Financial Exploitation of a 99 1/2 year old woman on Hospice care, by AARP United Health Care plans

[toodles04]

I have a long and painful story about my mother, now deceased as of 4/22/2023, who was financially exploited (qualifying as elder abuse) by AARP's United Health Care plans - both supplemental insurance and prescription insurance.  To whom in the system should I address my complaint?  

Thank you, 

Dr. Shelley P. Caswell-Moore

[GailL1]

You have to give details - because I think this is a dangerous claim without giving details.  

Medicare (Part A) covers ALL of Hospice care - with a small copay for meds - like $ 5.00.  In fact, not even a Medigap plan has to pay any for Hospice care since it is covered at 100% rate by Medicare.

Now it is important to understand exactly what Hospice is - it is a defined coverage item.  Things outside of it, if medically necessary that is covered by Traditional Medicare + Medigap are still covered as long as they don’t relate or conflict to the Hospice coverage.

Maybe it would help to read up on Medicare Hospice - a few links

Medicare.gov - Hospice Care Coverage

Medicare.gov - Medicare Hospice Benefit

Medicare.gov - How Hospice Works 

To answer your specific question 

If the links don’t give you a solution - address your concerns to UHC cause AARP is not involved in the actual insurance - they only sell their branded name for financial support of their programs.  

[toodles04]

The issue has nothing to do with Medicare or Hospice. The problem is that my mother tried numerous times via snail mail, fax, and phone, to cancel both her UHC plans due to the coverage she had with Hospice and knowing she wasn't going to need/use anything else. We have a paper trail of her attempts, and for months, she continued to get billing statements. Every month she wrote back saying she had canceled, providing her documentation. Each month, UHC wrote her back acknowledging that she was trying to cancel and each month giving her a different explanation of what she had "done wrong." She tried her best - she was hard-of-hearing, old, frail, and dying. But she was cognitively intact and knew exactly what she was doing. Where is the advocacy for our venerable older adult population in this scenario?  Where is the compassion?  What kind of customer service is this? 

As recently as yesterday, my sister (Executor) spent 6 hours on the phone with UHC being given the "run-around" just like our mom had been given.  At one point, while my sister was on hold, UHC turned this $309 bill over to a collection agency!!  Where is the respect and understanding for a nonagenerian (almost 100 years old) who had, in all good faith tried to cx her coverage to save money as many people on fixed incomes would do? 

This is surely UHC's business, but we have already tried talking to them.  AARP endorses UHC plans - it is right on all the literature and insurance cards. 

As a gerontology professor, I can assure you that this kind of treatment for a 99 1/2 year old American, is reprehensible at best.  The family feels that our mother was taken advantage of due to her age and frail condition and that she was mistreated by a large organization that is supposed to be a friend and advocate for older adults. 

[GailL1]

I believe your problem has more to do with the Medicare rules of enrollment / disenrollment on the part D coverage (PDP)

• there are SPECIFIC time periods when one can switch or cancel prescription drug plans.  I'm thinking that's what UHC was trying to tell her.

Medicare.gov - How to drop your Medicare drug plan

also notice the specific heading of this in the link

Can I drop my Medicare drug plan outside the Open Enrollment Period?

You can't drop your Medicare drug plan outside the Open Enrollment Period unless you meet certain special circumstances.

Were there any claims put through from Medicare to the Medigap plan after she notified them of cancellation?  Her Medicare account should have shown that the Medigap coverage was terminated and any amount that may have been due from them for something other than Hospice would have been billed to her.

Like I said, Hospice is pretty complete coverage (and I hate to sound cruel adding this next thing) as long as one knows they will be dying shortly (very shortly).  

The thing is if she had fallen and broken something as an example - Hospice would not cover that condition - not the treatment and not any meds she might get for pain from it. 

One of the ways to have a Medigap plan or a PDP cancelled is to stop making premium payments - but that does take time for it get from the beneficiary thru the insurer to her actual Medicare account.

I understand your frustration but remember this is insurance and insurance doesn't work unless people pay into it - that's the reason why Medicare has penalty rules if people don't get coverage when they are supposed to -