford this life saving medicine when I need to refill it.

I had a wonderful dentist who partnered w his patients; his staff could tell you to a nickel what the share was for each visit. He tried to hold costs down. Unfortunately he passed away, and I’ve not been unsuccessful at duplicating the experience. One dentist provided me w a treatment plan, but I could not pin her down on what the actual cost would be. Lasers for pockets, a back tooth implant w a graft, etc. I didn’t want any of it. Thousands! My current dentist’s staff puts a clipboard in front of you while you’re in the chair and makes you sign responsibility for the ‘estimate.’ Fine, OK, but he just did an onlay that cost $1200 above the estimate, now I’m on the hook for $1700. My dental insurance paid $85 would have covered 50% of a crown had he done one. No one in my retirement planning told me to have $40,000 in an account held in reserve for dental care. I’m at a loss in more way than one. It’s costing $3000 a year for dental care and I have insurance. How can seniors advocate

After 45 years of using the same insurance company, we decided to look into Hartford. What a mistake! I set up auto pay for Auto insurance when I took out policy. I verified all info in system was correct, yet they failed to take payment and cancelled policy without notifying me. I found out when I checked bank statement and saw it was not withdrawn. No problem, I thought. I called and called and could get noone to help me. AARP members are lowest on priority. Finally, after hours of being shuffled around, I talked to a live person that informed me there was nothing they could do. It was cancelled due to non-payment and it could not be reinstated. She advised that I call and get coverage right away with another company. I also have my homeowners with them, so now they leave me stuck to get coverage and also change my homeowners since it is too expensive without bundling. I wish I had never changed. They are the worst company I have ever dealt with and it is not worth switching. How can

On 04.26.2024, HHS issued a whole lot of new rules on health care coverage -HHS.gov-HHS Issues New Rule to Strengthen Nondiscrimination Protections and Advance Civil Rights in Health CareThis is just one small part of it -For the first time, the Department will consider Medicare Part B payments as a form of Federal financial assistance for purposes of triggering civil rights laws enforced by the Department, ensuring that health care providers and suppliers receiving Part B funds are prohibited from discriminating on the basis of race, color, national origin, age, sex and disability.By just reading this very short statement, I am sure everybody would say, That’s great - but then when you get down to reading all the fine print which one only finds in reading the whole rule in the Federal Registry do you understand that there is gonna be a lot of cost to this for Medicare Beneficiaries to absorb in their Part B premiums and by proxy, into their Medigap premiums if one has chosen this way

 If you have Original Medicare, your doctor should let you know if you are - An Accountable Care Organization (ACO) is a group of doctors, hospitals, and/or other health care providers who work together to improve the quality and experience of care you get. Medicare.gov- Accountable Care OrganizationYou could be in one of these through Original Medicare if your doctor belongs to one.You could be in one of these if your Medicare Advantage plan with your doctor has placed you within one.CMS.gov - Accountable Care and Accountable Care Organizations YouTube Video from CMS.gov on ACO (Accountable Care Orgaizartions)  

Looking for a way to estimate the total annual dollar exposure I will have arising from Medicare's 20% Part B Coinsurance.

Does anyone know if Eyemed is really available if you have the UHC plan G supplement? It’s listed as a benefit for AARP UHC supplement G, with $50 eye exams. My eye doctor is listed as a provider but they do not seem to recognize me as in the program. Neither does LensCrafters or another eye doctor near me (I’m in NH, near the MA border) who is listed as being an Eyemed provider. They’ve asked me for a group number which I don’t have. The UHC AARP Medicare Supplement website says I’ve got coverage but that’s it. Call the number listed and my doctors are in the plan. Call various doctors and they say they don’t see me as having insurance/where is your group number. I’ve called the UHC customer service line and no one calls me back (wait times 30 minutes plus.)

   Investopedia:  PERSONALFINANCE - INSURANCE. Statutory Reserves: Definition and Examples I know as seniors who i have been around for a very long time, we feel we should know it all - but since I retired, many moons ago, I have found that there is still much more to learn.  And it help to know about the things that really affect us.  

  AARP.org 10/11/2023 - 10 Things You Need To Know About Choosing A Medigap Plan Some of the 10 from the link ~  7. Some States Set Their Own Enrollment Rules Connecticut and New York let Medicare beneficiaries buy a Medigap plan at any time without being denied. Other states (including California, Idaho, Illinois, Louisiana, Maryland, Missouri, Nevada, Oregon and Washington) let you switch plans at designated times. Premiums will be higher for states that are more liberal with their Enrollment rules - You pay for the added risk. 8. Different plans have very different prices For example, a 65-year-old nonsmoking man in Fort Myers, Florida, could pay $64 a month for a Plan K policy or $263 for Plan D. A 65-year-old nonsmoking woman in Wichita, Kansas, might pay $32 a month for a high-deductible Plan G policy versus $455 for a regular Plan G. And by picking up more of the risk - you get a lower premium as the high-deductible plans show. &

   Investopedia 12/04/2023- Medicare Supplement Insurance Costs  A really interesting and informative article - this chart is just a small part of it.Medicare Supplement Cost Comparison Chart The following price ranges are for a 65-year-old male nonsmoker living in Florida ZIP code 33012.  Medigap Plan Type  Medigap Cost Range (monthly) Medicare Supplement Plan A$166 - $345Medicare Supplement Plan B $218 - $327 Medicare Supplement Plan C$294 - $364 Medicare Supplement Plan D $290 - $339 Medicare Supplement Plan F$254 - $461 Medicare Supplement High-Deductible Plan F $64 - $156 Medicare Supplement Plan G $237 - $409Medicare Supplement High-Deductible Plan G $64 - $144 Medicare Supplement Plan K $82 - $162Medicare Supplement Plan L $182 - $212 Medicare Supplement Plan M $268 - $268 Medicare Supplement Plan N $191 - $312  High-Deductible Plan F and High-De

If we raised the enrollment age of Medicare to correspond to the Full Retirement Age of Medicare - (almost 67) - then it would be so much easier for people to understand the process and timely complete their enrollment. It was like this before - I think it should go back to that way again. There would be far fewer late enrollment penalties assessed for Part B particularly. There are other + reasons too like saving cost to the (Part A) program while adding contributions. Your opinion?   

    Get ready for your Part D premiums to escalate -   KFF.org - 04/24/2024 - A New Use Opens the Door for Medicare Coverage for MILLIONS from the link ~ lots more at the link tooThe FDA recently approved a new use for Wegovy (semaglutide), the blockbuster anti-obesity drug, to reduce the risk of heart attacks and stroke in people with cardiovascular disease who are overweight or obese. Wegovy belongs to a class of medications called GLP-1 (glucagon-like peptide-1) agonists that were initially approved to treat type 2 diabetes but are also highly effective anti-obesity drugs. The new FDA-approved indication for Wegovy paves the way for Medicare coverage of this drug and broader coverage by other insurers. Medicare is currently prohibited by law from covering Wegovy and other medications when used specifically for obesity. However, semaglutide is covered by Medicare as a treatment for diabetes, branded as Ozempic.

I'm trying to sort out how to receive unscheduled medical care while travelling. My current primary care provider in the Northern Virginia area will not provide telehealth services unless you are physically in the state at the time of the call.  So if you're on Medicare and just need a consultation and maybe a prescription to treat a minor illness, are there any other options other than visiting a local urgent care facility?

   I cannot find mobile home insurance asap & don't recommend Hartford please.  

I am still attempting to get my wife added as a dependent on my Delta Dental policy.  This started in November of last year - it is now May 1. In November of 2023, I contacted the Delta Dental customer advocate about adding my wife as a dependent.  They required an affidavit from the former company that we were cancelling the former policy and a cover letter with all pertinent information - and also required that the documents be SNAIL-MAILED to a processing address.  I did all of this. All that they did was change the name on the policy to hers.  With my birthdate.  This caused the premium notices to carry her name, so I thought that the request had been completed. This January, when I discovered the mistake, I began a conversation with another Delta Customer Advocate named Ladoris Walker.  She was very nice and it sounded like the situation was well in hand.  It turns out, though, that all she could do was issue requests to Delta.&nbs

Sort of new to medigap/supplemental plan and was surprised to receive letter June 2023 that my 2023 plan G is hiking up my premium by $10.85 starting in Aug 2023 and then another hike of $7.19 for 2024 till July 2024.  Is this normal?  Does UHC do rate hikes mid-year?  That is like 6% for rest of 2023 and a bit over 4% for 2024.  

Why is the AARP welcoming the privatization of Medicare? I thought more members and people in general should know the AARP earns as much as $814 million annually from insurers advertising the plans. The safety net so many rely on for dignity and basic care is being gutted and AARP is happily joining right in as far as I can tell. With this kind of 'advocacy' there won't be any Medicaid left by the time I retire, let alone the gaps I am soon going to have to help my parents navigate. Shame on you, AARP.

I have surveyed the AARP archives and find no articles on the political risk to Social Security and Medicare posed by the current Republican Party’s platform. As a former Republican I attended a meeting where the guest speaker former Utah  US Representative Jason Chaffitz. I was shocked as he described the current Republican plan to eliminate Social Security and Medicare. ASRP is a defacto retired person’s information source. I’m amazed that this issue is not more thoroughly covered since it affects a majority of it’s members.  

I had a medication that was ordered and paid for on 4/2.  They said it would be here on 4/8.  Then the arrival date changed to 4/19.  There's a picture of the med inside the order processing page which showed a different generic. So today I checked the Optum page again and it showed the order on hold saying I needed to call them.  Ugh.I forsaw a 2 hour phone call where I could not understand a word being said. Called just now and a woman from the US answered - i was shocked.  I asked whether I had actually reached Optum, lol. She explained my medication was not available from any of the 12 generic manufacturers and this was considered a 'long term' hold but said the original med could be ordered instead.  I suppose this is related to the covid situation - no fault of Optum. I was transferred to another rep who went through the whole thing with me and the cost was more but I need the med and understood the cost would be more so she went ahead

 Some info for those who are experiencing a higher rate of increase on their MediGAP plan premiums in 2024 - You are not alone - no matter the insurer.  TELOS Actuarial Blog - Medicare Supplement Rate Action - 2024 Q1 Update   As you can see from the charts on Medigap Plan G and Plan N from all of these insurers - rates are going up in 2024 no matter the insurer.   Although UHC does seem to be the highest in 2024 but either similar or less in previous years.  

For two years running, I've had trouble with the coverage for my eye exam.  My ophthalmologist (in network) does a comprehensive exam, as I have MD, including refraction (vision test for glasses).  My Humana advantage plan. Mandatory Supplemental Vision Benefit VIS752, says (P88) says I get covered forRoutine Eye Exam (includes refraction) (1 per calendar year)OR• Refraction exam (1 per calendar year) when completed at the same appointment as a Medicare covered comprehensive eye examThe ophthalmologist bill lists 3 services: 92014, 92015,92134. The other exams get covered but the refraction (92015) is rejected by Humana with the following message:Message:THIS ROUTINE VISION PROCEDURE IS NOT ALLOWED SEPARATELY. YOU ARE NOT RESPONSIBLE FOR THIS AMOUNT.I got billed for the refraction but, when I call the eye dr, they say it was rejected by Humana and I should call Humana.  Humana subcontracts to EyeMed and told me to call them.  EyeMed says they never processed the cla