Thursday, January 04, 2018

Insurance Issues Are the Pits! (edited)

Edited to add info....I received a letter from Aetna this week, telling me to review my prescription drug coverage and if any of it is wrong, I had to report it to Medicare Benefits Coordination and Recovery Center. 

Side Note:  until January 1st we were insured by another firm, but now we have Aetna.

I read what was listed and it was incorrect, so I called the number for the above Medicare section. I was told that the incorrect listing was for an accident I was involved in in April of 2013, while I had Kemper Auto Insurance (which I no longer have.) I was rear-ended while stopped for a light and the person who hit me had Progressive Insurance.

Somehow, the Kemper adjuster to whom I reported the accident filed a report as if I (and Kemper) were responsible. That means that Kemper would be paying a settlement and paying for any medical expenses, including prescription drugs. Except he was wrong and Progressive is the insurance company which covered my expenses, fixed my car and paid a settlement. But Medicare doesn't know that because the Kemper guy filed the report in an incorrect fashion.  

All that took me 7 phone calls to ascertain and it still isn't settled yet.  Medicare tells me I have to get Kemper to send info by fax, on letterhead, indicating that the case is closed and settled.  Otherwise, I may not get medicare benefits to pay for my prescription drugs this year.   The Kemper guy told me that he would not send them any information unless they personally requested it of him. And, of course, Medicare isn't going to do that.  

The Progressive guy would be happy to fax them the settlement info - but since Medicare doesn't have Progressive listed as the insurance of record - it would fall on deaf ears. 

Meanwhile I am playing phone tag with Aetna, Medicare, Kemper and Progressive......all of whom have hellish voice mail chaos.  

What do do???

EDIT:   I got the Kemper guy to send Medicare a letter saying that the account was closed, but the response was that Medicare had to hear it from the doctor's office. Now I have to contact a doctor I have not seen in nearly 5 years and hope he still has the records!!

2 comments:

Star said...

We are having issues as well, but not as difficult to deal with. I have said before that I should be on the insurance company payroll for the amount of time I spend on the phone resolving issues. Perhaps your doctor’s office knows of someone who can intercede on your behalf ? Good luck.

Pat said...

Gosh that sound like my worst nightmare. I seem to have so much paper work now but yours seems so very complicated. My eye work wasn't too bad but inevitably it cost £500 more than I expected due to my not listening properly when the insurance was explained. I expect Alastair would be having a quiet giggle.