Friday, December 21, 2018

IBM Medicare Via Benefits versus OneExchange lament

It's been about a year that Towers Watson changed the name and it's obvious they did more than change the name, they changed the subcontracted provider that provides the customer interface.  Time to give feedback on observations about it but my overall assessment is they are not good.

I did not have much interaction with the new services provider because most of my reimbursement are automatic.  However, the few times I did submit claims, if they were routine, it worked.  The two times I tried to submit claims that were "not routine" were not successful.  They seem to not know how to handle claims from doctors who do not accept Medicare nor do they know how to accept claims for procedures that are not covered by Medicare (such as annual physical). In both cases I decided to not go on the war path because I knew I would be using up my HSA on other stuff.  It wasn't worth the fight.

I truly hate the statements they send when they do a reimbursement.  They are unintelligible.  However, if I get the money, that's what really matters.

I also did not spend a lot of time on the website, given I don't need to make changes.  I did call to change my medigap insurance in October and when I spoke to them, the agent tried to say I could not do it without underwriting until I reminded her I could do it whenever I want without consequence because I live in New York.  She apologized for her mistake, but if I had not known I would have believed her. The quality of the service representatives seems to have degraded.

My next encounter happened when a friend told me he was advised, when he called,  he could not file claims for part D IRMAA.  For those that don't know, it is a Medicare income based assessment (don't call it a tax) imposed by Medicare for people with high incomes.  He was told by Via Benefits it was not eligible for reimbursement.  Of course, that was wrong.  It is part of the part D premium but it is paid out of social security benefits or as a separate bill from Medicare.

I double checked it with Via Benefits via an inquiry on their site.  The representative confirmed it was a legitimate recurring expense.  Then he told me how to get a recurring expense form.  Shock of shocks, he gave me the wrong information on how to find the form and I had to troll through the website until I figured it out. He directly sent me that answer to my email address.  I do recommend putting inquiries in writing because it is less likely you will get a wrong answer. They don't want to have hard evidence of wrong answers.

Finally, I complained to Via Benefits via an inquiry message on their site that I no longer get email confirmations when I submit claims and could no longer find the setting on the website to double check it was still activated.  This time, I got an email back telling me they had answered my question and it was posted on the site.  It took me about 10 minutes to find where it was posted.  I had to go to the reimbursements function and dig around until I found the message.  There was no indication in the home screen that a message was pending.  When I read the message, it said I could get a text, but no email confirmation.  That's nuts twice.  They could have put that in the email they sent to me telling me they had answered the question AND not everyone wants to give out their cell phone numbers so they can be texted!

Anyway, I guess we are lucky we still get HRA/FHA money.  However, good luck figuring out all the Via Benefit quirks to be able to access that money to pay claims.

I wish you all a wonderful 2019 and a lot of patience and success getting claims paid.  Complain, complain, complain if you have problems.  It's the only way they will fix it.

2 comments:

  1. To get reimbursed for the part of my Medicare part B premium that is not covered by the SHAP $900, I send in a Reimbursement form in January of the next year, after the previous years last quarter SHAP has processed. I include a copy of my SS letter showing what the Medicare Part B premium will be for that previous year, a copy of the 4 quarterly payments by SHAP for the previous year, and ask for the balance not paid by SHAP, on reimbursement form. I sent all this data for 2019 in in early January 2020, expecting the balance to be taken out of my 2019 HRA. VIA Benefits treated it as a recurring premium reimbursement for 2020,divided the balance due by 12, and took the first months(January 2020) payment out of my 2020 HRA. After spending an hour on the phone with VIA Benefits(half of it when rep put me on hold to talk with someone else), I was told they would try to straighten it out. I would need to call back in about 10 days to see if it got straightened out. I asked if they could email or txt me to tell me the status, but no, I would have to call back after 10 days. Since you never talk to the same person twice, I imagine I will have to go through the whole thing again with the new rep. Omaha worked much better for claims than El Paso does.

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    1. Thank you for letting me know about your situation. I will put it into a new posting. I also am having trouble with Via Benefits reimbursement. Mine is not as significant as yours. You might want to file a complaint with the IBM plan administrator.

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