Thursday, September 26, 2013

IBM Extend Health Medicare Briefing in Poughkeepsie 9/25/13 More Qs & As

I decided to attend one of the briefings Extend Health is doing for retirees.  It was worth going because I did pick up a little information.  I was also able to see first hand just how difficult this transition will be for many retirees.  People are overwhelmed by it and many will not be capable of really understanding all the ramifications. I could tell by the questions they asked at the end of the session. Shame on IBM for making this so hard. I will try to not be snarky in this post but I don't think I will succeed.

The Extend Health presenter was a little too slick and glib for me.  He made several mistakes along the way but you'd have to be seeped in this stuff to know it - the audience was oblivious.  He also ever so subliminally pushed Medicare Advantage plans. I bet it's because insurance companies pay a higher commission for those plans.  He mentioned several times that Medicare Advantage plans focus on wellness. Fat chance they do. Unless the measure is the rate at which they deny claims for sickness. He talked about being "over insured". That is ridiculous - a person is not like a house or an automobile which has a fixed asset price and can be over insured.  There is no such thing when it comes to health insurance because health catastrophes are totally unpredictable and a person's life has no price tag.  Basically you should buy however much health insurance as you can afford!

Regarding commissions - the presenter confirmed in the meeting that Extend Health receives commissions from insurance companies. It is actually on the last page of the "Getting Started" brochure you received.  He then said the agents were paid a salary so they were unbiased.  That is, once again, ridiculous. It is akin to saying IBM technical support people are not are commissioned so they are not biased to selling IBM products to their clients!  I believe commissions are why we MUST buy a medical insurance plan through EH to get our subsidy.  It was probably a negotiated item in the EH contract with IBM. 

As I said - I did pick up a few tidbits and I realized a couple of things that are important to know if you use original Medicare and medigap insurance.  First, we are losing insurance coverage for preventative medical services such as routine physical exams by a doctor and blood tests.  These procedures are not covered by Medicare but were covered by IBM medical supplement and by Aetna Integration.  Medicare only covers something called "wellness checkups" which is significantly less. Second is that we also had coverage for acupuncture in those plans.  Medicare doesn't cover it.

I created a new question/answer list: 

Extend Health – more questions and some answers
 From EH meeting in Poughkeepsie on September 25, 2013

1.       What type of insurance plans must be purchased from Extend Health to be able to access the HRA subsidy?

Answer:  You must buy a Medical Plan from Extend Health to be able to use the HRA subsidy.  The only plans that qualify are Medicare Advantage, medigap plans and Part D, dental and vision plans are not medical plans.  (updated 10/7/13)
2.       How do you establish a caregiver who can act on your behalf in making Extend Health choices?

Answer:  You can designate a caregiver either in your profile or when you talk to an agent.  The caregiver can then ask questions on your behalf and help you decide what plans to use but you need to be able to listen and answer questions when it comes time to enroll.  If you cannot do it then the caregiver will need a power of attorney on file with EH before your enrollment call.  Also, the insurance plan you choose may ask to see that power of attorney to complete your enrollment. 

3.       Will auto-reimbursement of policy premiums be implemented for policies not purchased from Extend Health?

Answer: No.  Auto-reimbursement is only available for insurance policies purchased through Extend Health.
4.       Will reimbursement from the HRA include medical expenses not covered by Medicare such as an annual physical by a doctor or acupuncture?

Answer:  They didn’t know.  The presenter in the meeting said “no”, then the agent I talked to the next day tried to read me the same list that was in our brochure.  IRS HRA rules do not limit the kind of medical expenses that can be reimbursed from an HRA. And HRA law has nothing to do with Medicare law.  It is IBM that will limit what medical expenses we can subsidize with HRA money.  I don’t know how to get an answer to this question beyond submitting a claim and then fighting with Extend Health and/or IBM if it is denied.
5.       Will reimbursement from the HRA include medical bills from doctors who do not accept Medicare insurance?

Answer:  The same as for answer #4.  They don’t know and I don’t know how we can find out.
6.       Can you make on-line changes to your plan selection after enrolling with an agent or must all changes be processed by an agent?

Answer:  Any changes you make to your plan selection on-line will not be confirmed until you call and speak to an agent.

12 comments:

  1. I don't have a question..BUT i want to thank you very much for your blog!

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  2. I am glad to do it and hope it helps people make wiser choices. Your feedback is much appreciated.

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  3. I second the motion: This is a great blog for IBM retirees trying to navigate the great IBM betrayal.

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  4. I've got (I think) a unique situation that hopefully, someone can give me some guidance. I retired from IBM, but am presently not Medicare age, but my wife will come of Medicare age next year (she's under my present IBM health plan - we pay her portion now). Do I need to do anything "now" to make sure - I'm doing what IBM/Extend Health requires from me ?

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    1. No, you will go through the regular IBM enrollment process and they will send you IBM plan information to do so. Extend Health insurance is only for people over 65. A month or two before your wife turns 65, IBM will send you information about her change in status. She might then use insurance through Extend Health but if she gets no subsidy there is no reason to do it. By the way, if she isn't collecting social secuity she will have to initiate Medicare enrollment and can do it up to three months before her birthday by going to medicare.gov to sign up. The one area where her turning 65 might affect you is regarding the subsidy aka HRA. You might need to decide if you want the HRA benefit to continue for her if you die and thereby get a lower subsidy while you are alive. I don't know when IBM will make you decide. Call the IBM employee service center and ask them when you decide - is it when she turns 65 or when you turn 65.

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  5. Beware of EH call agents. As part of my sign up today I had selected the RX plan offered by Humana Walmart at $12.60 per month in my area( Ca) . During the enrollment process the EH agent said I could only get my drugs at a Walmart store and not my local CVS pharmacy. So I had to select a more expensive plan. Halfway thru the enrollment process I went to Medicare.gov and looked up this Humana Walmart plan and found that CVS is in this plan and part of their network. It took one hour for a new agent to back out the other plan I was put in and then enroll me in the lower Humana Walmart plan. Another example of weak EH call agents. The entire enrollment process took 1hour and 45 mins. I had no idea that EH and IBM had made this so difficult. They also gave me the impression that they lead with more expensive Medigap plans so do your homework and tell EH which plan you want.

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  6. What ever happened to the Old IBM? The extended health system isn't any better the Obama's web site. I can't get it to take a password. Same ole IBM youngster, let the customer test for them.

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    1. It is almost worthless to use the website since they don't post up every plan they sell but you can see what they sell without having to log on. However, logging on does tell you your subsidy. I suggest you call them and start asking questions the old fashion way. Most of what is on the website is worthless. You must call them to enroll so you may as well get used to calling. Sorry to say the old IBM evaporated years ago.

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  7. IBM really is dumbing us. I'm retired because of on job injury and on SSD. The service are not very educated on our benefits. I was first told no vision or dental plan and was told to call Fidelity. I called and was told yes there are dental and vision plan was connected on conference call and the person at EH said they rarely offer these plans in the past and the benefits for the plan they offer are the worst and I be better off getting my own. She said hopefully next year they will have better plans to offer. IBM is taking these new obama care too far. it is for Medical coverage. IBM should still cover us for vision and dental.

    When I was hired I signed up for full benefits paid by IBM in full for Retirees(and Disabled) and their families. A couple years after my accident IBM said they were losing money and was allowed to change our benefits and we start paying premiums, a little at first then it went to $500 a month(on Disability Income). It went down a little but now they are dumping us.

    We need to do something here.

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  8. Yes, Plato ...thank you. I retired from IBM after 29 years (mostly in 1st & 2nd line management) and moved to Mexico. I had UnitedHealthcare thru IBM and needed it as I went a fantastic hospital here -- was in coma for 9 months. The wonderful Mexican Dr who saved my life became friends with my husband and told my husband that he should make arrangements for burial. Had tracheotomy, tubes everywhere (kidney dialysis twice a day) every organ failed except beating heart. Woke up and it has taken me 4 years of constant determination to walk, etc. left with neuropathy in feet and taken 14 pills a day for blood clots, etc. I slowly learned to drive again and tomorrow I have to make a 250 mile trip to see a new Dr. in Arizona (only one in area taking new medicare patients). This will be a challenge (my first long trip, staying in motel, meeting new Dr., trying to figure out how do I know get my drugs in Mexico. IBM & Unitedhealthcare sent me a letter that my insurance was cancelled effective 12/31/13. So, if I get sick here --it will be very difficult and if emergency -- a large expense on my husband and I who are 68 yrs of age. We hired someone to paint our house here, then will try and sell, spends lots of money trying to relocate to Arizona with 8 dogs and 6 cats and this will take time.
    What else can we do? My husband and his business partner will have to sell boats and business which is very difficult in these times. When hiring new employees in IBM, managers told prospective employees -- the reason IBM is not paying as much as OTHER technical companies is because you have to realize the medical benefits that IBM PROVIDES FOR LIFE. You will always remain part of the FAMILY. Right?????????

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    1. Have you called the IBM Service Center to ask them about out of the country coverage? You have to ask to speak to the Plan Administrator because there is a special provision for people who live outside of the USA that at a minimum gives you access to your HRA subsidy. You did not say if you bought Medicare secondary insurance or part D insurance. You have until the end of February 2014 to do so (albeit the insurance then won't be effective until March 1st) without penalties and you cannot be denied a supplemental plan because the IBM plan is ending. The IBM we knew is long gone. Corporate America does not "respect the individual" and values the efforts of "human resources" the same way they value corporate equipment or buildings. Once the utility is gone the resource is discarded. Hope things work out for you.

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