Yesterday I spent about hour helping a friend understand more about how to pick replacement insurance plans to replace his IBM Medical and drug Supplemental plan that he had for himself and his wife. After talking through the differences between a Medicare Advantage plan and Original Medicare - he decided he wants the flexibility of Original Medicare + a medigap + part D for both him and his wife.
First, we went to www.medicare.gov and looked at part D drug plans in his zip code. He takes no drugs so it was easy to pick a plan for him. He will buy the cheapest drug plan available. Then we looked at a plan for his wife who has expensive prescriptions and picked a plan for her that covers her drugs. We next looked at www.extendhealth.com/ibm to see if both plans were offered by EH and they are which was great news! That means he can buy at least two plans through Extend Health, qualify for his subsidy and is free to buy medigap plans from insurance companies with the cheapest premiums in his zip code.
We looked for insurance companies selling medigap plans in his zip code by going to www.medicare.gov for the medigap policy finder at the top of the home page.Unfortunately, www.medicare.gov does not provided policy prices for each insurance company but they do give a price range for all the companies that sell a type of medigap policy in your zip code. I asked him to get his "Medicare and You" book and we kept it open to the page that has the chart showing the different kinds of medigap plans and what is covered. He decided to get the F high deductible plan as he rarely goes to the doctor but should something go wrong he will cap his medical cost. Mostly, he likes that F-HD has the lowest premium. Extend Health offers the cheapest medigap F high deductible plan available in his zip code, which is, again, great news, so he will also buy his medigap "F high deductible" plan through EH.
However, his wife needs different medigap supplemental coverage because she does have health issues. He'd love to buy an F no deductible plan for her but the premium cost is too high - the cheapest plan offered is $206/month premium. It wasn't any better getting an F high deductible plan because the "adjusted premium" of an F high deductible plan was even higher (adding $176/month to the F HD plan premium provided a premium comparison of about $209/month).
He needed to find a cheaper medigap plan for her that provided "good" coverage. We looked at other medigap plans with lower premium cost. He decided the premium price for an "N" medigap plan was a better fit given the lowest premium price offering is $140/month and there is no deductible. The things N doesn't cover are not important to her. I told him to call the state SHIP (find your state SHIP by going to www.shiptalk.org) to find out exactly who sells the cheapest N policy. Unfortunately, it's not the the N medigap plan offered by Extend Health.
When he enrolls through Extend Health he will tell them exactly what part D plans and medigap plans he wants to buy. He knows he will buy 3 policies through EH. For the "N" plan he will ask EH if they sell the plan he wants and tell them the name of the insurance company. If they can't sell it he will buy the "N" medigap directly from the insurance company.
This was a useful exercise for both of us. I realized I should have offered more advice about picking the "right" medigap plan when premium affordability is an issue. My friend is now ready for his call with Extend Health and no longer feels overwhelmed by the whole process.
Sunday, October 13, 2013
Wednesday, October 9, 2013
IBM Medicare www.extendhealth.com/ibm Part D insurance - What if you already have a part D plan ? UPDATE & CONFUSION
Written on 10/30/13 ----Correction to what was written on 10/9/13
I just got off the phone with a friend who tried to "enroll" in the same drug plan he already has. He was told that he cannot do that because then Extend Health will not be the insurance agent on record and he will not be entitled to his HRA subsidy. He talked to three different EH people and they all said the same thing. He now has to pick a new drug plan because it is still better to do that then to buy an EH medigap plan which is substantially more expensive than what he can get on the open market.
Even though I asked an agent before I enrolled if we could use the same part D plans as we already had and then I asked the enrollment agent again when we enrolled if we could just reenroll in the same plan - they both are wrong. I am told that our enrollment will be rejected. Now, when will they tell us this? Beats me. I was going to just let it go until they caught it but am not sure that is a good idea. I just spent a couple of hours trying to sort through our alternative choices. None of which are great.
So, I called Extend Health and asked them if we had a problem with our enrollment. The Benefits Agent checked our status and insisted we are enrolled and there is no problem. I haven't a clue what else to do but wait and see what happens. This is insanity --- just insanity.
Written on 10/9/13
My spouse and I already have part D prescription drug insurance and want to keep the plans we have. I looked on Extend Health's website and those plans are on the list. So, my question to them was how does that work since we already have the plans.
The agent told me the enrollment call will just consist of us telling them the part D insurance plans we have and they will modify our profiles showing we have those plans. She said that will then give us access to our subsidies (we are both IBM retirees). I sure hope she is right! We only will buy medigap plans through EH if they offer the cheapest F high deductible plan available in our zip code. I will be surprised if they do as it is not listed on their website.
A reminder - not all Medicare Advantage plans include drug insurance coverage (part D). If there is a Medicare Advantage plan in your zip code that does not include part D but it is a plan you want for your coverage - the rule change allows you to just buy the part D plan through Extend Health to get your subsidy.
The only people who will be locked in to buying a medical plan from Extend Health are people who want a Medicare Advantage plan that includes prescription drug coverage. Then you must buy the plan through Extend Health.
I just got off the phone with a friend who tried to "enroll" in the same drug plan he already has. He was told that he cannot do that because then Extend Health will not be the insurance agent on record and he will not be entitled to his HRA subsidy. He talked to three different EH people and they all said the same thing. He now has to pick a new drug plan because it is still better to do that then to buy an EH medigap plan which is substantially more expensive than what he can get on the open market.
Even though I asked an agent before I enrolled if we could use the same part D plans as we already had and then I asked the enrollment agent again when we enrolled if we could just reenroll in the same plan - they both are wrong. I am told that our enrollment will be rejected. Now, when will they tell us this? Beats me. I was going to just let it go until they caught it but am not sure that is a good idea. I just spent a couple of hours trying to sort through our alternative choices. None of which are great.
So, I called Extend Health and asked them if we had a problem with our enrollment. The Benefits Agent checked our status and insisted we are enrolled and there is no problem. I haven't a clue what else to do but wait and see what happens. This is insanity --- just insanity.
Written on 10/9/13
My spouse and I already have part D prescription drug insurance and want to keep the plans we have. I looked on Extend Health's website and those plans are on the list. So, my question to them was how does that work since we already have the plans.
The agent told me the enrollment call will just consist of us telling them the part D insurance plans we have and they will modify our profiles showing we have those plans. She said that will then give us access to our subsidies (we are both IBM retirees). I sure hope she is right! We only will buy medigap plans through EH if they offer the cheapest F high deductible plan available in our zip code. I will be surprised if they do as it is not listed on their website.
A reminder - not all Medicare Advantage plans include drug insurance coverage (part D). If there is a Medicare Advantage plan in your zip code that does not include part D but it is a plan you want for your coverage - the rule change allows you to just buy the part D plan through Extend Health to get your subsidy.
The only people who will be locked in to buying a medical plan from Extend Health are people who want a Medicare Advantage plan that includes prescription drug coverage. Then you must buy the plan through Extend Health.
Monday, October 7, 2013
IBM Medicare www.extendhealth.com/ibm IBM CHANGED THE RULES!!!! Part D insurance qualifies for HRA subsidy
THE PLAN PURCHASE REQUIREMENT HAS BEEN CHANGED.
IF YOU BUY A MEDICAL PLAN OR A PART D DRUG PLAN YOU WILL BE ABLE TO ACCESS YOUR HRA SUBSIDY.
I just got off the phone with an Extend Health agent. I was asking questions (of course) and one was pertaining to changing a plan in the middle of the year (Medicare allows a one time change to a 5 star plan if you have one in your zip code) at which point he said - oh, we just got an email this morning from IBM. They changed the requirements for HRA subsidy access. You can access your HRA as long as you have either a medical plan OR a drug plan that was purchased through Extend Health.
That will make life a little easier for some people.
Here are the questions I was asking:
1.
Can I submit bills to my HRA for reimbursement
of medical procedures that are not covered by Medicare such as an annual
physical by a doctor and associated blood tests (assuming I have money left to
do so)?
Answer: Yes, the IRS ruling for HRA accounts only require that it be a medically related procedure or drug cost. Paying out reimbursement money from HRA accounts has nothing to do with Medicare.
Answer: Yes, the IRS ruling for HRA accounts only require that it be a medically related procedure or drug cost. Paying out reimbursement money from HRA accounts has nothing to do with Medicare.
2.
Can I submit bills to my HRA for reimbursement
of doctor bills if the doctor does not accept Medicare insurance?
Answer: Yes – same rules apply as for answer #1. HRA reimbursement has nothing to do with Medicare.
Answer: Yes – same rules apply as for answer #1. HRA reimbursement has nothing to do with Medicare.
3.
Can
I submit bills to my HRA for reimbursement of dental bills if I do not have
dental insurance?
Answer: Yes – same rules as #1 - dental qualifies as a medically related procedure.
Answer: Yes – same rules as #1 - dental qualifies as a medically related procedure.
4.
Both
my spouse and I retired from IBM.
Can we submit bills for reimbursement to each other’s HRA accounts if
there is money left in one account and not the other?
Answer: Yes!!!!
Answer: Yes!!!!
5.
If
my medigap plan is no longer offered by EH in 2015 do I have to switch to a new
EH plan at the end of 2014 to keep my subsidy?
Answer: You have to have at least one plan purchased through EH. You would have to then buy a part D plan through EH if you didn’t want to switch medigap plans. (I did not like this answer because not all part D plans are offered by EH and your drugs might not be covered by plans they offer. My bet is you could lobby for an exception in that case)
Answer: You have to have at least one plan purchased through EH. You would have to then buy a part D plan through EH if you didn’t want to switch medigap plans. (I did not like this answer because not all part D plans are offered by EH and your drugs might not be covered by plans they offer. My bet is you could lobby for an exception in that case)
6.
If
I want to switch to a 5 star Medicare advantage or part D plan during 2014 –
which Medicare allows – will I lost my subsidy if it is not a plan sold through
EH?
Answer: You will not lose the subsidy for a part D switch if you still have an EH medigap plan. You would lose the subsidy for a Medicare Advantage switch. (Again, I do not like this answer and will bet you could lobby for an exception)
Answer: You will not lose the subsidy for a part D switch if you still have an EH medigap plan. You would lose the subsidy for a Medicare Advantage switch. (Again, I do not like this answer and will bet you could lobby for an exception)
Sunday, October 6, 2013
IBM Medicare www.extendhealth.com/ibm Confusion Abounds - Beware What you Hear and Read
I've been looking at some of the chatter about Medicare medigap and Medicare Advantage plans that has been posted other places. Too often what people write is wrong. Sadly, the Extend Health agents are also saying things that are wrong. Double check everything to be sure you are getting an accurate description of Medicare rules and offerings and Extend Health rules.
For example, people are saying some doctors won't accept medigap plans. Doctors don't chose to participate or not participate in medigap plans unless they are are "Medigap Select" plans. There are only a couple of states that have those kinds of plans and even then "Select" plans are only available in a subset of state counties. Everywhere else a doctor cannot say they don't accept a medigap as Medicare automatically sends the claim to the medigap for processing. The doctor can say they don't want to wait for a medigap plan to pay them because the plan may be slow to pay. The doctor might therefore ask for coinsurance payment up front. You will then be reimbursed by the medigap for the coinsurance. If you decide to get a medigap with a deductible you obviously have to pay the doctor coinsurance anyway until you reach the deductible amount for the policy. Reminder - any coinsurance you pay will be reimbursed by Extend Health if you still have money left in your subsidy (I keep seeing postings where people are really confused about that). People also write about a lifetime cap for medigap reimbursements. Maybe it applys to Select plans but regular medigaps are required to payout and can only cancel a client if the client stops paying medigap premiums.
I have seen people mix up medigaps and Medicare Advantage plans. Someone wrote about the vision and dental coverage provided by a medigap. Again, unless it was a "Select" plan - medigaps never offer vision and dental coverage but Medicare Advantage plans often do. I have seen people write about how medigaps are age rated so the older you get the more expensive it will be. IT DEPENDS ON YOUR STATE. I have seen people focus totally on the cost of Original Medicare + medigap+ part D versus a Medicare Advantage plan. There is so much more to the decision of what insurance to have than the price tag of the plans you choose. Reminder - if you need an expert doctor (say, for a second opinion) and they don't accept your MA plan (but do accept Medicare) you will have to pay the total cost of the doctor visit out of your pocket if there is no money left in your HRA. There is no way to factor that into a "cost" analysis.
There are still a lot of unanswered questions about Extend Health. EH stated that you must buy a "medical insurance policy" from them to qualify for your subsidy. So, what if you just buy one policy from them will you then be able to submit bills for premiums and copays for both you and your spouse? That would mean you can buy a cheaper medigap for your spouse if EH doesn't offer it. EH has said you must buy a medical or part D plan for your spouse to be able to file bills for your spouse's against your HRA.
The medigap insurance policy that Extend Health offers for medigap F high deductible in my zip code is one of the more expensive offerings in my area and it is also Humana - which is famous for poor customer service (try to call Humana once you have a policy with them - it is easier to reach the Pope). It is the only one they offer for my zip code. I keep reading that Extend Health will sell you the policy you do want if you ask for it! So, I know that Empire Blue Cross's price for exactly the same policy is $30/month less --- I am specifically going to ask them if they can sell me that plan!
There are other questions you have to ask your state health insurance assistance agency that are important questions to get answered before you sign up. The top of the list is whether the state that has rules for issue age rated medigap pricing (also known as entry age rated pricing) require insurance companies to sell you a medigap plan at the issue age you bought IBM's insurance because you had continuous secondary coverage and have a guarantee issue right. It might dramatically lower your premium price if it applies. I doubt Extend Health will know and I doubt the insurance company will tell you unless you ask the question.
I just looked at the drug plans offered by Extend Health. First off, there are 25 drug plans available in my zip code in 2014. I just looked on medicare.gov to see it. EH offers me 12 plans!!! It is also difficult to determine if my drugs are covered by those plans when I look at the EH information. Don't rely on EH information alone to pick a drug insurance plan.
Finally, EH had ONE dental plan and ONE vision plan to offer in my zip code. The dental plan was "stupid". I would have to pay about $626 in premiums and deductible to get $1000 in coverage for the year. The vision plan wasn't much better but I only had to pay about $168/year to get nothing. Maybe there are more plans they will offer if you ask? Make sure you ask your dentist and you eye doctor/eye glass store what plans they take and what they think are the best plans to get before buying a plan from Extend Health. Reminder - no matter how you buy a dental or vision plan or self insure you can get reimbursed for the premiums, copays and total bills from EH as long as you bought an EH medical or part D plan and still have $$$ left in your HRA.
For example, people are saying some doctors won't accept medigap plans. Doctors don't chose to participate or not participate in medigap plans unless they are are "Medigap Select" plans. There are only a couple of states that have those kinds of plans and even then "Select" plans are only available in a subset of state counties. Everywhere else a doctor cannot say they don't accept a medigap as Medicare automatically sends the claim to the medigap for processing. The doctor can say they don't want to wait for a medigap plan to pay them because the plan may be slow to pay. The doctor might therefore ask for coinsurance payment up front. You will then be reimbursed by the medigap for the coinsurance. If you decide to get a medigap with a deductible you obviously have to pay the doctor coinsurance anyway until you reach the deductible amount for the policy. Reminder - any coinsurance you pay will be reimbursed by Extend Health if you still have money left in your subsidy (I keep seeing postings where people are really confused about that). People also write about a lifetime cap for medigap reimbursements. Maybe it applys to Select plans but regular medigaps are required to payout and can only cancel a client if the client stops paying medigap premiums.
I have seen people mix up medigaps and Medicare Advantage plans. Someone wrote about the vision and dental coverage provided by a medigap. Again, unless it was a "Select" plan - medigaps never offer vision and dental coverage but Medicare Advantage plans often do. I have seen people write about how medigaps are age rated so the older you get the more expensive it will be. IT DEPENDS ON YOUR STATE. I have seen people focus totally on the cost of Original Medicare + medigap+ part D versus a Medicare Advantage plan. There is so much more to the decision of what insurance to have than the price tag of the plans you choose. Reminder - if you need an expert doctor (say, for a second opinion) and they don't accept your MA plan (but do accept Medicare) you will have to pay the total cost of the doctor visit out of your pocket if there is no money left in your HRA. There is no way to factor that into a "cost" analysis.
The medigap insurance policy that Extend Health offers for medigap F high deductible in my zip code is one of the more expensive offerings in my area and it is also Humana - which is famous for poor customer service (try to call Humana once you have a policy with them - it is easier to reach the Pope). It is the only one they offer for my zip code. I keep reading that Extend Health will sell you the policy you do want if you ask for it! So, I know that Empire Blue Cross's price for exactly the same policy is $30/month less --- I am specifically going to ask them if they can sell me that plan!
There are other questions you have to ask your state health insurance assistance agency that are important questions to get answered before you sign up. The top of the list is whether the state that has rules for issue age rated medigap pricing (also known as entry age rated pricing) require insurance companies to sell you a medigap plan at the issue age you bought IBM's insurance because you had continuous secondary coverage and have a guarantee issue right. It might dramatically lower your premium price if it applies. I doubt Extend Health will know and I doubt the insurance company will tell you unless you ask the question.
I just looked at the drug plans offered by Extend Health. First off, there are 25 drug plans available in my zip code in 2014. I just looked on medicare.gov to see it. EH offers me 12 plans!!! It is also difficult to determine if my drugs are covered by those plans when I look at the EH information. Don't rely on EH information alone to pick a drug insurance plan.
Finally, EH had ONE dental plan and ONE vision plan to offer in my zip code. The dental plan was "stupid". I would have to pay about $626 in premiums and deductible to get $1000 in coverage for the year. The vision plan wasn't much better but I only had to pay about $168/year to get nothing. Maybe there are more plans they will offer if you ask? Make sure you ask your dentist and you eye doctor/eye glass store what plans they take and what they think are the best plans to get before buying a plan from Extend Health. Reminder - no matter how you buy a dental or vision plan or self insure you can get reimbursed for the premiums, copays and total bills from EH as long as you bought an EH medical or part D plan and still have $$$ left in your HRA.
Saturday, October 5, 2013
IBM Medicare www.extendhealth.com/ibm The Value of Keeping Promises
I keep thinking about Rhee's response to my email and how what Human Resources is doing is nothing more than a maneuver to steal from the elderly earned IBM services. I need to rant.
There is an implied message in the literature we received that we are lucky to get anyting from IBM. It had nothing to do with luck. The employment contract we had with IBM was a
promise to defer payment of services earned so that we could receive a long
term payout over our lifetimes in the form of health benefits. Somewhere along the way we even started to believe that we are "lucky" to have the benefits. Never forget - you earned them. We worked hard to earn them and we were given a promise that we would be paid those earnings over our lifetimes. It is simple what is happening. IBM is breaking the promise.
Although there was no legal contract there was a social
contract between the employee and the company.
It was a moral commitment between both parties. We provided high quality work and IBM put
part of our earned services in a “benefits bank”. It was a handshake deal and IBM agreed to be morally
obligated to fulfill the promise. The IBM Human Resources community has now decided to break the promise and Ginni is letting them do it. The board of directors is no less complicit. Shame on all of them. We kept our end of the deal.
The value of keeping a promise is measured in moral
terms. The cost of breaking a promise is
measured by lost ethics. IBM worked harder
to keep their ethical bank account higher than any other corporation in the
global marketplace. Business conduct was
the cornerstone of IBM’s success. It is
what made IBM a superpower in the corporate world. Whether an eroding of ethics occurs in
customer interactions or in human resource support it erodes IBM superpower
standing and eventually erodes the very fabric of the organization. Stealing earned services away from retirees is undeniably a major erosion no matter how much lipstick is applied. It is likely a symptom of a broader IBM collapse.
The most important aspect of this rant is to remind you that we worked for most of our careers during an era of trust and that makes me feel "lucky".
Thursday, October 3, 2013
IBM Medicare www.extendhealth.com/ibm IBM's Answer - Why We are Forced to Buy from Extend Health
I posted an entry earlier this week of a email I sent to Dr. Rhee complaining about being forced to buy a medical policy through Extend Health to get my subsidy. How could I have not realized that IBM was doing this for my own good because I would not have been able to figure out what insurance to buy all by myself. How wonderful that IBM still cares about me and that makes it so worthwhile for me to have to pay about $50/month more for my medigap insurance than if I could buy a plan in the open market. I feel so loved.
Here is Dr. Rhee's answer:
I want to respond to your letter regarding IBM’s announcement that Extend Health will provide you with new health plan options for 2014.
IBM decided to require retirees to enroll through the Medicare Exchange because we consider the benefit advisor important to helping retirees through this transition. For most retirees, a plan is available on the Medicare Exchange that delivers equal or better value than under the current IBM group plan options, at a lower cost. You may have chosen a plan that costs more, or you may be in one of the few areas of the country where plans are more costly. Previously, IBM used a “national” pricing strategy, meaning regardless of where a retiree lived, he or she paid the same amount for their IBM plan option.
Since you are not satisfied with the cost of the plans you've reviewed on the Extend Health website, I encourage you schedule an appointment with an Extend Health benefits advisor at 1-855-359-7380 to explore these options and to ensure there are no other plans or other suggestions that they may have for you that may meet your needs.
Thank you for your past contributions to IBM, and for writing.
Here is Dr. Rhee's answer:
I want to respond to your letter regarding IBM’s announcement that Extend Health will provide you with new health plan options for 2014.
IBM decided to require retirees to enroll through the Medicare Exchange because we consider the benefit advisor important to helping retirees through this transition. For most retirees, a plan is available on the Medicare Exchange that delivers equal or better value than under the current IBM group plan options, at a lower cost. You may have chosen a plan that costs more, or you may be in one of the few areas of the country where plans are more costly. Previously, IBM used a “national” pricing strategy, meaning regardless of where a retiree lived, he or she paid the same amount for their IBM plan option.
Since you are not satisfied with the cost of the plans you've reviewed on the Extend Health website, I encourage you schedule an appointment with an Extend Health benefits advisor at 1-855-359-7380 to explore these options and to ensure there are no other plans or other suggestions that they may have for you that may meet your needs.
Thank you for your past contributions to IBM, and for writing.
IBM Medicare www.extendhealth.com/ibm More Information on Doing Plan Research
George posted excellent information in a comment on how to do plan research and how important it is to do that research. I am reposting it here to make it easier for you to read.
Thank you, George!
Thank you, George!
There
is an additional readily available and very easy to review source of factual
information accurately and comprehensively summarizing the plan you may be
contemplating: the PLAN BROCHURE. Thus, some related thoughts after years of
working directly with CMS [Medicare] and insurance companies, and assisting
many people.
After selecting (or comparing) Medicare Supplement (Medigap) or Medicare Advantage (Part C) plans on the Extend Health (EH) Web site, as part of the plan information near the bottom of the respective listing(s) you will see a link - “View” - to the insurance company's “PLAN BROCHURE” [in PDF format] - at least I did for plans available in Zip Codes / counties I checked for multiple states. Plan documents (brochures) are also available on most insurance company's Web site – again, at least for the several companies for the states I checked.
After selecting (or comparing) Medicare Supplement (Medigap) or Medicare Advantage (Part C) plans on the Extend Health (EH) Web site, as part of the plan information near the bottom of the respective listing(s) you will see a link - “View” - to the insurance company's “PLAN BROCHURE” [in PDF format] - at least I did for plans available in Zip Codes / counties I checked for multiple states. Plan documents (brochures) are also available on most insurance company's Web site – again, at least for the several companies for the states I checked.
After
reviewing the somewhat legalistic information on EH, I strongly suggest you
review the PLAN BROCHURE as it will present and compare plans usually in an
easier to review format with a comparison of like-type plans. While NOT usually
the legal plan-coverage document, the brochure may be referenced. For the
complete legal plan document, you will need to review a very thick document(s).
For most states / Zip Codes / counties, ONE brochure will summarize coverage for ALL of the choices for a company's specific plan type, for example, all of the company's Medicare Supplement plans from A to N in one brochure, and all Medicare Advantage HMO or PPO plans (and variations) in another brochure, often with specific rate information which you may cross-reference to rates EH states for you.
Remember ALL plan brochures cover a specific geographic area and time period, therefore do NOT refer to an old document or one that is NOT for YOUR state / Zip Code / county.
For most states / Zip Codes / counties, ONE brochure will summarize coverage for ALL of the choices for a company's specific plan type, for example, all of the company's Medicare Supplement plans from A to N in one brochure, and all Medicare Advantage HMO or PPO plans (and variations) in another brochure, often with specific rate information which you may cross-reference to rates EH states for you.
Remember ALL plan brochures cover a specific geographic area and time period, therefore do NOT refer to an old document or one that is NOT for YOUR state / Zip Code / county.
Once
you have reviewed the information available from EH AND the plan information
from the insurance company from either EH or the company's Web site, if you
have questions, then you will be able to specifically address them by calling
the insurance company directly or, in some cases by talking with EH. Either
can, and will, help clarify your questions or concerns. I encourage everyone to get all of your
questions answered before proceeding with enrollment. If you are unhappy with
the conversation, call again as it is not uncommon for questions to be answered
incompletely or even incorrectly, even with EH; and make sure you document the
call.
Keep in mind, for a variety of legal reasons, while it may in some limited circumstances enhance a subsequent claim (or complaint), talking with an insurance company (or EH) representative does not make your conversation - questions or answers - a part of, or not a part of, the plan document or coverage thereunder.
Nevertheless, it is imperative that your review all available plan information and follow-up with all available sources, including calling the respective insurance company, CMS, and applicable state insurance agencies, to have all of your questions or concerns answered before proceeding with enrollment; and, that you fully understand the plan, including coverage, payments, and limitations, in which you are enrolling, BEFORE you enroll.
Keep in mind, for a variety of legal reasons, while it may in some limited circumstances enhance a subsequent claim (or complaint), talking with an insurance company (or EH) representative does not make your conversation - questions or answers - a part of, or not a part of, the plan document or coverage thereunder.
Nevertheless, it is imperative that your review all available plan information and follow-up with all available sources, including calling the respective insurance company, CMS, and applicable state insurance agencies, to have all of your questions or concerns answered before proceeding with enrollment; and, that you fully understand the plan, including coverage, payments, and limitations, in which you are enrolling, BEFORE you enroll.
IBM Medicare extendhealth.com/ibm Helping You Choose a Medigap Plan
There is an OUTSTANDING brochure on medicare.gov that describes medigap insurance plans, enrollment rules and variations in pricing.
After reading it I realized how big an impact this change will be for some people. In some states if you bought a medigap plan when you first turned 65 you would not have to keep paying more for the plan as you age. The price of the plan would always be whatever the entry price is for "65 year olds". If you used IBM's insurance, I think you may have lost that right. Call your state insurance agency (www.shiptalk.org has the phone numbers) to find out --- don't rely on Extend Health to tell you.
I know this is a lot of work but you have to be your own advocate to be sure you are getting the maximum benefit. READ the medigap brochure on www.medicare.gov - your tax dollars paid for it:
http://www.medicare.gov/Pubs/pdf/02110.pdf
Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare
I know this is a lot of work but you have to be your own advocate to be sure you are getting the maximum benefit. READ the medigap brochure on www.medicare.gov - your tax dollars paid for it:
http://www.medicare.gov/Pubs/pdf/02110.pdf
Wednesday, October 2, 2013
IBM Medicare extendheath.com/ibm Plan Verification Process
Someone just asked a great question that prompted me to give this advice. Before you actually enroll in a plan offered through Extend Health make sure you are getting the coverage you think you are getting. DON'T rely on Extend Health's information. There already has been too much written about how EH agent quality is highly variable.
If Extend Health gives you bad advice you can complain to Medicare that you were misled. Extend Health is acting as the insurance agent for the plan and is subject to Medicare law. That's why they record conversations. HOWEVER, it is much more effective to file a Medicare complaint if the actual provider gives you bad information. REMINDER - IBM plays no role in this complaint process. There is no point calling the IBM service center if something goes wrong.
If it happens - and you can prove it - you can ask Medicare for a special enrollment period to switch plans. No matter who you talk to --- TAKE NAMES, DATES and NOTES about the conversation so that you have EVIDENCE of being misled. If you need to file a complaint you just call 1-800-MEDICARE and tell them you want a special enrollment to switch plans because the information you got about the plan was wrong. They will then take you through the process. But, that is onerous. It is much easier just to double check before you enroll.
There are a couple of ways to verify that Extend Health is providing accurate information.
The ONLY time you can be sure you are getting exactly what is being described by a plan is if you are buying a medigap supplemental plan for Original Medicare. By law, those plans must provide the coverage that is associated with the letter of the plan. Ergo, all N plans are the same, all F plans are the same, all C plans are the same and so on.
If Extend Health gives you bad advice you can complain to Medicare that you were misled. Extend Health is acting as the insurance agent for the plan and is subject to Medicare law. That's why they record conversations. HOWEVER, it is much more effective to file a Medicare complaint if the actual provider gives you bad information. REMINDER - IBM plays no role in this complaint process. There is no point calling the IBM service center if something goes wrong.
If it happens - and you can prove it - you can ask Medicare for a special enrollment period to switch plans. No matter who you talk to --- TAKE NAMES, DATES and NOTES about the conversation so that you have EVIDENCE of being misled. If you need to file a complaint you just call 1-800-MEDICARE and tell them you want a special enrollment to switch plans because the information you got about the plan was wrong. They will then take you through the process. But, that is onerous. It is much easier just to double check before you enroll.
There are a couple of ways to verify that Extend Health is providing accurate information.
- Go to www.medicare.gov and look at the plan description for a Medicare Advantage medical plan and/or drug insurance plan you are interested in using. Do both by using plan finder. When you do, you enter the drugs you take and Medicare will provide information about whether the plan does or doesn't covers your drugs. Take print outs of the plan information.
- No matter what the answers are for step one - CALL THE INSURANCE PLAN. The plans offered by Extend Health are STANDARD insurance plans offered in the open market. For example, if you are choosing an AARP United Healthcare Medicare Advantage PPO plan through Extend Health - then that SAME plan will show up on www.medicare.gov in your zip code. There will be phone numbers associated with the plans. Verify the information by calling the medical plan or the drug plan to confirm you are getting the coverage you think you are getting. There is one exception - for Aetna PPO a special deal was arranged to allow the insurance company to continue to offer the plan for two more years to retirees already enrolled in the plan in 2013. That plan will not show up in medicare.gov. I believe Aetna is directly mailing plan information to enrollees.
The ONLY time you can be sure you are getting exactly what is being described by a plan is if you are buying a medigap supplemental plan for Original Medicare. By law, those plans must provide the coverage that is associated with the letter of the plan. Ergo, all N plans are the same, all F plans are the same, all C plans are the same and so on.
Tuesday, October 1, 2013
IBM Medicare Extend Health Medigap Offerings Complaint to Dr. Rhee
I just sent an email to Dr. Rhee and copied Ginni. I doubt it will do much good but thought I at least had to try -----
I signed on to the Extend Health website this morning to look at the medigap plan choices Extend Health offers in my zip code and I am extremely disappointed by the selection they are offering. It is very limited and the associated prices for the plans are significantly higher than those offered by other insurance companies in the Medicare open marketplace. For many reasons, not the least of which is the ability to go to any specialty clinic in the United States such as the City of Hope or Sloan Kettering, I must stay on Original Medicare.
I specifically looked at the Extend Health medigap F high deductible offering in my zip code and there is only one plan available. It is also the lowest priced medigap plan that Extend Health is offering in my zip code so it is the cheapest medigap plan I am able to buy. It is priced at $115.86/ month and is offered by Humana.
I can get EXACTLY THE SAME insurance policy (as you know by law they must be the same) from THREE other insurance companies who sell medigap insurance in my zip code for as much as HALF that premium price if I were able to buy it in the open market. This is really onerous as you have made it a requirement that I MUST BUY A MEDICAL plan through Extend Health to be able to access my subsidy. I will now be forced to spend substantially more of my subsidy on premiums to get medigap coverage. WHY IS THAT A REQUIREMENT?
Please reconsider how you have structured this transition and REMOVE the requirement that we MUST purchase a medical plan from Extend Health to be able to use our subsidy money. It is an unnecessary restriction that will cause many retirees to pay MORE to get the EXACT same coverage as can be purchased in the Medicare open market and thereby puts an unnecessary additional burden on retirees already reeling from this dramatic shift to Extend Health.
Dear Dr. Rhee,
I signed on to the Extend Health website this morning to look at the medigap plan choices Extend Health offers in my zip code and I am extremely disappointed by the selection they are offering. It is very limited and the associated prices for the plans are significantly higher than those offered by other insurance companies in the Medicare open marketplace. For many reasons, not the least of which is the ability to go to any specialty clinic in the United States such as the City of Hope or Sloan Kettering, I must stay on Original Medicare.
I specifically looked at the Extend Health medigap F high deductible offering in my zip code and there is only one plan available. It is also the lowest priced medigap plan that Extend Health is offering in my zip code so it is the cheapest medigap plan I am able to buy. It is priced at $115.86/ month and is offered by Humana.
I can get EXACTLY THE SAME insurance policy (as you know by law they must be the same) from THREE other insurance companies who sell medigap insurance in my zip code for as much as HALF that premium price if I were able to buy it in the open market. This is really onerous as you have made it a requirement that I MUST BUY A MEDICAL plan through Extend Health to be able to access my subsidy. I will now be forced to spend substantially more of my subsidy on premiums to get medigap coverage. WHY IS THAT A REQUIREMENT?
I thought you said we would be offered BETTER choices through Extend Health and you were doing this transition to help us contain our insurance costs. Given what I have seen so far what you are saying is not true as Extend Health is restricting our options because of your requirement to use their offerings.
Please reconsider how you have structured this transition and REMOVE the requirement that we MUST purchase a medical plan from Extend Health to be able to use our subsidy money. It is an unnecessary restriction that will cause many retirees to pay MORE to get the EXACT same coverage as can be purchased in the Medicare open market and thereby puts an unnecessary additional burden on retirees already reeling from this dramatic shift to Extend Health.
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