When should you get your annual flu shot? AARP has advice for you.

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

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Message 31 of 105

After reading some of the complaints of AARP supplemental plans not paying for things like Whooping Cough vaccinations, I am amazed at how many new enrollees (or maybe even ones who have had the ins for a while) don't understand how Supplemental Insurances work. It is Medicare that decides what is approved, how much to charge and then the Supplemental coverage like Plan F pays the difference since Medicare will pay 80% and the rest is the responsibilty of the indivdual (therefore the ins covering the 20%). Plus this is the key which is apparant is not understood.  MEDICARE DOESN'T APPROVE EVERYTHING LIKE THE WHOOPING COUGH OR SHINGLES VACCINE. It would be very smart before one gets such vaccines to ask if Medicare covers the shots, procedures etc.

Also one needs to know that when Obamacare was put into place, monies were taken out of Medicare to help pay for the tax credits etc under Obamacare, therefore reducing some of the benefits of us older people with our healthcare.So don't blame AARP or United Healthcare plans such as Plan F as they are controlled by Medicare guidelines that got more expensive when Obamacare went into effect. (This is not being political but only truthful) For me having Plan F for a few years has been a Blessing as you will understand once you have a Hospital surgery for over $100,000 and never see a bill. That's when it pays to get the great insurance AARP provides)

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

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Message 32 of 105

rker321 wrote:

GailL1 wrote:

rker321 wrote:

 


MORE info - from General information on various insurance agents websites about Medigap application process in various states where they write Medigap policies -

 

Boomer Benefits - Can I Pass Medigap Underwriting To Change My Supplemental Plan?

 

An old (2011) instructions PDF to their company agents writing Medigap policies 

NOTE:  all private companies that write Medigap policies can use their own underwriting criteria if that be the case.  Only in those cases stipulated by Medicare (CMS) when NO underwriting or denial is permissible do they HAVE to write or deny a supplemental policy with no strings attached - meaning that a person is within the Medigap Open Enrollment period or have Medigap protection or Guaranteed Issue Rights.

 

2011 CSI - Agent Underwriting Guidelines for Medicare Supplemental Policies

 

Just a few examples of when and how your info can be asked and used.

 

 

Gail, thank yo so much for those two links. I read and re read than to make sure that I understood what they said. and this is what i came out with.

First of all, Macular Degeneration is not mentioned anywhere in the list of  disease that may disqualify you. at all. 
I happen to use Avastin. and saw that Avastin has other uses besides Macualar degeneration.
The only thing that I could have that could disqualifies me is that I receive those injections at the Dr's office. 
Right now, My doctor is considering extending the time that I receive those injections because there has not  been any progression for almost two years. On top of all of this I receive help with the cost of these injections which for Avastin is not very much. from a Foundation that helps me.
The other link is what I am referring to. I will go to them and see what they can do. because, I do believe that the way in which they generalize the fact that you receive  injections is a disqualified is something that they need to really become more specific.
so that is my next step. and then Medicare will be my last resort.  

 

 


 


Like I said in my post - these are just some examples - one is old (2011)

These are PRIVATE insurers offering this SUPPLEMENTAL coverage to Medicare.  EACH one can made their own risk rules about any condition.

 

AMD is an expensive disease to treat and there is no actual cure.  I believe since the treatment is done in the doc's office under original Medicare, it is covered by Part B if a person has ORIGINAL Medicare so maybe the supplemental insurers see a heightened $$$$ risk for them - I don't know, just a guess.  

 

Please se understand that these are just examples - insurers in this SUPPLEMENTAL market evaluate their OWN risk individually - they are not all the same.  I gave you this example only for you to see how the rules are developed by each company individually.

 

I don't even think this insurer writes Medigap policies in Florida.

 

Again I tell you - Nobody can deny you Medicare benefits.

original Medicare = Medicare Advantage - they are one in the same just different ways of covering the SAME benefits.

 

Supplemental coverage or Medigap is not health insurance, it is supplemental coverage and thus does not have to be offered to anybody outside of the times when it cannot be denied for pre-existing coverage or premium level.

- during the Medigap open enrollment period and

- during specified times when "guaranteed issue" as listed by original Medicare is in play.

I don't believe any of these apply to you and your situation.

 

You do not get a supplemental policy before picking up original Medicare.

You can only buy supplemental coverage from the insurers that offer it in your state.  They have the right to deny you or approve you with underwriting and most likely charge you more or even underwrite you, charge you more and hold off coverage on a pre-existing condition for a specific amount of time.

 

why don't you get some clarification from SHINE (FL SHIP) or even from the FL Dept. of Insurance.

 

Florida Dept of Consumer Affairs - Medicare Supplement Insurance Overview

 

Florida Office of Insurance Regulation - Medigap

notice the "important information"

 

Florida Office of Insurance Regulation - SAMPLE Medicare Supplement Rates by County

 

This last one gives the insurers that write Medigap policies in Florida by county.  Remember even if one of them decides to underwrite you, your premiums might be much higher and they may also disqualify your pre-existing condition(s) for a specified amount of time.

 

You are not promised access to a supplemental policy - it is something extra available to those who meet the timing and other criteria.  

 

A question - would you still want a supplemental policy if the insurer wanted to charge you $500 or more per month for it and perhaps not cover your pre-existing condition for 6-months?  

 

Do you want original Medicare in place of a Medicare Advantage plan?

That might be original Medicare WITHOUT a supplemental policy or perhaps one if you are underwritten by a Medigap insurer that might cost you a very heafty premium each month.

 

Added:  How Macular Degeneration is covered under ORIGINAL Medicare

Medicare.gov - Macular Degeneration Original Medicare coverage

 

I think  if it were me, I would think about this very hard.

 

 

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

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Message 33 of 105

GailL1 wrote:

rker321 wrote:

 


MORE info - from General information on various insurance agents websites about Medigap application process in various states where they write Medigap policies -

 

Boomer Benefits - Can I Pass Medigap Underwriting To Change My Supplemental Plan?

 

An old (2011) instructions PDF to their company agents writing Medigap policies 

NOTE:  all private companies that write Medigap policies can use their own underwriting criteria if that be the case.  Only in those cases stipulated by Medicare (CMS) when NO underwriting or denial is permissible do they HAVE to write or deny a supplemental policy with no strings attached - meaning that a person is within the Medigap Open Enrollment period or have Medigap protection or Guaranteed Issue Rights.

 

2011 CSI - Agent Underwriting Guidelines for Medicare Supplemental Policies

 

Just a few examples of when and how your info can be asked and used.

 

 

Gail, thank yo so much for those two links. I read and re read than to make sure that I understood what they said. and this is what i came out with.

First of all, Macular Degeneration is not mentioned anywhere in the list of  disease that may disqualify you. at all. 
I happen to use Avastin. and saw that Avastin has other uses besides Macualar degeneration.
The only thing that I could have that could disqualifies me is that I receive those injections at the Dr's office. 
Right now, My doctor is considering extending the time that I receive those injections because there has not  been any progression for almost two years. On top of all of this I receive help with the cost of these injections which for Avastin is not very much. from a Foundation that helps me.
The other link is what I am referring to. I will go to them and see what they can do. because, I do believe that the way in which they generalize the fact that you receive  injections is a disqualified is something that they need to really become more specific.
so that is my next step. and then Medicare will be my last resort.  

 

 


 

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

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Message 34 of 105

danf224027 wrote:

 

. . . . - - -Their advertising and sales promotion claims: UNITED will pay for bills and claims which basic MEDICARE does not.  Yet, when I recently had a new vaccination for whooping cough, as recommended by my doctor and pharmacy---I was forced to pay $60---on top of my expensive   monthly premiums.  When I telephoned through the process provided on the website---some indifferent clerk with no knowledge simply said:  You have to call MEDICARE.  When I called MEDICARE---another indifferent clerk with no knowledge said:  We don't cover it!  (This was over a half hour sitting on the phone.)

---Why did I have to pay $60 to RITE AID for this immunization, when every month I am paying hundreds to MEDICARE, hundreds to UNITED HEALTHCARE SUPPLEMENTAL, and several hundred a year for my WALGREEN drug plan?

 

 . . . . I would be surprised if anyone at AARP actually responds to my complaint here---their process is a joke!

 


I am not from AARP but wanted to respond to you about your Tdap vaccination-  ( tetanus, diphtheria and pertussis).

 

Your Medicare prescription drug plan covers most immunizations/vaccinations.

Medicare.gov - Tdap shot (tetanus, diphtheria, pertussis shot)

 

You called it  (your drug plan) your "Walgreen Drug Plan" - You went to Rite Aid for the vaccination so we're they able to file the claim with your prescription drug plan - is Rite Aid listed as a covered pharmacy on your drug plan?  Perhaps you can call your drug plan and see if there is anyway you can recoup some of your money by filing a claim with them with a copy of the paperwork.

 

You have original Medicare with a supplemental plan.  You should get a booklet every year entitled "Medicare and You" - this booklet is pretty thorough as to how the different parts of Medicare work in the original program and how your supplemental coverage works.    Original Medicare is your main insurance; your Medigap coverage or supplemental is just that "supplemental" to original Medicare.  Original Medicare makes all the coverage rules and determines which part covers what services.

 

You can can always reference Medicare.gov to see if a particular service is covered and how it is covered. Medicare.gov - Is my test, item or service covered?

 

Insurance (public or private) is only as good as our proper use of it.  Complicated at times, I know . . . . It is what it is -  since original Medicare is your main coverage - call them if you need clarification on something about coverage.

 

 

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

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Message 35 of 105

I am disappointed with the UNITED HEALTHCARE SUPPLEMENTAL "Cadillac" policy I have---which does not adhere to the supposed standards of AARP.  

---AARP's consumer advice always advocates for you to: "get a proper ID of whom you are speaking with on the phone, a first/last name, before giving out any personal information."

---When you telephone UNITED HEALTHCARE SUPPLEMENTAL to review your account---the person refuses to properly ID themselves, most likely because they do not want to be held accountable or responsible for the information they provide!  Additionally, as their way to cover up and defuse any accountability, you never get to speak with the same person twice.

---Consider that I am paying hundreds of dollars per month for UNITED HEALTHCARE SUPPLEMENTAL---this is not something I'm buying for $9.99!

---In contrast, I had an EXCELLENT experience with THE HARTFORD on my auto/homeowner's insurance in the past two years.  I consider their customer service to be spot on, efficient, courteous, reliable---and all of their representatives do give a proper ID, first/last name for accountability purposes.  (I recommend AARP's programs with THE HARTFORD, because besides very good customer service, they are very cost competitive.)

---With the AARP list of "Member Rights & Responsibilities" UNITED HEALTHCARE SUPPLEMENTAL fails miserably!  

---Their advertising and sales promotion claims: UNITED will pay for bills and claims which basic MEDICARE does not.  Yet, when I recently had a new vaccination for whooping cough, as recommended by my doctor and pharmacy---I was forced to pay $60---on top of my expensive   monthly premiums.  When I telephoned through the process provided on the website---some indifferent clerk with no knowledge simply said:  You have to call MEDICARE.  When I called MEDICARE---another indifferent clerk with no knowledge said:  We don't cover it!  (This was over a half hour sitting on the phone.)

---Why did I have to pay $60 to RITE AID for this immunization, when every month I am paying hundreds to MEDICARE, hundreds to UNITED HEALTHCARE SUPPLEMENTAL, and several hundred a year for my WALGREEN drug plan?

---This whole experience is a NEGATIVE TURN OFF, a source of aggravation.  These companies hope that they can intimidate you and discourage you so you just disappear and do not bother them---and they can pretend that everything is wonderful after taking your money!

 

MEANWHILE, there is no ability to send direct e-Mails to any leadership executives at AARP like Lawrence Flanagan, President of AARP Services, to let them know what is going on here!  These executives pretend they are so sensitive to your customer service needs---yet other than sending direct mail, paying $7+ for certified mail to make sure it gets there, it is impossible to communicate with these people who run these programs, there is no way to confront them. 

 

I would be surprised if anyone at AARP actually responds to my complaint here---their process is a joke!

 

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

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Message 36 of 105

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.? 


MORE info - from General information on various insurance agents websites about Medigap application process in various states where they write Medigap policies -

 

Boomer Benefits - Can I Pass Medigap Underwriting To Change My Supplemental Plan?

 

An old (2011) instructions PDF to their company agents writing Medigap policies 

NOTE:  all private companies that write Medigap policies can use their own underwriting criteria if that be the case.  Only in those cases stipulated by Medicare (CMS) when NO underwriting or denial is permissible do they HAVE to write or deny a supplemental policy with no strings attached - meaning that a person is within the Medigap Open Enrollment period or have Medigap protection or Guaranteed Issue Rights.

 

2011 CSI - Agent Underwriting Guidelines for Medicare Supplemental Policies

 

Just a few examples of when and how your info can be asked and used.

 

 

 

 

 

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

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Message 37 of 105

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

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

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Message 38 of 105

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.

 

 

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

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Message 39 of 105

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.? 

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

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Message 40 of 105

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.

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