Question of the Day, Wednesday, October 9, 2024

neely

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Good morning and Happy Whiskers Wednesday! :lovecat: I had to call my health insurance company yesterday. Maybe it was the wrong time of day to call but I was on the phone for almost an hour. The first 3 calls were automated but I really needed to speak to a live person. The next 3 were different representatives who transferred me before I got the help I needed. I’m happy with my insurance policy but dread having to call with a question.

DO YOU HAVE ANY PROBLEMS WITH YOUR INSURANCE PROVIDER? ARE THEY HELPFUL ANSWERING YOUR QUESTIONS?
 

misty8723

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I got my health insurance (Medicare and supplement) from a broker service called Boomer Benefits. Any issues I have had with the insurance, I've called them and they help me sort it out. The one time I did call an insurance company, it was pretty much the same issues you had, and the people I did talk with were obviously overseas and very difficult to understand.
 

cheshirecat

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Fortunately I have not had to call my insurance company about anything. They sometimes call me to promote a service but I usually refuse to give them any info. And remind then that I am not supposed to give personal information unless I make the call.

I am very lucky to have a plan paid for by a former employer. I dread the day when they stop paying.
 

MoochNNoodles

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We’ve been in a transition with who is administrating our Insurance and benefits so that’s been interesting. Our insurance is through DHs union; not his employer directly. Whoever was handling it before basically stopped answering the phone or doing anything. So they found a new company and now things are finally caught up getting paid.

I used to be able to call and get a person easily but billing a new provider always went wrong the first time. I’m hoping now that won’t be an issue anymore. My only other issue is that because the union is technically in another state; there used to be no actual in-network providers. (I’m hoping that has changed.) BUT they never failed to pay who we do have here; it just changes payouts a bit. Sometimes we have to pay up front and get reimbursed. The only place that won’t take my insurance is the walk-in connected to the hospital. I think there are a couple other I could try but I’ve been able to get in with my primarys office instead.
 

NY cat man

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I have Medicare parts A and B, with a third-party part D. I haven't yet needed the part D, and as for the others, it's a waste of money. A few months ago, I needed new glasses. Medicare paid $110, while I had to pay the other $800. Meanwhile, my part D monthly premium dropped by a whole 10¢, but my deductible went up $45.
 

fionasmom

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Not with health insurance, but I did with with another company which specializes in life insurance which has gone to an entirely computerized, for lack of a better word, format. You cannot speak to anyone. You can email and they will reply, or you can choose options from a menu on the phone and they will comply with those, or you can send a letter.
 

denice

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I haven't had issues with my private insurance which I will be losing sometime early next year when I retire. I have only called Medicare once. I started Part A when I turned 65 and I wanted to get Part B started before I retire without paying the late enrollment fee. Maybe I got lucky but I wasn't on hold very long and got someone who was very helpful. She told me which form I needed, where to get it and the part that my employer had to fill out. I faxed the completed form to my local Social Security office and everything when smooth as silk. I won't get any of the Medicare Advantage plans, I work in medical billing and seen the copays that people often get stuck with, I will stick with the 20% of the Medicare allowable for everything that Medicare covers. I am paying for both Medicare and my work plan until the end of the year but I wanted to make sure I don't have a break in coverage.
 

catloverfromwayback

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I don't have health insurance. Too expensive and I'm on a government pension (unemployment at present). That gives me access to cheaper medications on the PBS, and I found a GP who bulk bills, a very rare thing these days! Nor do I have insurance for P&D, because even if I could afford it (I can't) no company would insure them, because of their preexisting, permanent health conditions. The only insurance I have is life insurance, car and house contents.
 
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neely

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I won't get any of the Medicare Advantage plans,
Are the Medicare Advantage plans considered a supplemental plan?
 

MonaLyssa33

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I have pretty good insurance for only paying $25 a month. I thankfully haven't had a lot of issues with them as I go through the IVF process. My insurance covers 80% of the procedures up to $30,000, so it's something considering fertility treatments are rarely covered, but it could definitely be better. For the first time ever, I met my yearly $3,000 out of pocket limit, so that's cool. I'll probably be meeting it next year too if I'm pregnant in the next few months.
 

vansX2

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I have Medicare part A & B. Tricare covers my part C. I had a issue last fall when getting a Shingles Shot. The Pharmacy called Tricare in my behalf and the problem was straighten out in a matter of minutes. No issues other than that.
 

lizzie

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We have our supplemental through Aetna,and we are very happy with them.He retired ahead of me,so he's had it longer,but with all his medical issues,we've been very pleased.
 

denice

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Are the Medicare Advantage plans considered a supplemental plan?
No The Medicare Advantage plans are a replacement for traditional Medicare Parts A and B. Supplementals are an additional insurance, AARP is a big one but there are several. Most of them cover the copays after a deductible. Supplementals are often called Medigap policies. If you enroll in one through the Medicare website then Medicare will take care of forwarding the claim after they process and pay.
 

susanm9006

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I have an Advantage supplement including part D. I have been in the same plan since I turned 65. It has a huge network in my area so I have never had trouble finding a participating provider and for reasons I don’t understand each year it has gotten cheaper. It was $52 a month premium when I initially enrolled and next year it will be $20 a month. And their prescription copayment have also decreased. Of the five I have, I used to spend about $100 a month in copayments . This year four of the five have no copayment at all and the third costs me about $7 a month. Not complaining.
 
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