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 41 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.


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

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Message 42 of 105

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??

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Message 43 of 105

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

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

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Message 44 of 105

It might be difficult to understand as a new enrollee with "Medicare" regarding drug coverage. Plan F is by far the best as you never see any co-pays, decutibles and if aprovider charges more than what Medciare allows as approval Plan F pays for everything. Now regarding the drug part d, which is mandatory as an addition to any of the Supplemental Plans (under the Government rules :not just AARP or United Healthcare), ALL prescription drug coverage no matter what company you are with, by law, must substitue name brands for generic (unless your doctor writes a valid reason why the generic will no work for the patient) This rule also applies to any "complete plans that will replace name brands for generic (unless a doctor writes of letter of needed approval). 

I have never heard of a doctor bad mouthing any memeber of the healthcare profession (doctors or providers) so if the doctor in question did such a commnet and is reluctant to write a necessary letter, which I am sure he has needed to do numerous times (I would question the doctor and not the insurance provider).Note: As my memory serves me as when I did have private insurance before 65 (and not Medicare) name branded drugs were simple to get with a simple script But Medicare has strick government rules that must apply for cost savings accross the board. If you do not like United Healthcare and the Plan F and drug coverage you can shop around (but honeslty my fear is that all the providers will be the same)


GailL1 wrote:

r58721w wrote:

United Healthcare is the worst!

Since just starting Medicare, I was told that Plan F was the best.

However, the perscriptions was a separate plan,, no problem, got that throught them as well.....BIG MISTAKE.

I take only 2 meds,,,Protonix & Zetonna (an inhaler) thats it..

My PC had to stop his work and dedicate time to write why I needed the name brand as other products previously tried never worked and resulred in many hospital visits, The generic does not work, as well...

They finally accepted the doctors orders and decided to pay a portion of this drug, that I have taken for years.

Now we get to the Zetonna, another drug they still refuse to help cover.

My ENT doctor just phoned me, on a Sunday no less, to see if I was all set in getting ths covered,,,,

He was very upset when I told him once again it was denied.

He said this group is nothing but "smoke & mirrors" and he's right/

5 times this man has filled out paperwork and sent it in and still, whoever makes this decision in UHC  to decline this med, better have a doctorate degree,

I think its disgusting that some office worker decides what a patient is in need of.

So right now for this spray I pay 750.00.

I am sorry I ever got involved with UHC and I am very sorry that AARP is involved with them...


I believe that your problem may have less to do with any particular Medicare Part D insurer and more to do with the meds which have been prescribed for you.

 

Since you have decided to stay with Original Medicare (with a supplemental policy to pick up the cost slack), you do have to pick a free standing Medicare Prescription Drug Coverage plan (Part D).

However, you can pick from several different insurance companies that are offering this coverage in your area.

 

Your selection criteria should be based on medicines which you use which are offered on their formulary.  

 

I am not sure that you are gonna find Protonix on a Medicare Part D Insurance plan in brand form since there is an equivalent generic.  Medicare Drug plans would cover the generic of Protonix ( pantoprazole ) - FACT: FDA requires generic drugs to have the same quality and performance as brand name drugs. FDA: Understanding Generic Drugs

 

You will find generics used in the place of brands on many medications and if you really want the brand, then you will have to have your doc ask for the exception as you did and pay the extra cost.

 

GoodRx.com indicates the difference in price in generic vs brand and states that Medicare only covers the generic form.

 

However, you can always check other plans by going through the Medicare Plan Finder (link below) for the brand name to see if any Part D plans do offer these meds on their formulary in brand form.

 

When Open Enrollment opens in the fall of this year, go to this  Medicare site and do personalized search for a better / different Part D plan if there is one, to suite your needs better.

MEDICARE Plan Finder

 

There is a video on the right side of the page if you need to see how to use it.  But here you will be able to list your meds and see what all the companies offering these meds in a Medicare Drug Plan in your area offer - then you can pick the best one for your current needs.  Remember, you can change companies for Part D coverage yearly so it is always good to do a review during the annual open enrollment period.

 

You may want to talk over these meds with your doctor(s) since it is the philosophy of Medicare that Part D plans encourage the use of generics to keep down cost.

 

 

 

 

 


 

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

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Message 45 of 105

GailL1 wrote:

john258

I looked the thread up and read all the comments.  YOU changed the subject of the thread when you responded to byrondennis without giving any description.  IMO, you sought to confuse the original poster when they were speaking about the donut hole of Part D Medicare - which was the subject of the original post.

 

Personally, I will now only ignore your post.  


Thanks for the taking the time to do that, Gail. Who knows what's going on there?

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

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Message 46 of 105

GailL1 wrote:

john258

I looked the thread up and read all the comments.  YOU changed the subject of the thread when you responded to byrondennis without giving any description.  IMO, you sought to confuse the original poster when they were speaking about the donut hole of Part D Medicare - which was the subject of the original post.

 

Personally, I will now only ignore your post.  


You better re read the post. The only thing you are correct about is it was about the donut hole and I commented on his answer which was bad using my own plan which has none either. I could care less what you ignore, but the one thing neither you nor Dennis can ignore is that you give advice to people which is usually incomplete, or incorrect, and they can be hurt by it. There is no state that would allow this to happen face to face because they have seen the pain and suffering it causes. Dennis did not have to answer me but he did telling me where to go for a cheaper rate. If I had followed what he said and got a cheaper part D rate it would have cost me over $1,000 per year. That is what happens when people who  do not know the subject give advice. Someday I think you might find a person who you  guys hurt badly by bad advice gets a lawyer and sues you, and would include AARP for allowing it on their website. I can not understand for the life of me how people can be so cruel to others just to make themselves look good.

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

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Message 47 of 105

Since this thread is about customer reviews of “AARP United Healthcare Medicare supplemental insurance”.  Here’s my review:

 

I’ve had an AARP united healthcare supplement letter plan for 3 years. I have also used it in those years and I have no complaints.

 

Medicare approves an amount of a medical charge and pays their 80%, the charges are then automatically forwarded to United Healthcare and they pay the remaining 20%. I do nothing other than file the explanation of benefits forms that are mailed to my house (I need to sign up for the paperless EOB statements).

 

Among my benefits I have silver sneakers, 24 hour nurse on call. Currently I pay $159 a month, a bargain.

 

Why I originally chose United Health care? Besides a good value at a low cost, they are the largest provider of both Medicare supplement and Medicare advantage plans thus they have a lot of weight to throw around when it comes to protecting my privileges as a Medicare recipient. I believe as UH goes so goes the rest.

 

I did a lot of research and talked with a lot of average Joe’s and Jane’s about their Medicare health plans before I came to my conclusion about which supplement plan I wanted. I separated the wheat from the chaff and didn’t pay attention to those that had an axe to grind about an organization and couldn’t be honest about their benefits. 

 

So far I’m very pleased with my United Healthcare Medicare supplemental 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 48 of 105

john258

I looked the thread up and read all the comments.  YOU changed the subject of the thread when you responded to byrondennis without giving any description.  IMO, you sought to confuse the original poster when they were speaking about the donut hole of Part D Medicare - which was the subject of the original post.

 

Personally, I will now only ignore your post.  

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

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Message 49 of 105

byrondennis wrote:

GailL1 wrote:

john258 wrote to byrondennis:

Might be hard for you to accept but you gave advice which if I had followed would have cost me over $1,000 per year. It is  up in here so go read it.

------------------------------------------------------------------------------

You have mentioned this time and again - can you point me to this "advice" so I can determine what you mean.  Should be easy for you to find and link it or just note the subject of the thread, time and date.

 

 


Gail, this commenter in chrono comment 54 -- who keeps repeating the same nonsense -- apparently has a reading comprehension problem or perhaps English is not his or her native language... or perhaps a problem understanding the meanings of adjectives and adverbs in English or... or perhaps does not even understand the meaning of the word 'advice' in English. I dunno... quite bizarre. Also I do not pay any attention to the writer of any comment I am commenting on... I almost always comment on the first comment on a Topic, chrono comment 1 - the comment that started the Topic, even if I am the sixth or 16th commenter so I basically have no idea what the commenter is talking about unless it is a Topic started by this commenter.

 

Whatever, the only "advice" I ever give, and I do not even think of it as "advice" but common sense, is to go look at such and such a page in "Medicare and You" or to go to the nearest senior center or like facility. Usually that particular "advice" relates to an explanation of how Medicare works. But I don't comment on that very often. More often I reference a GAO or MedPAC or Trustee document relative to a statistic. I certainly never discussed any 30% discounts or $1000 "savings" with anyone as is claimed (but I might have used a percentage as in "about 30% of the people on Medicare are on Part D").

 

In fact based on the description in chrono comment 54, it sounds like the commenter is saying he or she does not have Part D. But there are a few Part D plans left that cover the donut hole so who knows:

  • Something about the donut hole
  • But he or she does not have a donut hole because he or she has something related to group retirement insurance that includes dental and nurses (but so do a lot of Part C plans?)
  • blah blah indemnity???
  • And he or she saves 30% (30% of what?)

Whatever, his or her whole series of  run-on stream of consciousness comments without English grammar and constantly completely reposting  every comment that came before should be deleted by the moderator.

 

The real irony that both you and I always tell people to go look it up and/or go to the senior center and or give a link, which appears to be what he is criticizing us for not doing. That's why I go back to the reading comprehension problem/ESL assumption


When facts prove someone wrong they can do one of two things. Accept the truth and change, or make up lies to try and justify what they did. You choose the later. What you do is hurt people badly by what you post telling them how to handle their problems in the Health Insurance field.  You have proven over and over again by your posts and advice you give to people that you have no understanding of the subject. I did not even ask you for advice but was commenting on your advice to another poster. You chose to give me unasked for advice which would have cost me over $1,000 per year. Here is some sound advice for you. Stop what you are doing. AARP should never allow such a problem to be on its web site.

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

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Message 50 of 105

GailL1 wrote:

john258 wrote to byrondennis:

Might be hard for you to accept but you gave advice which if I had followed would have cost me over $1,000 per year. It is  up in here so go read it.

------------------------------------------------------------------------------

You have mentioned this time and again - can you point me to this "advice" so I can determine what you mean.  Should be easy for you to find and link it or just note the subject of the thread, time and date.

 

 


Gail, this commenter in chrono comment 54 -- who keeps repeating the same nonsense -- apparently has a reading comprehension problem or perhaps English is not his or her native language... or perhaps a problem understanding the meanings of adjectives and adverbs in English or... or perhaps does not even understand the meaning of the word 'advice' in English. I dunno... quite bizarre. Also I do not pay any attention to the writer of any comment I am commenting on... I almost always comment on the first comment on a Topic, chrono comment 1 - the comment that started the Topic, even if I am the sixth or 16th commenter so I basically have no idea what the commenter is talking about unless it is a Topic started by this commenter.

 

Whatever, the only "advice" I ever give, and I do not even think of it as "advice" but common sense, is to go look at such and such a page in "Medicare and You" or to go to the nearest senior center or like facility. Usually that particular "advice" relates to an explanation of how Medicare works. But I don't comment on that very often. More often I reference a GAO or MedPAC or Trustee document relative to a statistic. I certainly never discussed any 30% discounts or $1000 "savings" with anyone as is claimed (but I might have used a percentage as in "about 30% of the people on Medicare are on Part D").

 

In fact based on the description in chrono comment 54, it sounds like the commenter is saying he or she does not have Part D. But there are a few Part D plans left that cover the donut hole so who knows:

  • Something about the donut hole
  • But he or she does not have a donut hole because he or she has something related to group retirement insurance that includes dental and nurses (but so do a lot of Part C plans?)
  • blah blah indemnity???
  • And he or she saves 30% (30% of what?)

Whatever, his or her whole series of  run-on stream of consciousness comments without English grammar and constantly completely reposting  every comment that came before should be deleted by the moderator.

 

The real irony that both you and I always tell people to go look it up and/or go to the senior center and or give a link, which appears to be what he is criticizing us for not doing. That's why I go back to the reading comprehension problem/ESL assumption

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