I got a call from my office the other day and said a confused and desperate couple had come in and needed some help with Medicare Part D coverage. The office told me that the plan would not cover one of their expensive medicines! It was not long before I realized that the mess was bigger than a simple phone call and I made an appointment to meet them. I had no idea what I was going into!
At the meeting, I began to ask questions as I would normally do, to try to understand what the problems were and how they developed. I found out that the woman was on Medicare at the beginning of the year because she had left her husband’s insurance. Let’s just say she is over 70 years old at the time. Apparently she had decided to take her insurance alone on the phone! I do not want to generalize here, but most people who go out of group insurance and go on Medicare should not run the process alone! You will see why, if I continue with this terrible story.
I found out she was enrolled in a Medicare Part D drug plan and was planning to cover her expensive brand drug. The problem is that the drug costs more than $ 400, and as most agents know, this will put you in the coverage gap. https://www.medisupps.com/mutual-of-omaha-medicare-supplement-plans-2019/
She of course did not know anything about it. In fact, she thought the plan would stop covering her drug. Just a short comment here; whoever was the genius that formulated the coverage gap should be required to give lectures throughout the country telling the senior citizens about it.
As I continued to inquire further, I found that she had received a letter in February from her plan saying she had “no credible drug selection” in the past six years, and that if she does not show proof of “Credible Cover” within 60 days, she should have to pay an extra $20 per month, which totals $ 240 per year. It was not so funny in that the husband asked for a file at my request, and at the top of the file was proof of coverage from his former employer. I immediately called the plan and, of course, I was told that it was not in their hands since the expiration of the time and that I should file a Medicare complaint. What a mess! If only they had used an independent, competent, and knowledgeable agent!
However, wherever there is a termite, there is usually another or something like that. So I had to ask for their supplementary coverage, and of course they did not know what they had or what they had done.
I discovered a letter sent by an insurer who said she had applied for a Medicare N supplementary plan, but missed a simple form to complete the process. Immediately, I called the company, and of course you guessed it. There was no cover! They never received the form, and so it was never placed correctly.
P.S. If you receive something about your insurance in your e-mail, you may want to open it and then do the needful.