Medicare with Aetna supplemental

Jul 10, 2019

  1. Kaspery
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    Kaspery New Member

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    Hi,

    This is my first time reaching out on this forum and it’s possible I missed a similar question being asked but here it goes.

    My father is currently on Medicare that either has Aetna as a supplemental plan or is managed by Aetna. He was recently diagnosed with inoperable lung cancer. At every turn his appointments have been cancelled due to insurance initially declining coverage. Since his diagnosis he has had a pet scan cancelled and rescheduled due to insurance and now it’s his radiation which was scheduled for two weeks and then cancelled because of problems through his insurance. He is currently being told to just wait for a call and in the meantime his cancer is progressing fairly rapidly. He is supposed to begin immunotherapy next week and now we are all expecting that appointment to be cancelled as well. We have the understanding that he is terminal with an extremely rare form of cancer which they are attempting treatments without Any documented treatments for his cancer. Is there anything we can do to make this process go more smoothly or do we just have to sit in frustration? We have wonderful doctors on our side that fight for him but is there something we can do as individuals to help their fight?

    Thank you for any time or answers!
     
    Kaspery, Jul 10, 2019
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  2. David Taylor Jr
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    David Taylor Jr Super Genius

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    First, I am so sorry to hear you are going through this. Second, do you know which Supplement Plan he has?
     
  3. Kaspery
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    Kaspery New Member

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    Thank you for both the sincerity and fast assist. I believe it is part D but I could be incorrect. I’m waiting on a confirmation from him.
     
    Kaspery, Jul 10, 2019
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  4. Northeast Agent
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    Northeast Agent Guru

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    Are these experimental treatments not covered by Original Medicare? If they won't pay, the Supplement won't, as they follow OM's guidelines.

    Or does he have Medicare Advantage (HMO, PPO)?
     
  5. David Taylor Jr
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    David Taylor Jr Super Genius

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    Ok, as soon as you know that will help to better assess what may be happening.
     
  6. Kaspery
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    Kaspery New Member

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    He does have Medicare advantage and to my knowledge they are not classified as experimental treatments. The immunotherapy is the Keytruda if that helps answer to the experimental aspect.
     
    Kaspery, Jul 10, 2019
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  7. Northeast Agent
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  8. vic120
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    vic120 Guru

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    Medicare Advantage is a lot different than a Medicare supplement

    If he currently does not live with you and moves in, This would be a change of address and would qualify for a guaranteed issue for medicare supplement plan F that would pay 100% of the leftover after Medicare pays

    Same would apply if he moves into a nursing home

    Apart from that, You can ask provider who they prefer to work with as far as MA, However, without change of address he would need either Medicaid or extra help or financial assistance from the state to be allowed to change before annual enrollment Oct 15th through dec 7th with Jan 1st effective date
     
    vic120, Jul 10, 2019
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  9. Kaspery
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    Kaspery New Member

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    Thank you both for the time and assistance. I will confirm the insurance plans shortly and make sure I have the correct understandings of his plans
     
    Kaspery, Jul 10, 2019
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  10. Kaspery
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    Kaspery New Member

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    So the correction is he strictly has Medicare advantage that is managed by aetna
     
    Kaspery, Jul 10, 2019
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