Medicare Can Sock My Duck!

[jerrykramer64fan]

30 min. with Humana. 45 min. with Medicare. 15 min. with Humana. 11/2 hr's with Medicare-"Click". 1hr 15 min. with Medicare.

Times Humana pointed the finger at Medicare - 2
Times Medicare pointed the finger at Humana - 5
Times Medicare admitted they were WRONG - 5 (at least)

Problem resolved? HELL NO

Times customer royally SCREWED???? -1

And that's 1x too many!









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[Mr. Bill]

Madam Bill say: I see a conference call feature on your telephone...

 

[Guest]

I work with this stuff on a daily bases, if you tell me the situation I can probably help you....I will check back on this post on monday june 9th. 99 times out of 100 these things seem much worse than they appear.

 

[jerrykramer64fan]

"Bob" has had Med A since 8/1/03. He was also on his wifes group. Bob turned 65 on 6/1/08. Med B kicked in 5/1/08.Wifes group stops when he turns 65. He has both his IEP & his SEP under law. Got his med sup no problem. Applied to Humana on 5/27/08 by phone for his pdp. Humana said Medicare kicked it back because he should have enrolled under SEP. They admit that either is legal, but Humana should have know that Medicare wants a SEP not IEP under those circumstances. Now he has no Rx until 7/1/08 and three days of meds left. Both Medicare and Humana told me to re-enroll him (did that) for a 7/1/08 eff, nad file a complaint (did that) and if it is approved, Humana will reimburse him for his 6/08 Rx that he will pay for out of pocket.

Lesson learned-pick the SEP if it applys at all.

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[The Rabbi]

I have one tied up now over the enrollment. The poor woman wasn't able to find out the problem at Medicare. I told her to get the letter of coverage from the group and that's all there can be to it. Sometimes we get a dumbass on the phone at the company. Ask for another person if you aren't being treated right. Get a supervisor.

 

[Guest]

There Is A Back Door To Getting Things Done In Medicare And That Is By Calling The Regional Cms Office...there Is Usually One Or Two In Every State. These Are The People That Can Make Instant Changes And Solve Problems Immediatly If You Can Find The Number Of The One In Your State When These Matters Arise It's Your Ace In The Hole. I Only Use This Resource In The Most Complicated Situations When There Is No Other Option Because I Don't Want To Abuse It. Cms Doesn't Want To Be Bothered With Inurance Agents All Day. I Called Them Twice Last Year And Senior Health Is The Bulk Of My Business

 

[jerrykramer64fan]

Thanks for the info. I'll check into it.

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[midwestbroker]

As a former captive Humana agent, I can tell you that Humana is scared silly to cause any problems with Medicare. They have been slapped on the wrist more then once.

Now, they will hold apps and tell you all day long that the enrollment code was wrong...and to get an app corrected at this point is like getting congress to work together.

Have the client call the DOI. Humana does not want the DOI or any other government authority to get involved.

Best of luck...

 

[jerrykramer64fan]

I faxed in the official complaint and no freaking sht,they/somebody fixed the problem. my customer got the 6/1/08 effective date the day my he ran out of meds. Great news for him, and he called to thank me for going to bat for him. Now I have another great referral source.

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