Pre-65 Medicare Supplemental Policies
I’m pre 65, on Blue Cross Healthcare - PPO & now have to be on Medicare Plan D for Medication, which I don’t like. I’ve been on Medicare Parts A & B since 1997. It seems no one offers a PPO Drug Plan in California…Why? I don’t qualify for Medicaid, nor want to. I would change my health plan also from Blue Cross if it is a PPO & offers medication. I don’t have cancer, worked all my life. I was on private coverage when I became disabled, then COBRA for full 3 yrs. They didn’t advise me that I could join a regular plan again within a certain time, so I paid out of pocket until this Medicare D came out. Is there anyone in CA who will cover me? I have Crohn’s Disease & am stabilized.
It is not clear why you want to switch to a different health plan from your current Blue Cross plan. Is your current policy a Medicare Advantage PPO plan? Or, is it a supplemental Medicare policy that covers medical expenses and the Part A and Part B deductibles? Are you hoping to switch to a standard issue individual health plan? If so, this is unlikely since you are Medicare eligible due to a permanent disability. All companies that offer standard issue individual health insurance in California use medical underwriting in determining who they will approve for coverage. This means that they can decline who they want to for medical reasons. As far as we are aware, Crohn’s disease is an uninsurable medical condition by all of the California insurance companies.
I sent a question in about PPO plans not offered to disabled or Medicare patients. You asked why Blue Cross, my PPO health plan doesn’t offer enough. They USED TO OFFER PRE-65 DRUG PLANS, but NEVER told us last year when Medicare Plan D’s came out. When I called to get on the only pre-65 Plan with Drugs, they told me they “JUST CANCELLED IT.” I called at the end of Dec. 2005, they said it was cancelled Dec. 15th 2005! I didn’t believe them either! I complained to everyone, to no avail. Your question about am I on a PPO Advantage Plan…there is NO SUCH THING! Medicare said last yr. it offered PPO Plans…when I called about them, they said not in California. This year, they still may call it PPO, but it’s not. I’m serious, check it out. Blue Cross says it has a “PPO” drug plan now; it’s very expensive, still has a formulary, can’t pick your doctors…have to go to B.C. doctors; need authorization for medications I’ve been on for 35 yrs.(as long as I’ve had a chronic illness). That is NOT a PPO…Correct? They all lie. I never thought this would go on another year. Again…no attorney, after the tiny amount of information I’ve written here about 2 Medicare Plans breaking about 10 of their own policies and procedures, and ALL PLAN Ds breaking several federal laws, attornies aren’t smart enough to take my case. I won one of the largest Workman’s Comps in CA when very sick..because I DON’T QUIT..Any attorney out there, if smart, will take my case. Trying to get a hearing with an Administrative Law Judge, as they write in their Grievences part of my Plan’s book…but no one tells us how to go about it! Everything I’ve written is the truth, more than what I can say for Medicare!
Comment by Andrea — November 20, 2006 @ 1:08 pm
Did you want my mailing address, home address, or e-mail address? XHTML??? Can I just write regular??? Geez !!
O.K. I live in Washington State. I am in my late 40’s and am also disabled after many years of hard work. This year, 2008, I am now in a Medicare Plan through AARP. It was recommended by the State, as I was eligible for Medicaid for almost two (2) months last year. The year before, they recommended another cheap policy because the year before that, I got coverage for three (3) months. That’s five months out of twenty-four (5 of 24) that I got help paying all those super-high medical bills that are ONLY approximately twenty percent (20%) of the doctor, hospital, dental, lab, etc. bills.
However, after graduating from high school, completing a one-year technical college computer course 10 years later, and working for thirty (30) years, I NOW only make one thousand dollars ($1,000) a month. I can barely LIVE on that, and my $10 or so on food stamp benefits (which are also a lot of work to get). BUT, the State keeps telling me I MAKE TOO MUCH MONEY. So, I need some Medigap insurance.
A few years ago, when I still lived in Arkansas, the only pre-65 Medigap insurance was over $150 a month. I made about $950 a month then. I couldn’t afford that. But I did get a little more help from the State in Arkansas than I do here in my home State of Washington. First - in Arkansas, most doctors will accept Medicare. Here in Washington, it is hard to find any doctors who WILL accept Medicare - let alone any who will take it as payment in full.
So . . . . I have now been on the computer this morning for over two (2) hours… just looking for a Medigap policy, or some Medigap policies, and see which ones offer it to pre-seniors, and how much they each charge, here in Washington. IT SHOULD BE EASY TO FIND, RIGHT???? Hell, no. Not even here on the AARP site.
I am very interested in what Andrea had to say / ask here. It also sounded like a great place to comment / ask AARP for their help, also. Andrea, I hope you get a clearer answer soon.
Comment by Kimberley — January 25, 2008 @ 11:50 am