UHC SUPLEMENT PLAN G complaints

[MarkS251233]

My wife turned 65 April 30 and wanted the supplement plan g she previously had an advantage plan,

signed up for plan g, was approved coverage starting August 1st 2024, requested disenrollment in advantage plan, was not disenrolled requested disenrollment July with application, disenrolled August, disenrolled Sept, disenrolled Oct and disenrolled Nov was not disenrolled even after hours on the phone saying I was disenrolled. The favorite tactic is to say advantage plan cannot see the supplement plan and vice verse to call them. Contacting CMS was told they do not have jurisdiction over Medicare. I Paid the $153 extra per month August thru December 2024, for the plan g. I was told I had to wait for the annual enrollment period, they could not understand there is a window when you turn 65 to join and I was well within it. Finally Jan 1st 2025 advantage plan was terminated.   As a result and countless hrs on the phone I am left with $1600 or more in copays plan g would not pay. They also would not refund the  premiums I had paid for even though they would not insure me because I also had a advantage plan that I asked to be disenrolled from but was denied. Anybody else have this problem? 

[GailL1]

@MarkS251233 

A few questions that might simplify the problem / and the solution:

• Is the MA plan and the Medigap Plan G  with the same insurance company? 
• How many claims are involved?  08/01/2025 - to whenever the right plan took over.
• Are they all Medicare Part B claims?

It is a mess . . . . . in essence, Medicare and the involved insurance companies - the MA company and the Medigap company- are gonna have to go back and redo all her claims since 08/01/2024 - to whenever it began correctly.

Medicare will actually have to help you solve this mess - but I don’t know how they will handle it - because traditional Medicare and Medicare Advantage plan are different in how the providers are paid.  It has to be done this way because Traditional Medicare (with the Medigap plan) and the MA plan pay different rates to the providers. What should happen IF THEY CAN DO IT is:

• Medicare will give back the money which the MA plan has paid to the providers 
• You get reimbursed for the copays you paid - depends on how Medicare reimburses the MA sponsor as to who gives you back this amt.
• Medicare will then pay these claims out of traditional Medicare and then send the claims onto the Medigap plan to pay any of the remaining but you might have to cover the Part B deductible - I think that is $ 240 in 2024 - Medigap Plan G does not cover the deductible amount.  Now $ 257 in 2025.

Now if they cannot do this - you should detail all of this in writing with how the claims were paid and your premium payment records for the Medigap Plan G and keep following them for some sort of reimbursement of the premiums.

IT IS AGAINST THE LAW FOR A BENEFICIARY TO HAVE BOTH A MA PLAN AND A MEDIGAP PLAN. 

What is the date shown for the issue date of the Medigap plan G?  Check her Medicare Account to make sure it is correct and see what date they are showing on her Medicare account.