Nightmare Applying for Husband's Medigap Policy

[WinniWoman]

So- my husband went through VIA BENEFITS- essentially a broker- for his Medigap Plan F policy for 1/1/20. He did so because his employer will contribute $60 per month into an HRA account if he does so and when I am eligible or Medicare the employer will also do so for me.

Because he is busy working, I called for him to apply. The broker has me as a verbal power of attorney so all was ok with that. Applied for Plan F and Part D. Took literally 2 hours over the phone. Crazy.

Got the Part D Plan right away for 1/1. But that company's- the drug company- customer service left a lot to be desired so I put in complaints with the state and the BBB and got things rectified- but that's another story.

Meanwhile, these past 3 weeks heard nothing about the Medigap plan and getting down to the wire for 1/1. Each week I have called to get updates and it has been hell to try to either reach a knowledgeable person or deal with the dopes who answer. You wouldn't believe it unless you go through it. They never even respond to emails. So today I call and ask for a phone number for the carrier since the broker reps didn't know - well- jack.

I had called the carrier- Empire- also in the past trying to track down the right phone numbers to follow up. There are zillions of them and no one could answer my inquiries about the application status.

But- ok. Today VIA Benefits insisted I had to call the carrier again and finally gave me the right phone number. The rep at Empire said they closed my husband's application because VIA Benefits never responded to their requests for more information! I was livid! They said something about Power of Atty and something else and a letter went out to us today interestingly enough. I knew something was wrong!

I called his employer and the rep there said she would do a 3 way call with me. After speaking with SEVERAL people there- I decided not to go through them for the Medigap plan because no way can I trust them so close to the effective date needed. They said he only needed to do one plan with them for the reimbursement so the Part D plan would suffice. Meanwhile- one person there said he does not even qualify for Plan F because he would have needed to have Part B in 2019 and he only had A. Part B is effective 1/1. But- another agent there at VIA BENEFITS told me that is not true- that as long as he was Medicare eligible in 2019 (65) he could get Part F. I was so disgusted! So wait- we applied for a plan through them that he supposedly is not eligible for? Why as a broker did they let him apply for it then?! I literally was crying having to go through all this. We did everything right- and now in this situation not our fault. I have just had it with this medical insurance BS. This is the reason my husband did not retire earlier so we could move to NH quicker this whole fre((^%ng health insurance process!

I decided to contact Empire directly. They, too, said he needed to have Part B in 2019 to be eligible to have Plan F. I decided to just apply for Part G through them directly- especially since they are in New Hampshire (as Anthem- same company) where we will be moving soon.

I immediately received an email saying they had the application and it was approved- though when I called back to confirm they said to give it a week to see in their system. Huh? Is it approved or not?!

I was supposed to visit my 94 year old aunt today that I have not seen since the summer and once move will not see again. Instead, I had to spend 4 hour- yes- 4 hours- never leaving my desk- on this!

I am just beside myself. My husband worked all his life and doesn't deserve this sh)*^@&t!

We did everything by the book exactly as instructed only to be scre8&^$d. It is just despicable.

For sure I will spend some time reporting VIA BENEFITS to the Center for Medicare and Medicaid Services and to the BBB and Dept of Insurance.

I might add that even IBM uses VIA BENEFITS for their employees and I am on the group Facebook page and they all are unhappy with them.

I am glad the Allstate rep person- also outsourced I might add- was on the phone call the whole time with me so she could hear exactly what goes on.

Bring on the Canadian health care system into this country. We are desperate!

 

[dmbrand]

Feeling your frustration in an indirect way. My mother’s health insurance administrator is also VIA Benefits for my late father’s company retirement health benefits. They regularly get payments/credits applied incorrectly, and she has to call them to make sure they notice the errors. She is way more laid back then me, so she waits for the situation to correct itself(months), and surprisingly, it does.

 

[geekette]

Yikes. I guess I will consider myself lucky that I have another 10 years to study up before attempting Medicare anything. Seems like a very confusing web so having extra hurdles from brokers and cust svc is just... I think you said it with something like #%*)(*($*_@($_

Hopefully it has made it to cocktail hour. I raise my chocolate Ensure to you!

 

[VacationForever]

Hence we cut out the middleman/broker and go directly to the insurer. There is no bottleneck in the middle which more often than not causes problems due to lack of response.

I buy my private off-exchange health insurance directly and my husband similarly goes directly to the Medicare Advantage insurer.

We do our own research.

 

[WinniWoman]

This is my retirement life day in and day out. One problem after another.

 

[Talent312]

Hence we cut out the middleman/broker and go directly to the insurer. There is no bottleneck in the middle which more often than not causes problems due to lack of response.

I agree.
DW needed verification that she was covered under my plan to avoid a Part B penalty. The benefits office said they would send it to another office who would send it to SS. The second office said they had 2 issues with this: (1) They don't send nothin' to SS. They send it us. But (b), they never got nothin' for us from the benefits office. After much wailing and gnashing of teeth, we finally got it. Luckily, we started this process five (5) months early. OTOH, her signing up online directly with the insurer (Blue Cross) for Plan F (pre-2020) was a piece of cake.

Now it's my turn to sign up.
Colonial Penn has state-retiree medigap plans. One of their agents has visited my house 3x. I'd still be in the state's benefit system, but their Plan G is significantly more costly than Plan G's from a host of other companies (United HealthCare, Humana, Blue Cross, etc) and there's no inducement for staying in the state's system, so why not look elsewhere? I'm anxious about leaving the nest after 30 years, but striking out on my own will save me $$.

I have 3 months to go, but I think I'll go ahead pull the trigger.
That way, I'll avoid saying: "Here comes that insurance man, again."
,
.

.

 

[Passepartout]

This is my retirement life day in and day out. One problem after another.

It gets easier when you're not trying to see/affect the future.

 

[WinniWoman]

It gets easier when you're not trying to see/affect the future.

HUH?

 

[bogey21]

The problem was that you were dealing with an incompetent middleman, VIA Benefits. I understand your reason for doing it, but you wouldn't have had any problems if you used a competent Broker or went directly to the companies selling Medicare Supplemental and Plan D policies. If you had, it would have been smooth sailing...

George

 

[Passepartout]

HUH?

Well, you're dealing with strangers in healthcare, and contactors building your new house and trying to nail down details. What will this cost- when will that be done. It's stressful. You're afraid of making a wrong decision. After you feel like you're more in control, the stress will melt away. That's normal.

Pour a glass of wine, put your feet up. Start a good movie.

 

[WinniWoman]

Well, you're dealing with strangers in healthcare, and contactors building your new house and trying to nail down details. What will this cost- when will that be done. It's stressful. You're afraid of making a wrong decision. After you feel like you're more in control, the stress will melt away. That's normal.

Pour a glass of wine, put your feet up. Start a good movie.

Oh I had 2 glasses of wine already. I filed a formal complaint with the BCRC at the Dept for medicare and medicaid Services. If you go on the BBB you see nothing but F's and 1 stars wanting to be 0 stars on there for VIA BENEFITS. This is absolutely horrendous! I also wrote my review on the BBB. No one should have to go through this nightmare to apply for Medigap after working all their lives.

As for my house, I found out they started installing the backsplash in the kitchen WITHOUT calling me with the price! AND - they installed the carpet without giving me the prices/selection of upgraded padding!

A very bad day..... smh...

 

[WinniWoman]

The problem was that you were dealing with an incompetent middleman, VIA Benefits. I understand your reason for doing it, but you wouldn't have had any problems if you used a competent Broker or went directly to the companies selling Medicare Supplemental and Plan D policies. If you had, it would have been smooth sailing...

George

I know. We just figured getting $1440 per year in an HRA would be a nice thing for a retiree and his spouse. I am telling you- these employers do everything to make it hard so you cannot get any benefits out of them. Just like the retiree medical being more $ than the COBRA- so they don't have to deal with you. It's all a scam.

 

[WinniWoman]

So out of principle I called Empire BCBS back this evening to inquire about this Plan F issue and boy did I hit the jackpot with the rep! She was fantastic! She also said that I was right and their agent was wrong- that my husband absolutely could have applied for Plan F and still could- she would help with that- and I could also file a grievance! She double and triple checked things with her supervisor and checked through documents. She also looked up rates for New Hampshire for both Plans F and G. She really left no stones unturned.

And for further comparison she looked up how both states rated the plans (ex: community rated, age issue, or attained age) and also she looked into the Guaranteed Issue requirement quirks. Now that is what I am talking about! Remember- I worked as an account executive for a health insurance company and designed plans for large and small groups so I am not stupid when it comes to this stuff.

Bottom line - after I finally had the correct information and ALL the necessary information for comparison between plans in BOTH states to make a decision for this, I decided to leave it at Plan G. Not only is it less expensive- especially in NH- it is NOT guaranteed issue in NH. So if we went with F in NY and wanted to change in NH to G at some point we could not get it because of other requirements (dates, etc) for issuing it, not even having to do with underwriting. So considering a big savings in premiums as well, G it is.

She was concerned for a minute that earlier I applied for the plan for my husband but then she looked up that I had Power of Atty for him. Now- this is just based on what I stated when doing the application- not a written form- though I do have a written durable power of atty (for health care decisions) that was drawn up when we did our wills and all that stuff many, many years ago. I offered to put my husband on the phone since he was home tonight but she said it was not necessary. So I hope this does not come back to haunt us with the application. I do have an email that it was approved. But enrollment is being processed.

She said he should get his card in about 10 business days. I asked her if I can consider him enrolled and she said yes- so I hope she is right.

But I have to say she was the best person I spoke with all day today and I spoke to a lot of idiots. I hope I can sleep. I have been so wired all day and my head is spinning.

 

[Talent312]

I'm happy to see that you finally found someone who knew what they were doing... I was going to say, "Who didn't have their head up their a**."

As for your backsplash, be thankful that they didn't install the wrong one. You gotta stay on top of these people. Our kitchen project manager tried to install an inferior tile on our floor. Luckily, we were there and noticed it wasn't what we picked out. He blamed the supplier, but we checked and they didn't even sell what he tried to use.
.

.

 

[dougp26364]

Think about this. Our government runs Medicare and the VA. They’re proposing Medicare for all as our form of single payer health care. They are NOT proposing the Canadian system or any other system.
Honestly, I’m not very hopeful about our (USA) governments ability to handle national healthcare.

 

[WinniWoman]

Think about this. Our government runs Medicare and the VA. They’re proposing Medicare for all as our form of single payer health care. They are NOT proposing the Canadian system or any other system.
Honestly, I’m not very hopeful about our (USA) governments ability to handle national healthcare.

I hear ya. It’s so convoluted right now and has only gotten worse over the years, but so has private health insurance. You put them both together like we have here in the USA and it’s a sh@&@t show.

One thing I am so surprised about is many seniors I know really don’t understand the Medigap plans they have or how it works. They will say- we have United Health Care, for example. I ask which plan-they either don’t know or if they do and say Plan F, they don’t even know it’s a Medigap plan. Or they don’t know that all plan Fs are the same no matter what company you go through except the premiums. They don’t understand the process- like they are oblivious. I guess that’s why they are happy with it. I don’t know how they applied but it must have been a lot easier than what I went through!

 

[WinniWoman]

And the other thing with all this Medicare/health insurance stuff - it's not like they are giving away the benefits for free! You are paying for it! But instead of treating you like a customer, they scrutinize and make it as hard as possible to collect benefits you have and are going to pay for- and it ain't cheap!

 

[Patri]

I think a broker can help choose the right plan. There are so many out there. I went through some garbage setting up my husband's disability Medicare accounts a few years ago. Broker signed us up, but I had to call a rep for something. I got several inept people and for awhile wasn't going to have any coverage for him! The broker had never heard of such a situation and stepped in. We even had to call the Medicare office in DC. We got everything settled, but it was very maddening. I guess there are so many strategies and the rules are so complex, that these hourly workers are not properly trained and there is probably a high turnover.

 

[bogey21]

I have been on Medicare for 19 year and am 99% satisfied with it. The key is understanding the choices and making the right ones for yourself. What is an Advantage Plan? Or do you want Traditional Medicare? Which ones require PCP referrals and which don't? If you opt for Traditional Medicare, do you want a supplement? If you do, which one? Whose Plan D do you want? Sure you have to educate yourself. No one is going to do it for you. But once you have educated yourself it is a piece of cake. My 1% dissatisfaction came from where a Doctor used the wrong code on something. Even though it was a simple mistake working my way through the appeals process took many months...

George

 

[dougp26364]

I hear ya. It’s so convoluted right now and has only gotten worse over the years, but so has private health insurance. You put them both together like we have here in the USA and it’s a sh@&@t show.

One thing I am so surprised about is many seniors I know really don’t understand the Medigap plans they have or how it works. They will say- we have United Health Care, for example. I ask which plan-they either don’t know or if they do and say Plan F, they don’t even know it’s a Medigap plan. Or they don’t know that all plan Fs are the same no matter what company you go through except the premiums. They don’t understand the process- like they are oblivious. I guess that’s why they are happy with it. I don’t know how they applied but it must have been a lot easier than what I went through!

I refer to those people as “The Oblivion’s” and they live in their own world of oblivion.

Unfortunately, most people are more than happy to me someone else do their thinking for them, then complain when they don’t get what they want and blame someone or something else.

 

[Talent312]

Unfortunately, most people are more than happy to me someone else do their thinking for them, then complain...

I resemble that remark. IDK what "most" people do or think on this subject.

IMHO, we should avoid ascribing motives to others and politics. including...
Comments on the performance of Medicare (which to me does fairly well).
.

 

[WinniWoman]

I think a broker can help choose the right plan. There are so many out there. I went through some garbage setting up my husband's disability Medicare accounts a few years ago. Broker signed us up, but I had to call a rep for something. I got several inept people and for awhile wasn't going to have any coverage for him! The broker had never heard of such a situation and stepped in. We even had to call the Medicare office in DC. We got everything settled, but it was very maddening. I guess there are so many strategies and the rules are so complex, that these hourly workers are not properly trained and there is probably a high turnover.

VIA Benefits is a broker company. And as you have read in my post- they were a disaster. I dread dealing with them for the Part D plan which hubby has to change immediately when we move. Any further issues with them- which I expect- I already told my husband we will just have to get that plan on our own, too and forfeit the lifetime of employer contributions to an HRA account. It is just not worth our sanity.

This company- VIA Benefits- has so many complaints and bad reviews on the BBB it is amazing they are allowed to operate.

I did much better going directly to the Medigap carrier on my own as I posted above.

And FYI- not all brokers "sell" all the plans available. They choose which ones to sell based on commission.

 

[Rolltydr]

Think about this. Our government runs Medicare and the VA. They’re proposing Medicare for all as our form of single payer health care. They are NOT proposing the Canadian system or any other system.
Honestly, I’m not very hopeful about our (USA) governments ability to handle national healthcare.

Seems to me the problem described here was not the US government Medicare program (original Medicare) but a private insurance company that offers Medicare Advantage/Medigap programs. The problem is that we’re trying to have it both ways in this country and it is unnecessarily confusing and expensive. Many (most?) advanced countries in the rest of the world provide their citizens with some type of government sponsored healthcare at a much lower cost than we pay for our convoluted system. The VA is another issue and I completely agree that it needs to be fixed or even reinvented. Of course, if we truly did have “Medicare for all”, there wouldn’t need to be a separate VA system, would there?


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[bluehende]

Think about this. Our government runs Medicare and the VA. They’re proposing Medicare for all as our form of single payer health care. They are NOT proposing the Canadian system or any other system.
Honestly, I’m not very hopeful about our (USA) governments ability to handle national healthcare.

But notice that all the problems are with private companies. As we have aged we have had to deal with health care much more. It is always a nightmare and I cannot wait for medicare next year.

 

[WinniWoman]

Seems to me the problem described here was not the US government Medicare program (original Medicare) but a private insurance company that offers Medicare Advantage/Medigap programs. The problem is that we’re trying to have it both ways in this country and it is unnecessarily confusing and expensive. Many (most?) advanced countries in the rest of the world provide their citizens with some type of government sponsored healthcare at a much lower cost than we pay for our convoluted system. The VA is another issue and I completely agree that it needs to be fixed or even reinvented. Of course, if we truly did have “Medicare for all”, there wouldn’t need to be a separate VA system, would there?


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The problem was the brokerage company that my husband's employer uses for retirees to apply for medicare plans.