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Valued Social Butterfly

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

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Message 31 of 102

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??

1,486 Views
Message 32 of 102

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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Valued Social Butterfly

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

1,553 Views
Message 33 of 102

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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Valued Social Butterfly

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

1,773 Views
Message 34 of 102

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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Valued Social Butterfly

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

1,762 Views
Message 35 of 102

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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Valued Social Butterfly

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

1,762 Views
Message 36 of 102

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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Valued Social Butterfly

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

1,779 Views
Message 37 of 102

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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Valued Social Butterfly

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

1,774 Views
Message 38 of 102

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.

 

 

 

 

 

 

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Valued Social Butterfly

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

1,770 Views
Message 39 of 102

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.

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

1,916 Views
Message 40 of 102

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

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