Forum Discussion

traveylin's avatar
traveylin
Explorer
Jan 15, 2014

Medical coverage in Dec and January

Now that 1/6 th of the US economy is turning to end of year contract renewals/program coverage selections, I get the feeling that there is an awful lot of tension on the part of providers regards in network/out of net work, correct billing insurance company and specific program.
I got a letter from a cpap durable med supplier today that medicare refused to cover because I was on medicare substitute provider that may not be in the providers network irregardless that the insurance carrier has diligently paid the cpap bill without delay the last 12 months. In the past 30 days the carrier has sent me three different membership cards and was the purpose of a meeting tomorrow, I had set up with provider get them the right card. Its also only about eight workdays since I turned medicare eligible, and wonder how the cpap provider had communicated with Medicare without my permission or copy of medicare card and gotten a reply in that short a period of time.
With a total fruitbasket turnover of policies and lightning fast electronic communication available to this economy, getting medical attention in Dec/Jan will be dicey unless on a cash basis.
The supplier closing statement was they expect me to pay for there service at list prices and sincerely hope to retain my business.


Stay close to home and don't get sick in Dec/Jan


pops
  • Not sure but seems most problems I have heard with Medicare is when people sign over their medicare benefits to an HMO. Then they seem to be limited to local areas and travel becomes a problem. My medicare works in all 50 states with no problem. Secondary also works but it is not a localized HMO. I do realize an HMO may work better if I was in one area.
  • WyoTraveler wrote:
    Not sure but seems most problems I have heard with Medicare is when people sign over their medicare benefits to an HMO. Then they seem to be limited to local areas and travel becomes a problem. My medicare works in all 50 states with no problem. Secondary also works but it is not a localized HMO. I do realize an HMO may work better if I was in one area.


    I have a friend who is somewhat of an expert on Medicare stuff, and she says to never, ever go with an HMO. She says they're notorious for trying to kick patients out of the hospital early, not paying for rehab stays, etc. She's told me so many horror stories there's no way we'd ever consider an HMO. Ever.
  • Our friend has the same problem this month getting his CPAP supplies.. It isn't Medicare in his case....it's that the COMPANY does not want or can't sign up to be a Medicare supplier. The ACA (Obamacare) has new restrictions and some providers do not like what they'd be paid. I have had Apria for years (I'm not on Medicare yet) and now I'm restricted by my ins. company by ONE CPAP supplier in Bend, Oregon.....even if I'm in Maine, I have to go to that provider. ARRRRRRGH! And I have to wait to get home to be able to set up an account!!!!!!! VERY frustrating for all of us.
  • amandasgramma wrote:
    Our friend has the same problem this month getting his CPAP supplies.. It isn't Medicare in his case....it's that the COMPANY does not want or can't sign up to be a Medicare supplier. The ACA (Obamacare) has new restrictions and some providers do not like what they'd be paid. I have had Apria for years (I'm not on Medicare yet) and now I'm restricted by my ins. company by ONE CPAP supplier in Bend, Oregon.....even if I'm in Maine, I have to go to that provider. ARRRRRRGH! And I have to wait to get home to be able to set up an account!!!!!!! VERY frustrating for all of us.


    Welcome to our new world of medicine.
    Don
  • This seems to be a new way of making people stay in thier home area so Big Brother will have another way of keeping their sheep corraled. This makes it is easier to locate you than if you are mobile!
  • My mother was & brother is on medicare HMO's. when she would snowbird with me here in Az. just a notification was necessary. She could be out of service area for 6 months @ a time. My brother has the same as she did. While visiting last year he had his 3rd Heart Attack. 1 stent replacement and another added he was only out of pocket $500. Mom passed in Oct 2013. Brother is doing well & in Nov when I am ready I will get the same HMO he has.
  • All I can relate is our experience. Our Blue Cross Blue Shield supplemental through wife's former Employer went up 800% this January. Most of it taxes to ObamaCare. She got a letter today of options we would have to deal with next anuary to prepare us. It looks like the cheapest option will be about 1600% increase and coverages go down.
    Younger people are facing things like 6,000.00 deductibles, up front, and huge copays and capped coverage and exclusions and exceptions. Where is the money going...to pay for Illegal Aliens already here and the huge flood amnesty/Immigration Reform will bring. Also all those who see good health care as white priviledge to be take from us.
    Politics or no we are emerging into a socialist world of poverty and limited or no future except suffering, repression, and living without, for a whole lot, of people. Just the Facts.